Can Depression Be a Sign of Heart Disease?

By Michele C. Hollow  @michelechollow
June 24, 2016

Cardiovascular disease is the number one global cause of death, and about one in five who recover from a heart attack are found to have depression soon afterwards.

Denise Brody sees herself as a changed person after having a heart attack. She’s fearful and depressed, which is out-of-character for the 59-year-old accountant. 

“Everyone who knows me knew me as an optimistic and cheery person,” she said. “Having a heart attack has made me depressed.”


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Depression and heart disease

According to Roy C. Ziegelstein, MD, and executive vice chairman of the Department of Medicine at Johns Hopkins Bayview Medical Center in Baltimore, “About one in five who have a heart attack are found to have depression soon after the heart attack. And it’s at least as prevalent in people who suffer heart failure.”

The link between heart attacks and depression makes perfect sense to Nieca Goldberg, MD, and medical director of the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center in New York City. “It’s possible that people who had no risk of depression before their heart attack get depressed because experiencing a heart attack is frightening and life changing.”

It’s also likely that people who suffer from depression after having a heart attack may have had episodes of depression that was not formally diagnosed. 

The statistics are scary. According to the American Heart Association, heart disease is the number one cause of death in the world and the leading cause of death in the U.S., killing more than 370,000 Americans a year. 

Those who experienced a heart attack often are afraid of having another one. “While that’s normal, it’s also terrifying,” Goldberg said. “That’s why it’s important to talk to your doctor about your feelings and equally important to take your medications.”


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Is heart medication to blame?

Some medications such as beta blockers, which are one type of medicine that treats heart disease, can disrupt sleep and cause fatigue. “Not getting a restful night’s sleep and being tired all the time can cause depression,” Goldberg said. “Heart medications don’t cause depression. If you are having trouble sleeping, talk to your doctor. The heart medication that your doctor prescribes is designed to prevent a recurrence of another heart attack. So it’s essential you take it. Talk to your doctor if you’re feeling exhausted, depressed, or have any side effects.” 

Recovery after a heart attack

While Brody was in recovery, her doctor counseled her husband and her adult children who lived nearby. “My doctor knows my family is important to me,” she said. “He wanted me to have a support system that would encourage me to walk and eat better. I’ve actually lowered my cholesterol by changing my diet and walking every day, rain or shine. We even bought a treadmill for those rainy days.”

In addition to exercising and eating healthier, Brody sees a therapist once a week to talk about her fears. “It’s helped immensely, especially understanding that having a life threatening disease was such a shock to my system that it made me fearful and depressed,” she said.

If you are feeling stressed, Goldberg suggests talking to a therapist and getting exercise. “If you’re feeling down for a couple of days, that’s okay,” she said. “But if it goes on for weeks, you need to seek help.”

“And walking, even for 30 minutes a day, can help your heart,” she added. “Exercise improves your moods while you’re doing it, and long-term studies show that people who exercise report better quality of life overall.” 


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March 02, 2020

Reviewed By:  

Christopher Nystuen, MD, MBA