Can depression contribute to a heart attack?
Depression and loneliness put a terrible strain on the heart, and not just in the emotional sense: Psychological distress can turn a survivor of heart disease into a victim.
Depression may even help heart disease get its start.
Several studies have suggested that depressed people who are otherwise healthy are more likely to develop heart disease than peers who aren't depressed.
Laura B. Huff, PA-C is here to discuss how depression may contribute to heart attacks.
Selected Podcast
Is There a Link Between Depression and Heart Attacks?
Featured Speaker:
Laura B. Huff, PA-C
Laura Huff, PA-C, earned her master of physician assistant studies at the Jefferson College of Health Sciences in Roanoke and her bachelor of arts in biology at Roanoke College. She previously worked at Southern California Psychiatric Associates, Hoag Memorial Hospital Presbyterian, A Mission for Michael and St. Joseph Health Mission Hospital in Orange County, California. She is a member of the Virginia Academy of Physician Assistants and the American Academy of Physician Assistants. Transcription:
Is There a Link Between Depression and Heart Attacks?
Bill Klaproth (Host): The Centers for Disease Control and Prevention found that severe depression and anxiety can more than double the risk of developing hypertension, a major contributor to heart disease. Then, study after study shows that people who are lonely, depressed, and isolated are more likely to die prematurely than people who feel connection in their lives. This is very interesting. Here to explain more is Laura Huff. She is a physician’s assistant at Centra Health. Laura, thanks so much for being on with us today. There really is something going on here with depression and heart disease. Can you just quickly share with us, what is the link between the two?
Laura Huff (Guest): Sure. Well, just to begin, sometimes folks that already have some preexisting depression, they are less likely to go ahead and get follow-up with any type of medical provider. And so, if they are suffering from any type of hypertension or increased cholesterol, then they are a lot less likely to follow up with their primary care providers in order to have what -- folks that are not struggling with depression, they typically would follow up with anybody to be able to get their blood work drawn and just to make sure that they’re not struggling with hypertension. Same deal is if they’ve already struggled with anything like a heart attack or they’ve had any type of CABG or cardiovascular event. If they’re struggling with depression, they’ll be just a lot less likely to follow up and get the care that they need.
Bill: Well, that makes complete sense. If you’re depressed, you’re probably not as interested in going to the doctor and potentially taking care of yourself. That makes total sense. Laura, why is depression so hard on the heart?
Laura: A few things. Whenever a person is depressed, then they are a lot more likely to have things like cortisol, which are very negative, things that can go through your body and course through your body. And a lot of the times also, you can have some hypertension, which is very hard on the heart, especially if you’re depressed and even anxious sometimes. If you struggle with anxiety and feeling very tense and just feeling like you can’t relax, that’s a lot more likely that you’re going to be struggling with hypertension, which can be very hard on your heart over the course of time. That’s typically what can happen.
Bill: Does mental stress and depression affect women’s hearts more than men’s?
Laura: Not necessarily more than, but what you have to look out for is that everybody expect for men to have cardiac disease. You always hear about “Oh, well my grandfather had a heart attack in his 40s or in his 50s.” That’s always things that you have to look out for because you get a lot of classic symptoms, like feeling like an elephant sitting on your chest or your left arm going numb or having perioral numbness around your mouth, the tingling kind of crushing chest pain. Those are all things that we’re informed of. But typically that’s a lot more likely to happen in males, whereas females, especially elderly females, they come in, they have nausea, they have vomiting. Maybe they’ll complain of feeling like they have some GERD in their throat. You have to be aware of those symptoms and think that that’s probably cardiac-related because women, they just don’t present the same. Women are not excluded from having any type of cardiac symptoms. They can absolutely have some heart attacks or hypertension or high risk of having a stroke. So you just have to be particularly careful. And I’m not sure if there is a link that’s more predominant in women with depression. However, I know that those men and women are at risk for suffering from depression especially after cardiac events.
Bill: What are the general warning signs of depression?
Laura: Of depression? There are certain things that we look out for. You always want to ask your patient if their sleep pattern has changed, so if they’re sleeping more or if they’re sleeping less. You always want to go ahead and ask if they’re suffering from any type of guilt, feelings of guilt or isolating themselves, preferring to be alone instead of hanging out with family or friends. You always want to ask about their appetite. Has it increased? We hear sometimes those that are depressed will eat more, or if it decreased, have you lost weight. That is a really important indicator. Also, energy level which is really tricky because any type of cardiac event, especially heart attack or bypass, you’re not going to have a lot of energy because you have been through such a difficult situation. If they are depressed, they also complain of not having a lot of energy or having fatigue and not being interested in doing things that they usually like to do. There are a lot of things that you need to ask for. But also, concentration issues can occur, and also something that’s called anhedonia or just having a lack of interest in things or activities that you usually like to participate in. So, just feeling very fatigued and very down.
Bill: When is it time to call the doctor? If you notice this depression in a loved one, when do you call the doctor? What do you need to see?
Laura: Persistent symptoms that last longer than two weeks, that’s when I would call. Of course, if your loved one is endorsing that they have thoughts of suicide or homicidal thoughts, then I would most definitely get them to someone immediately, if not even the emergency department.
Bill: What are the general tips for treating depression? I take it when you treat depression, then you’re also treating the potential heart disease at the same time?
Laura: Correct. Definitely. By treating the depression, you could do that of course in multiple ways. Gold standard treatment of depression is often serotonin agents, things like Zoloft, Prozac, Lexapro, maybe even serotonin and norepinephrine agents like Effexor, Pristiq, and others.However, you do have to be a little bit cautious because the norepinephrine can increase blood pressure. Those are things that you can certainly try, but then also therapy—psychotherapy, cognitive behavioral therapy—and then also just making sure that you’re spending time with your loved one and they can feel like they’re not alone in the situation and just giving them more choices about activities, things to do, just making them feel like they’re a part of what’s going on.
Bill: Social interaction is really important.
Laura: Definitely.
Bill: What other tips can you give a caregiver or a spouse or a family member that’s dealing with somebody that may have depression?
Laura: I would say make sure that you’re taking care of yourself as well. Because sometimes caregivers can put more focus and effort on their loved one that’s just been through cardiac events, especially if they realize that they’re struggling with some depression. Sometimes loved ones and significant others, they tend to put all of their efforts on the person that is struggling with those things. I would definitely encourage them to make sure that they’re taking care of themselves. It’s good for the person that has suffered from depression with the cardiac event for them to have their own alone time but not too much. But also, it’s very helpful for the caregiver to get some time to recollect and make sure that they are spending on themselves so that they don’t end up with depression.
Bill: Well, that makes sense. You got to take care of yourself too so you can take care of that loved one as well. Why should people come to Centra Health for their healthcare needs?
Laura: I would recommend Centra to my loved ones, which I think is always important. You always want to work somewhere that you feel comfortable referring people to. I’ve had nothing but positive comments come back saying that everyone that they’ve come in contact with at Centra, from the person that checks them in at the front door to the person that sees them to the nursing staff to everybody, they just overall are very comfortable and feel like they’re very welcoming and kind. I think that that’s it. And also very knowledgeable and intelligent staff, physicians, and providers as well as different levels of folks. I think it’s a good place to come. If you want the best of care, then come to Centra.
Bill: Absolutely. Laura, thanks so much for your time today. For more information on depression and heart attack, please visit centrahealth.com. That’s centrahealth.com. This is Centra Healthy Radio. I’m Bill Klaproth. Thanks for listening.
Is There a Link Between Depression and Heart Attacks?
Bill Klaproth (Host): The Centers for Disease Control and Prevention found that severe depression and anxiety can more than double the risk of developing hypertension, a major contributor to heart disease. Then, study after study shows that people who are lonely, depressed, and isolated are more likely to die prematurely than people who feel connection in their lives. This is very interesting. Here to explain more is Laura Huff. She is a physician’s assistant at Centra Health. Laura, thanks so much for being on with us today. There really is something going on here with depression and heart disease. Can you just quickly share with us, what is the link between the two?
Laura Huff (Guest): Sure. Well, just to begin, sometimes folks that already have some preexisting depression, they are less likely to go ahead and get follow-up with any type of medical provider. And so, if they are suffering from any type of hypertension or increased cholesterol, then they are a lot less likely to follow up with their primary care providers in order to have what -- folks that are not struggling with depression, they typically would follow up with anybody to be able to get their blood work drawn and just to make sure that they’re not struggling with hypertension. Same deal is if they’ve already struggled with anything like a heart attack or they’ve had any type of CABG or cardiovascular event. If they’re struggling with depression, they’ll be just a lot less likely to follow up and get the care that they need.
Bill: Well, that makes complete sense. If you’re depressed, you’re probably not as interested in going to the doctor and potentially taking care of yourself. That makes total sense. Laura, why is depression so hard on the heart?
Laura: A few things. Whenever a person is depressed, then they are a lot more likely to have things like cortisol, which are very negative, things that can go through your body and course through your body. And a lot of the times also, you can have some hypertension, which is very hard on the heart, especially if you’re depressed and even anxious sometimes. If you struggle with anxiety and feeling very tense and just feeling like you can’t relax, that’s a lot more likely that you’re going to be struggling with hypertension, which can be very hard on your heart over the course of time. That’s typically what can happen.
Bill: Does mental stress and depression affect women’s hearts more than men’s?
Laura: Not necessarily more than, but what you have to look out for is that everybody expect for men to have cardiac disease. You always hear about “Oh, well my grandfather had a heart attack in his 40s or in his 50s.” That’s always things that you have to look out for because you get a lot of classic symptoms, like feeling like an elephant sitting on your chest or your left arm going numb or having perioral numbness around your mouth, the tingling kind of crushing chest pain. Those are all things that we’re informed of. But typically that’s a lot more likely to happen in males, whereas females, especially elderly females, they come in, they have nausea, they have vomiting. Maybe they’ll complain of feeling like they have some GERD in their throat. You have to be aware of those symptoms and think that that’s probably cardiac-related because women, they just don’t present the same. Women are not excluded from having any type of cardiac symptoms. They can absolutely have some heart attacks or hypertension or high risk of having a stroke. So you just have to be particularly careful. And I’m not sure if there is a link that’s more predominant in women with depression. However, I know that those men and women are at risk for suffering from depression especially after cardiac events.
Bill: What are the general warning signs of depression?
Laura: Of depression? There are certain things that we look out for. You always want to ask your patient if their sleep pattern has changed, so if they’re sleeping more or if they’re sleeping less. You always want to go ahead and ask if they’re suffering from any type of guilt, feelings of guilt or isolating themselves, preferring to be alone instead of hanging out with family or friends. You always want to ask about their appetite. Has it increased? We hear sometimes those that are depressed will eat more, or if it decreased, have you lost weight. That is a really important indicator. Also, energy level which is really tricky because any type of cardiac event, especially heart attack or bypass, you’re not going to have a lot of energy because you have been through such a difficult situation. If they are depressed, they also complain of not having a lot of energy or having fatigue and not being interested in doing things that they usually like to do. There are a lot of things that you need to ask for. But also, concentration issues can occur, and also something that’s called anhedonia or just having a lack of interest in things or activities that you usually like to participate in. So, just feeling very fatigued and very down.
Bill: When is it time to call the doctor? If you notice this depression in a loved one, when do you call the doctor? What do you need to see?
Laura: Persistent symptoms that last longer than two weeks, that’s when I would call. Of course, if your loved one is endorsing that they have thoughts of suicide or homicidal thoughts, then I would most definitely get them to someone immediately, if not even the emergency department.
Bill: What are the general tips for treating depression? I take it when you treat depression, then you’re also treating the potential heart disease at the same time?
Laura: Correct. Definitely. By treating the depression, you could do that of course in multiple ways. Gold standard treatment of depression is often serotonin agents, things like Zoloft, Prozac, Lexapro, maybe even serotonin and norepinephrine agents like Effexor, Pristiq, and others.However, you do have to be a little bit cautious because the norepinephrine can increase blood pressure. Those are things that you can certainly try, but then also therapy—psychotherapy, cognitive behavioral therapy—and then also just making sure that you’re spending time with your loved one and they can feel like they’re not alone in the situation and just giving them more choices about activities, things to do, just making them feel like they’re a part of what’s going on.
Bill: Social interaction is really important.
Laura: Definitely.
Bill: What other tips can you give a caregiver or a spouse or a family member that’s dealing with somebody that may have depression?
Laura: I would say make sure that you’re taking care of yourself as well. Because sometimes caregivers can put more focus and effort on their loved one that’s just been through cardiac events, especially if they realize that they’re struggling with some depression. Sometimes loved ones and significant others, they tend to put all of their efforts on the person that is struggling with those things. I would definitely encourage them to make sure that they’re taking care of themselves. It’s good for the person that has suffered from depression with the cardiac event for them to have their own alone time but not too much. But also, it’s very helpful for the caregiver to get some time to recollect and make sure that they are spending on themselves so that they don’t end up with depression.
Bill: Well, that makes sense. You got to take care of yourself too so you can take care of that loved one as well. Why should people come to Centra Health for their healthcare needs?
Laura: I would recommend Centra to my loved ones, which I think is always important. You always want to work somewhere that you feel comfortable referring people to. I’ve had nothing but positive comments come back saying that everyone that they’ve come in contact with at Centra, from the person that checks them in at the front door to the person that sees them to the nursing staff to everybody, they just overall are very comfortable and feel like they’re very welcoming and kind. I think that that’s it. And also very knowledgeable and intelligent staff, physicians, and providers as well as different levels of folks. I think it’s a good place to come. If you want the best of care, then come to Centra.
Bill: Absolutely. Laura, thanks so much for your time today. For more information on depression and heart attack, please visit centrahealth.com. That’s centrahealth.com. This is Centra Healthy Radio. I’m Bill Klaproth. Thanks for listening.