COVID-19 notwithstanding, the number one cause of death in the United States is heart disease. And one of the leading causes of heart disease is depression.
While about 20% of Americans suffer from depression in their lifetimes, it affects almost twice that proportion – 38% – of bypass surgery patients. For heart attack survivors, the risk of depression is triple the general population’s.
Thanks to a combination of psychological and physiological factors, heart disease can bring on depression and depression can bring on heart disease.
Psychologically, heart disease can make patients feel stressed by a serious chronic condition they can’t control. This stress affects their mood, their sleep, their energy, and their ability to manage their coronary vascular disease. They may skip taking their medications, binge on comfort foods instead of following a heart-healthy diet, or veg out instead of exercising regularly.
Physiologically, depression can cause autonomic dysfunction, which, among other things, raises resting heart rate and blood pressure. It can worsen insulin resistance, aggravating inflammation and diabetes. And by affecting platelet reactivity, it can thicken the blood, making it easier to form more clots that can break off and travel to the brain or the heart, where they cause strokes or heart attacks.
One result is that adults with depression have a 64% greater risk of developing coronary artery disease, while depressed coronary artery disease patients are 59% more likely to have a heart attack or cardiac death in their future.
In 2019, the American College of Cardiology recommended a new, practical approach to breaking this cycle. It’s multidisciplinary, involving the patient, the cardiologist, the primary care physician, and, sometimes, mental health professionals, pharmacists, and care coordinators.
This holistic assessment leads to a personalized treatment plan which comprises a combination of proven treatment options for depression, including exercise, prescription meds, cognitive behavioral therapy, or a group cardiac rehabilitation program for people who have undergone angioplasty, gotten a stent, are recovering from bypass surgery or have survived a heart attack. If you’re 65 or older, Medicare covers cardiac rehab at no extra cost.
We’re big believers in this kind of holistic approach, because it’s like what we do (albeit on a lower level) in our thorough, three-part needs assessment leading to a coordinated care plan tailored to your specific needs.
So if you’re feeling down or hopeless, if you’ve lost interest or pleasure in doing things you like, if you’re having a hard time sleeping or concentrating, if you’ve been losing energy or your appetite, talk it over with your PCP or cardiologist.
It’s a good first step towards breaking the cycle that can lead to literally broken hearts.
To learn more about our holistic, coordinated approach to senior care, please call or contact us.