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Depression and heart failure

It is common to feel sad after a new diagnosis or after being in the hospital. About 75 percent of people with heart failure feel this way.

Temporary feelings of sadness are normal and should gradually go away as you get back to your normal activities. Treatment is necessary however, if you feel very depressed every day for two or more weeks. Talk with your health care provider who can diagnose and start depression treatment.

Why is depression a problem for people with heart failure syndrome?

  • It can add to an increased risk of illness or other heart problems.
  • It can make it hard for you to take your medications on time.
  • It can make it hard to put in the effort to make needed changes in your diet and exercise.
  • It can change your nervous system and hormonal balance. If this happens, you could get a heart rhythm disorder (arrhythmia).

 What causes depression?

  • The chemicals that control your mood get out of balance
  • Family history; genetics may be a factor
  • Your physical health
  • Stress
  • Major losses

How do I know when to seek help?

Sometimes depression symptoms are caused by certain medications or other illnesses. Depression symptoms can include:

  • Not feeling like doing your normal activities
  • More and more negative or hopeless thoughts
  • Crying a lot
  • Being irritable

 

Your primary care provider may do a physical exam or lab tests to find out if there is a physical cause for your signs of depression. Your provider will also evaluate your personal and family medical history, as well as any history of drug or alcohol use.

If you have thoughts of suicide or hurting yourself or others, please call your health care provider or a mental health professional now.

Treatment and support

  • Get in touch with friends and family. Being connected with friends or family can help you return to the person you were before.
  • Look into cardiac rehabilitation. Get active. Studies have shown that returning to normal activity can put you in a better mood and give you confidence. With cardiac rehabilitation, you learn what activities and nutrition plans work best for heart failure patients.
  • You might need an antidepressant medication. Selective serotonin reuptake inhibitors (Saros), such as sertraline and citalopram, are safe for heart failure patients. Some studies suggest that tricyclic antidepressants and monoamine oxidase inhibitors are not good for heart failure patients.
  • You might need to see a counselor.  Mild depression can be treated by "talk" therapy.  You could do either one-to-one or support-group therapy. Behaviorial services, psychiatrists, psychologists and social workers can help.

Tips for friends, family and caregivers

Supportive family and friends can greatly help someone who is depressed.

  • Remember that depression is a disorder. It is not a personal weakness or failure.
  • Encourage your depressed friend or family member to get professional help.
  • Get more information from support groups or organizations.
  • Inform yourself and your family about depression.
  • Help your depressed friend or family member to follow their prescribed treatment plan and keep appointments.
  • If medication is needed, make sure your depressed friend or family takes it as prescribed.
  • Encourage your friend or family member to follow recommended lifestyle changes.

 

Warning Signs of Mental Health

 

For more information

- NIH Depression and Heart Disease - National Institute of Mental Health

- AAHFN Patient Community - American Association of Heart Failure Nurses.  AAHFN education hotline: 856-539-9006

- National Hopeline Network - National crisis hotline in the U.S. for suicide intervention: 800-784-2433

- Center for Substance Abuse Treatment - National referral hotline in the U.S. for substance abuse treatment: 800-662-4357

- National Alliance for the Mentally Ill (NAMI) - Toll-free phone number: 800-950-6264

 

References

1.  Reference:  Jiang W. Davidson JRT. Antidepressant therapy in patients with ischemic heart disease. American Heart Journal, November 2005. 150(5):871-881

2.  Wei Jiang, M.D.,a,b Christopher O'Connor, M.D., FACC et al. Safety and Efficacy of Sertraline for Depression in Patients with CHR (SADHART-CHF): A Randomized, Double-Blind, Placebo-Controlled Trial of Sertraline for Major Depression with Congestive Heart Failure. Am Heart J. 2008 September; 156(3):437-444. Published online 2008 July 7

3.  Blumenthal AA, Babyak MA, O'Connor C, et al. Effects of Exercise Training on Depressive Symptoms in Patients with Chronic Heart Failure: The HF-ACTION Randomized Trial. JAMA. 2012;308(5):465-474. doi:10.1001/jama.2012.8720