Anger and anxiety

What you can expect:

It's normal to feel angry and fearful after a heart attack. A patient may be frustrated that he can no longer perform tasks that were once easy for him. He may feel anxious and worried that he'll have another heart attack. He may also feel depressed.

What you can do:

• Let him talk about his fears. Don't brush off his concerns; keeping his feelings bottled up will make him feel worse. If it's difficult for you to listen to his worries, help him find a support group or an online community.
• Encourage him to keep a journal. Sometimes just writing about negative feelings can defuse them.
• Remind him -- and yourself -- that his anger and anxiety are most likely temporary. As recovery progresses, he's likely to feel more like himself again.
• Encourage him to get back into a normal routine as soon as possible. Dressing first thing in the morning, getting out of the house and walking, and resuming favorite hobbies and social activities are all excellent strategies for relieving fear and anxiety.
• If his anger and anxiety persist for more than four weeks, talk to his doctor. The doctor can arrange for counseling or antidepressant treatment.

Depression

What you can expect:

Depression is one of the most common emotions to affect people who have had a heart attack -- even if they've never been depressed before. One out of three patients reports feeling anxious or depressed after a heart attack or heart surgery. Sometimes it takes time for symptoms of depression to appear; it may be a while before the implications of a patient's heart attack really sink in. He may feel his life is over or will never be the same, or he may feel the recovery process is taking too long.

What you can do:

• Watch for these common warning signs of depression: frequent crying episodes; feelings of hopelessness or worthlessness; poor appetite or increased appetite; sleeping too much or not enough; increased agitation and restlessness; loss of interest in life; expressing thoughts of dying or suicide.
• Notify the doctor if you believe the person in your care is depressed, as it's a serious problem that requires evaluation and treatment.
• Help him be as physically active as possible. Talk to the doctor and rehabilitation team about what exercises are appropriate.
• Structure the day around activities that give the patient pleasure and a sense of purpose. For example, meet friends for lunch or enjoy a leisurely walk through the mall.
• Try to stay positive and upbeat, but don't foster unrealistic expectations. Instead of saying, "You'll be hiking again in no time," you might say, "If we keep walking together every day, you'll notice that it gets a lot easier."