Depression may follow a heart attack
After a heart attack, most people experience a whirlwind of emotions. On the one hand, a patient may be grateful to still be alive, but he may also feel frightened and anxious about the future. Will he be able to go back to his former lifestyle? Will he have another heart attack? He may also feel angry and upset about the unfairness of it all.
- Feelings of sadness and anger are natural after a catastrophic illness like a heart attack. Survivors need to go through the grieving process, which involves a certain amount of unhappiness. But when those feelings linger and start affecting a patient's recovery, it's cause for concern. As many as one out of three heart attack survivors report feeling depressed.
- Depression can sap a person's will to recover and make him less likely to follow his doctor's recommendations.
- Heart patients with depression are less likely to eat a heart-healthy diet, give up smoking, or exercise regularly.
- Worse yet, depressed heart patients have a greater risk of suffering future heart attacks.
The good news is that depression can be treated. With the appropriate care, a patient will lead a happier life -- and life will be easier for you, too. Here are some practical things you can do if you think a patient is depressed after a heart attack:
Warning signs of depression and getting tested after a heart attack
Knowing whether it's depression
Is it really depression or just a case of the blues? It's not always easy to tell the difference. And you may be thinking that the person in your care has good reason to feel down in the dumps. After all, he's just had a heart attack. But there's a difference between the normal grieving process and depression. The warning signs of depression include:
- 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
The patient should be evaluated for depression if he has had several of these symptoms for more than two weeks.
Encourage the patient to go for testing
If you believe he's depressed, the first step is to talk to him about his feelings. This isn't always easy, especially if he isn't used to expressing emotions. Ask him if he's feeling sad or hopeless. Try to get an idea if it's really depression or just a temporary case of the blues.
The next step is to schedule an evaluation. His primary care physician may want to talk to him first, or she may refer him to a psychiatrist or counselor. In any case, the evaluating doctor will talk to him and assess his mood. She may also order screening tests to rule out other medical conditions that can mimic depression, such as a thyroid disorder or infection.
If he's resistant to the idea of testing because he's embarrassed or afraid, help him understand that a diagnosis of depression isn't the shameful secret it once was. It doesn't mean he's "crazy" or is going to be taken away to a nursing home . What's more, his test results are private, so no one but he and his doctor needs to know.
If he absolutely refuses to see a doctor, there's not a whole lot you can do. You can't force the issue unless he's psychotic or suicidal, or his depression has progressed to the point where he can no longer take care of himself. If none of those circumstances apply, your best bet is to enlist family members and friends to try to persuade him to seek help.
Providing support for someone's who depressed after a heart attack
Supporting the patient
If he's diagnosed with depression, the doctor may prescribe antidepressant medications and/or psychotherapy. She may also recommend lifestyle changes. Even if a primary care doctor diagnosed his depression, a patient may still benefit from seeing a mental health professional. Not all primary care physicians are comfortable treating depression.
He may be anxious about taking antidepressants, either because of the stigma he associates with those medications or because he's afraid of potential side effects. Assure him that the doctor can work with him to find the medication that's most effective with the least severe side effects.
Other ways you can help
Simply supporting someone as he struggles with depression can help him a great deal. Here are some other things you can do:
- Help him stay as physically active as possible. Talk to the doctor and rehabilitation team about what exercises are appropriate. Find activities you can do together, such as a morning walk around the neighborhood. Exposure to sunlight can help break the cycle of sleeping during the day that many depressed people fall into.
- Structure the day around activities that g ive him 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 running a 10K next month," you might say, "The more we walk together, the easier it'll be."
- Join a support group -- for either or both of you. Talking to other people who're struggling with similar issues can be enormously comforting and helpful. It's also a great way to connect with other heart attack survivors and caregivers .
Remember that it's not all up to you
In the end, it's really the patient's responsibility to get help for depression. If he won't talk to his doctor or comply with treatment, you can't make him -- and you shouldn't blame yourself. Keep offering support and provide positive reinforcement when he takes those difficult steps toward recovery.
But there's only so much you can do. If feelings of guilt and sadness overwhelm you, you may need help coming to terms with the fact that the person you're caring for isn't going to get help. Ask his doctor for information about support groups and other resources to help you manage your own feelings.