The link between heart failure and mental health

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Upon first consideration, you may think that heart health and mental health have no connection. However, your mental health can affect your heart, and your heart health can, too, affect your mental wellbeing.

An article published by Harvard Health in 2018 reported that individuals living with depression or anxiety are more prone to developing cardiovascular disease. Factors known to contribute to a higher risk of heart disease, including an unhealthy diet, a lack of exercise, and smoking, are also common in people with poor mental health.

Cardiovascular disease can often result in congestive heart failure, and it’s estimated that many people do not yet know that they are suffering from this illness, according to the Ted Rogers Centre for Heart Research. At present, over one million Canadians are affected by heart failure, with 50,000 people being newly diagnosed each year.

“Mental health disorders and cardiovascular problems might not just co-occur in adulthood. Instead, people may be vulnerable to both conditions over a lifetime because of their early exposures,” Dr. Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School, told Harvard Health. Living with depression or anxiety has an impact on heart failure, and it can affect how you manage your illness.

Depression

Depression is a constant feeling of dejection and loss that stops you doing your normal activities. The Heart and Stroke Foundation states that the two main signs of depression are a low, sad mood, and/or loss of enjoyment or interest, on most days for at least two weeks. Everyone feels depression differently — some patients may experience trouble sleeping or a general feeling of tiredness and low energy, but in all cases, it’s important to recognize it and treat depression.

Many forms of poor mental health can affect the heart, including depression. An article for The Washington Post by Dr. Nathaniel P. Morris, resident physician in psychiatry at the Stanford University School of Medicine, states that the U.S National Center for Biotechnology Information has discovered that between 17 and 44% of patients with coronary artery disease also have major depression. “As many as 40% of patients undergoing coronary artery bypass surgery suffer from depression.”

When patients are sick and under stressful circumstances, it can foster depressive symptoms. “But depression itself is also a risk factor for developing heart disease. Researchers aren’t sure why, but something about being depressed — possibly a mix of factors including inflammatory changes and behaviour changes — appears to increase the risk of heart disease,” Dr. Nathaniel P. Morris reports.

Anxiety

Anxiety is one of our most common emotional experiences and it's the normal, healthy reaction to a threat. The Heart and Stroke Foundation explains that, when you become nervous or stressed, part of the anxiety response is to speed up the heart. “Most of the time this is healthy and keeps us safe. However, anxiety can get to the point where it isn’t healthy. It can become an anxiety disorder that damages the quality of people’s lives, keeping them from living a normal life, and it needs to be treated.”

This could be in the form of generalized anxiety disorder, when a person believes there is danger in almost any situation and develops feelings of anxiety about most things in life, such as family life and work, or a panic disorder, when someone has recurring panic attacks that start suddenly and reach a peak within a few minutes. PTSD (post-traumatic stress disorder) and phobias can also cause feelings of anxiety to rise.

It is common for individuals to develop anxiety or depression when living with heart failure as the illness can trigger stress when symptoms worsen.

Support for heart failure patients

Although there is currently no cure for heart failure, many patients can improve how they live with the illness by making lifestyle changes such as eating heart-healthy foods, learning to reduce stress, exercising regularly, getting enough sleep, and quitting smoking. Medications and medical devices can also help manage the symptoms of heart failure, as reported by the Heart and Stroke Foundation.

Due to the stigma often associated with mental illness, many people avoid or delay seeking treatment. However, Health Canada advises that if you are experiencing signs of mental illness, it’s important that you seek help as soon as possible. If a loved one, friend, or colleague close to you is showing signs of poor mental health, talk to them about getting help.

Don’t be afraid to reach out to your family doctor, a psychologist, mental health nurse, counsellor, or social worker, to ask for help. There are also online support and resource options available from the BC’s Heart Failure Network and of course our closed HeartLife Foundation Facebook Support Group.

Talking about your feelings of sadness, anger, frustration, and even excitement, can help lower feelings of anxiety. Remember to care for yourself, be proud of your strengths, and accept your limits — without blame or criticism.

IF YOU’RE LIVING WITH HEART FAILURE, OR SOMEONE YOU LOVE HAS THIS CHRONIC ILLNESS, CLICK HERE TO VISIT OUR CLOSED FACEBOOK SUPPORT GROUP AND JOIN THE CONVERSATION.