Heart to Heart: Depression often linked to cardiac issues

By: Nick Reiher

Depression can be caused by many factors, major life changes, such as heart issues and surgery.

Conversely, depression and stress can trigger many physical problems, including high blood pressure and heart ailments.

“Stress affects everything,” said April A. Balzhiser, MA, LCPC, ICDVP, Program Director at Silver Oaks Behavioral Hospital in New Lenox. “If one part of us is off, all of us is off.”

According to an article from the Cleveland Clinic, up to 15 percent of patients with cardiovascular disease and up to 20 percent of patients who have undergone coronary artery bypass graft (CABG) surgery experience major depression.

Studies have shown that mental stress has a negative effect on a person’s heart health. Unmanaged stress can lead to high blood pressure, arterial damage, irregular heart rhythms and a weakened immune system.

For people with heart disease, depression can increase the risk of an adverse cardiac event such as a heart attack or blood clots. For people who do not have heart disease, depression can also increase the risk of a heart attack and development of coronary artery disease.

In one landmark study, the article said, the continued presence of depression after recovery increased the risk of death (mortality) to 17 percent within six months after a heart attack (versus 3 percent mortality in heart attack patients who didn’t have depression).

Also, during recovery from cardiac surgery, depression can intensify pain, worsen fatigue and sluggishness, or cause a person to withdraw into social isolation. Patients who have had CABG and have untreated depression after surgery also have increased morbidity and mortality.

In fact, according to the Cleveland Clinic article, Depression has been proven to be such a risk factor in cardiac disease that the American Heart Association (AHA) has recommended that all cardiac patients be screened for depression.

Not that some depression following major surgery is uncommon. The Cleveland Clinic article notes that If you’re recovering from heart surgery, a heart attack, or another heart condition, temporary feelings of sadness and a depressed mood are common for the first few weeks.

However, treatment is necessary when depression is severe and accompanied by other symptoms (including withdrawal from activities, not responding when visiting with family and friends, increased negative thoughts and tearfulness).

A Johns Hopkins Medicine article notes depressed heart attack patients can have decreased motivation to follow healthy daily routines, which can result in skipping important heart medications, avoiding exercise and proper diet, and continuing or intensifying smoking and drinking habits.

They also can experience changes in their nervous system and hormonal balance, which can make it more likely for an arrhythmia to occur. The combination of depression and a damaged heart (from a heart attack), seems to make people particularly susceptible to potentially fatal heart rhythm abnormalities, according to the article.

“It is imperative, then,” Balzhiser said, “to make sure people are monitored closely in both situations.”

“When our patients come in, they are given a full medical examination within 24 hours,” she said. “Absolutely, there have been times when we noticed heart issues, and if not too severe, we will monitor them in-house. If they are more severe, we’ll refer them to a heart doctor at Silver Cross next door.”

“On the other end of the spectrum, if doctors and nurses notice a cardiac surgery patient struggling with emotions,” Balzhiser said, “they will refer them to Silver Oaks.”

“Not all heart patients struggle after surgery,” she added, “and not all show symptoms right away. It’s not unusual for Silver Oaks to get a call from a heart patient weeks later asking if what they’re feeling is normal post-surgical fatigue or depression.”

“A lot of your recovery has to do with your outlook,” Balzhiser said. “Some people are relieved to be feeling better, and that eases a lot of their stress.”

“The key is, you have to take care of your whole body, and not just put one part over another.”

About Silver Cross Hospital
Silver Cross Hospital is an independent, not-for-profit health care provider serving Will County and southwest suburban communities since 1895. Silver Cross has been recognized as a Truven Health/IBM Watson 100 Top Hospitals National Award winner for eight years, and honored with an “A” Hospital Safety Grade by The Leapfrog Group. With over 4,500 employees, physicians and volunteers, Silver Cross operates a 300-bed acute care hospital and 5 satellite facilities providing outpatient services and physician offices. Silver Cross opened a state-of-the-art replacement hospital in 2012 at I-355 and Route 6 in New Lenox. In 2019, Silver Cross provided over $39 million in charity care and other community benefits. To learn more about Silver Cross Hospital or a referral to a physician on staff, visit silvercross.org. Physicians on Silver Cross Hospital’s Medical Staff have expertise in their areas of practice to meet the needs of patients seeking their care. These physicians are independent practitioners on the Medical Staff and are not the agents or employees of Silver Cross Hospital. They treat patients based upon their independent medical judgment and they bill patients separately for their services.

About Silver Oaks Behavioral Hospital
Silver Oaks Behavioral Hospital specializes in mental health and substance use disorder treatment. Our facility is equipped with the latest safety features designed to provide patients with a comfortable environment to receive therapeutic care.

Our therapy modalities are evidence-based models proven to decrease symptoms of mental illness and help patients find lasting change. Silver Oaks Behavioral Hospital offers a caring environment with licensed psychiatrists, nurses, therapists and technicians who are dedicated to providing exceptional care for you, a loved one or your client.

Silver Oaks Behavioral Hospital provides mental health and substance use disorder programming for adolescents to senior adults. Additional specialized programs will be designed based on identified needs in the community.

Silver Oaks Behavioral Hospital stands with our community as we treat those with mental health conditions. As a community service, we offer free mental health assessments 24 hours a day, seven days a week. Call us at (844) 580-5000 or walk-in anytime.