Depression after heart attack: Is there a link between depression and heart problems?

Many people become depressed after having a heart attack, and depression can make heart problems worse. Treating depression could improve the quality of life in people who are depressed after a heart attack.

The most common cause of death in industrial countries is myocardial infarction (heart attack). But many people who survive a heart attack become depressed for a while. Milder symptoms of depression usually get better by themselves a short time after a heart attack. However, some people develop more major depression, which can last longer.

Despite the importance of this illness, not enough is known about how common depression is after a heart attack, and how to successfully treat it. This is why researchers from the American Agency for Healthcare Research and Quality (AHRQ) systematically reviewed the evidence about this topic. The research they found had been done in the USA and Europe. Among other things, they were interested in:

• how many people became depressed after a heart attack,
• how many people were still depressed 1 or 2 months after the heart attack, and
• whether treatment was shown to help.

One conclusion of their study: about 1 in 5 people admitted to the hospital with a heart attack develops major depression. However, many more have milder symptoms of depression.

Some studies show that the majority of people who become depressed while in the hospital for a heart attack may still be depressed 1 to 4 months after discharge from the hospital. Sometimes major depression after a heart attack could still affect psychological and physical health as many as 5 years later.

The researchers confirmed that it is possible that there is a physical connection between depression and heart problems. Major depression could add to the risks of people who have had a heart attack. It could also slow down recovery, and increase their chances of dying earlier.

The researchers also came to the conclusion that psychological treatment together with the right medication can probably reduce depression after a heart attack. Because of this, treatment can also most likely improve the quality of life of people who have major depression after a heart attack. But it is still not certain whether or not treatment can reduce the risk of a heart attack or the risk of dying earlier. Some kinds of anti-depressants are not suitable for use by people with heart problems, so it is important to talk to a doctor before using these drugs.

In 2007 and 2008, researchers from Canada and the Netherlands also analyzed studies about depression following a heart attack. Their results confirm the conclusions of the AHRQ researchers. Also, some research showed that cognitive behavioral therapy (CBT) might be able to help people with depression after a heart attack. You can read about how CBT works here.

If you would like to know more about how someone who is depressed can be supported by friends and family you can find information here.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)