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depression after heart attack

Definition
Depression is a continuing feeling of sadness, despair or hopelessness. It affects a person's ability to function. Roughly 1 out of 4 people suffers from depression after a heart attack.

What is going on in the body? 
Several factors can make a person feel depressed after a heart attack. The stress of being in the hospital, the fear of another heart attack, and the reality of having to make lifestyle changes can all contribute. If the person had to have bypass surgery, he or she will have to endure a long recovery period. This could include being out of work for up to 6 weeks.

What are the signs and symptoms of the condition? 
Signs and symptoms of depression may include:
  • a loss of interest in life or boredom
  • sleep disorders such as insomnia, too much sleep, or disturbed sleeping
  • a loss of appetite or overeating
  • a loss of energy
  • feelings of agitation
  • a loss of sexual drive
  • trouble concentrating
  • feelings of guilt
  • thoughts of death or suicide
What are the causes and risks of the condition? 
A person is more at risk for depression after a heart attack if he or she has suffered from depression in the past.

What can be done to prevent the condition? 
There is no prevention for depression. However, early diagnosis and treatment of depression following a heart attack will help the person make a better recovery.

How is the condition diagnosed? 
Depression is diagnosed based on symptoms. The person will report feelings of sadness. He or she may also complain of other symptoms such as insomnia and loss of appetite. A physical examination should be performed to rule out any other causes of depression.

What are the long-term effects of the condition? 
People who suffer from depression after a heart attack are less likely to make the lifestyle changes necessary to decrease the risk of another heart attack. These changes include: Also, depressed people may not take the medications they have been prescribed.

What are the risks to others? 
There are no risks to others since depression is not contagious.

What are the treatments for the condition? 
The goal of treatment for depression is to reduce symptoms so the person feels better. The best results usually come from combining medication with counselling.

Medication. This treatment involves taking drugs called antidepressants. These medications lift mood in 60% to 80% of people who use them. It may take 2 to 4 weeks before the drugs take effect.

Counselling or therapy. Individual psychotherapy, support groups and cognitive behavioural therapy can all be used to treat depression.

What are the side effects of the treatments? 
The side effects of anti-depressant medication include:
  • sleepiness
  • dizziness
  • insomnia
  • weight loss
  • anxiety
  • loss of sexual desire. This problem may be compounded if the person is also worried that sexual activity will place too much stress on the heart.
What happens after treatment for the condition? 
With treatment, depression symptoms can be completely or partially eliminated. Resolving depression will better enable the person to make the changes necessary to prevent another heart attack.

How is the condition monitored? 
A person on antidepressant medications may need to have frequent blood level checks. The individual will also have to have follow up care to monitor the heart disease.

Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 24/11/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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