Depression After a Heart Attack: Signs, Symptoms, & How to Cope

Many people who have a heart attack go on to experience symptoms of depression. If you notice changes in your mood, sleep, activity level, or appetite, you may be dealing with depression in addition to managing your heart disease. Recognizing that you are dealing with depression and seeking appropriate treatment is beneficial to recovery.

How Common Is Depression After a Heart Attack?

It is very common for those who have suffered from a heart attack to also have depression, much like experiencing depression after a stroke or while living with a chronic illness. All are major health events that greatly impact the way one thinks, feels, and behaves. About 30% of people who have a heart attack experience symptoms of depression afterwards.¹

Some may suffer from depression prior to a heart attack, whether they realize it and seek treatment for it or not. In fact, those with depression  may develop heart disease at a higher rate than the general population.² This indicates the importance of addressing any symptoms of depression in order to improve mental health and minimize the risk of another cardiac event.

Signs & Symptoms of Post-Heart Attack Depression

There are a range of symptoms that indicate you may be experiencing depression. Some are typical of how depression is commonly portrayed, such as tearfulness, apathy and fatigue. Others may be confused with medical problems, like chest pain, headaches, chronic pain or upset stomach.

Signs and symptoms of post-heart attack depression can include: ³

• sad, irritable, or apathetic mood most of the time
• short temper, loss of patience, or being easily angered
• restlessness
• trouble falling asleep or staying asleep
• sleeping more than usual
• fatigue
• isolating or difficulty engaging with others
• feeling helpless, hopeless, guilty, or worthless
• loss of interest in things you once enjoyed
• pain, including chest pain, headaches, and digestive issues that do not have a clear cause and do not get better with treatment
• difficulty concentrating, this may include forgetting to take medications
• lack of motivation, such as not feeling like going to doctors appointments
• increase or decrease in appetite
• unintentional weight gain or loss
• thoughts of death, suicide, or feeling like you don’t want to keep going

Reasons People Get Depressed After a Heart Attack

A heart attack is a life changing event. It is normal to experience a range of emotions including sadness, anger, and fear, but if you notice that you are feeling that way most of the time, then you may be depressed.

People may often feel depressed after a heart attack because:

• They can’t do the things they once enjoyed – After a heart attack, people may not be able to participate in activities that they once enjoyed. They may feel isolated and as though they will never get their old life back.
• Unhealthy lifestyle – People who have had a heart attack might feel guilty about parts of their lifestyle that contributed to their heart attack. They may lack the motivation, energy, time, or resources to be physically active, or make diet changes.⁴ These are risk factors for both heart disease and depression.
• Fear – Many people who have had a heart attack are scared of having another heart attack. Their fear may lead to avoidance of things like exercise that are beneficial for both mood and physical health.
• Helplessness or hopelessness – Sometimes people don’t know what to do or feel there is nothing they can do to improve their health. These feelings can lead to or worsen depression.
• Stress – After a heart attack, people may experience high levels of stress or anxiety and may lack healthy coping skills ⁵ Not only is a heart attack a stressor but the changes to your life following a heart attack can be stressful. You may already have a high stress life and without the tools and skills to manage stress, both your physical and mental health are at risk.
• Existential Crisis – Having a heart attack often triggers questions about the purpose of one’s existence. The feeling of existential dread may spill over into all aspects of life.

10 Tips for Overcoming Depression After a Heart Attack

1. Make Meaning by Sharing With Community

Patients in cardiac rehab have reported that they realize retrospectively that they were experiencing signs and symptoms of heart disease prior to their cardiac event that they were unaware of at the time. Following their heart attack, they find that sharing their experience with others in order to increase awareness of early signs and symptoms gives them a sense of purpose.

2. Set Realistic Goals

You are going to be tasked with making a lot of changes after having a heart attack. Being intentional and practical when setting goals is important for your success in making any  change. Learn about how to set SMART goals that are realistic so that you can make incremental, lasting changes and feel a sense of accomplishment as you progress. ⁶

3. Create Healthy Habits

Use your heart attack as a catalyst for making lifestyle changes that will ultimately benefit both your physical and mental health.⁷ Identify where you currently are in terms of your diet and exercise and begin to take small steps towards improving your nutrition and activity level. Tackle unhealthy habits such as smoking, drinking, or drug use.

4. Participate in Cardiac Rehab

Certain cardiac rehab programs follow the Pritikin ICR program and have a three pronged approach to recovery that includes nutrition, exercise, and mental health education. A cardiac rehab can help you find hope and healing while getting support from peers and professionals who can provide guidance in making changes.

5 .Schedule Activities You Enjoy

Make a conscious effort to plan and engage in activities that you know you have enjoyed in the past or that you have wanted to try. For an added benefit, schedule time with people who make you feel good.

6. Join a Support Group For Heart Attack Survivors

Those who have had a heart attack often experience social isolation, fear, and loss of control. Engaging in a support group can provide patients with peer support from others who understand their experience, which leads to improved confidence, comfort, and reassurance. ⁸

7. Find or Reconnect with Faith or Spirituality

Having a strong support system and community is an important part of recovery from a heart attack and for managing depression. If you have been religious or spiritual in the past or have interest in finding a new community, this is a good time to explore your options as research has shown participation in religious activities shortens the length of recovery for depression and some medical issues (Koenig, 2007)⁹

8. Practice Mindfulness or Stay Engaged in the Present Moment

We often want to distract ourselves from uncomfortable experiences, however, that usually worsens our symptoms. Focus on what you feel. Notice how it changes from moment to moment. Tune into each of your five senses. All feelings will pass. Continuously redirecting your attention to the present moment is a valuable tool for dealing with depression and anxiety.¹⁰

9. Talk to Your Doctor

Speak with your primary care physician or cardiologist about the symptoms you are experiencing. They may prescribe medication, such as antidepressants,, refer you to a specialist, or offer other resources to address your concerns.

10. Meet With a Therapist

Find a therapist that you feel comfortable with so that you have the support you need during this challenging time. If possible, locate a therapist who is familiar with the issues you are experiencing.

When to Seek Professional Help

If you’re experiencing symptoms of depression, reach out to a trusted provider and consider seeking therapy. Talking with your cardiologist or primary care physician is one place to start.

Many people find that cognitive behavioral therapy is very beneficial in treating depression as it targets the interaction between thoughts, feelings, and behavior. You can search for a therapist who specializes in CBT or meets other criteria you’re looking for in an online therapist directory.

Final Thoughts

Depression after a heart attack is difficult to overcome but it can be done. It’s important for you to know that you’re not alone and there are many people who can help. If you are struggling to make or maintain changes to address your cardiac health, this may be a result of untreated depression. Chronic illness and depression are so closely intertwined that neither can be ignored and should both be addressed with specialized professional help.

By Natalie J. Fraize, LMHC