Heart Attack and Depression

2o years ago if you had a heart attack and survived chances are you spent a significant amount of time in the hospital. Your doctor or doctors would be around daily and everyone from the nurses to the food servers would be checking on you to make sure you were doing okay. Back then if you had a blocked artery that caused your heart attack you had 2 choices depending on how badly it was blocked. A bad blockage would mean heart bypass surgery where a minor blockage meant drugs to bust the blockage.

Either way you spent at least 2 to 3 weeks in the hospital. Nowadays if you have a heart attack from a severely blocked artery chances are you will have heart catheterization and a stent would be placed in the effected area. After 3 days in the hospital being monitored you`ll be sent home. Efficient and fast, just how we like it in the 21`st century, but is this really a good thing for you?

2 years ago when I had my heart attack it was minor by today`s standards, a small artery the size of a small vein on the back of my heart was blocked. I went to the emergency room and within 1/2 hour I was in a neighboring hospital having a stent placed in a cath lab. 3 days later I was discharged with a prescription for plavix , statins and told to get well. The doctor told me I could go back to work in a week or so. They treated the heart attack but something was missed and went untreated…my depression.

Depression is common in first time heart attack sufferers especially if they are young and didn`t see the heart attack coming. 20 years ago the longer hospital stay for a heart attack gave doctors and nurses more time with the patient to assess their total condition. Depression would be talked about and understood to be a part of the process. Today in our effort to turn everything into the fast food model we treat heart attacks with speed and efficiency but we neglect to treat the whole patient.

Deppresion is a common side effect of a heart attack, you start to question your life, your choices, your habits and then you start blaming yourself for all the things that went wrong and it becomes a downward spiral. When I had my heart attack I was scared, I was only 44 years old, did this mean I would die young? I beat myself up over poor lifestyle choices and stressful jobs I should have quite. As the depression settled in I wondered how I would go on.

I was being told I would be on plavix forever  and I was told there is a chance that I could have another heart attack from a blockage in the same spot due to the stent. I really became paralyzed with all these thoughts. As with me, most heart attack patients depression goes unnoticed and untreated. They are sent home to recover without a second thought. A new study is now suggesting that every heart attack and heart disease patient go through a basic depression management program before leaving the hospital.

Even though the American Heart Association has long recommended depression screening for all heart disease patients along with coordinated treatment for both the heart and the mind at best most hospitals today recommend patients seek mental health treatment after they are discharged.

Having a heart attack or heart disease is already bad news but the following depression can be a crippling blow impeding recovery if it`s not treated along with the original problem.

The study followed 175 people who were discharged from a hospital after heart attacks, treatment for acute coronary syndrome, arrhythmia or heart failure. They were screened for depression and then randomly assigned to receive either standard care or to participate in a depression management program.

Heart attack and Depression Study Results

In the program, a psychiatrist developed individualized treatment recommendations and, together with the patient`s other doctors, coordinated prescriptions and therapy referrals. Care managers — who were not doctors — acted as facilitators between the patients, their doctors and the psychiatrist. They provided educational material on depression, including treatment options, to the participants, and helped them schedule “pleasurable activities.” Care managers also coordinated inpatient and outpatient care, based on the psychiatrist`s and medical doctors` guidelines.

“An even more complete and intensive program might lead to even larger or longer improvements in these heart disease patients,” Huffman suggested.

Bradi B. Granger, director of the nursing research program and a clinical nurse specialist at the Duke University Heart Center in Durham, N.C., described the effort to address depression related to heart disease as “a great idea, because we know that depression is common in patients following these kind of cardiovascular events.”

By six weeks after discharge, people in the collaborative care program were faring much better on all measures of mental health. Depression symptoms were cut in half for about 60 percent of those in the collaborative program, compared with 30 percent of the others. Outcomes remained significantly better among program participants at the three-month mark as well, the study found.

Six months after discharge, which was three months after the program ended, the groups` scores on depression rating scales more closely resembled each other, and re-hospitalization rates were similar.

However, those who had participated in the program were far more likely to have stuck to their recommended diet and exercise regimen, the study found. They were also less likely to experience cardiac symptoms, and symptoms that did develop were far less severe.

The team concluded that a minimal amount of hospital resources and time devoted toward depression care appeared to have a big payoff.

What`s more, the researchers noted, the post-discharge treatment intervention was shorter and less intense than most out-patient management programs, which often involve weekly or biweekly in-person assessments. By contrast, the tested program involved no more than three phone contacts between hospital staff and patients over the course of the 12-week program.

If you have heart disease or have had a heart attack you will undoubtedly have some form of depression, talk to your doctor and get help.