Nobody warns you about this part. You survive a heart attack, you have the surgery, you get through rehab, and then you fall apart. Depression after a cardiac event is so common that it would be unusual not to experience it. Roughly one in five people develops clinical depression after a heart attack, and many more experience anxiety, panic attacks, or a pervasive sense of dread that something is going to happen again.
Why It Happens
Part of it is physiological. A cardiac event triggers a massive stress response in the body, flooding it with cortisol and adrenaline. Part of it is psychological. You have had a brush with mortality and your brain is processing that. And part of it is practical. Your life has changed. You might not be able to work, or exercise the way you used to, or eat the things you enjoyed. That is a lot of loss to deal with at once.
The cruel irony is that depression is itself a risk factor for further cardiac events. People who are depressed after a heart attack are less likely to take their medication, less likely to attend rehab, less likely to exercise, and more likely to smoke and drink. So treating the depression is not a luxury. It is part of treating the heart disease.
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Feeling low for a few weeks after a heart attack is normal. Feeling low for months, losing interest in everything, not sleeping, not eating, withdrawing from people, feeling hopeless about the future, that is depression and it needs treatment. Anxiety is equally common: constant worry about another attack, avoiding physical activity out of fear, checking your pulse obsessively, panic attacks.
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Getting Help
Tell your cardiac team. They hear this constantly and they will not think less of you. Your GP can refer you for talking therapy (CBT is particularly effective for cardiac-related anxiety) or prescribe antidepressants if appropriate. SSRIs like sertraline are commonly used after cardiac events and are considered safe.
Cardiac rehabilitation programmes usually include a psychological component. If yours does not, ask about it. The British Heart Foundation also runs a helpline and has support groups where you can talk to other people who understand what you are going through.
Do not wait for it to pass on its own. Early treatment makes a significant difference both to your mental health and to your cardiac outcome.
This article is for general information only and is not a substitute for professional medical advice. If you have concerns about your health, speak to your GP or a qualified healthcare professional. If you believe you are experiencing a medical emergency, call 999 immediately.
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