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Surviving a heart attack can be the start of another fight: A study
– Reported, 13 May 2013
Dr Murphy, who will speak at next week’s Heart Foundation Conference in Adelaide, wants to raise awareness of the depression after a heart attack which, if untreated, can increase the risk of a second cardiac event.
Two kinds of gloom can kick in. One is the ”cardiac blues”, a generally short-lived period of low mood that can last for six to eight weeks.
”A heart attack can have a strong emotional impact because it comes as such a shock; it makes you realise you’re not immortal,” Dr Murphy says.
”People can feel angry and irritable. They can lose their appetite and their sex drive or have difficulty sleeping. But people need to know this is a normal reaction. I want to let people know that when they leave hospital they may find themselves on an emotional roller coaster for a couple of months and if they can ride it out they’ll be fine – but if the feelings don’t go away they need help.”
For about 20 per cent of those who survive a heart attack, a more serious wave of depression can come a few weeks into recovery. It’s less likely to go away by itself and important not to ignore.
”The warning signs are if someone’s mood starts to get worse, rather than better, after a couple of months,” Dr Murphy says. ”Or perhaps they were OK for the first few weeks and then become depressed. This is more common in people with a history of depression, including post-natal depression, before they had the heart attack. It’s also more common in people who are socially isolated or who have financial problems – a heart attack seems to amplify problems.”
Dr Murphy is working with the national depression initiative Beyondblue to produce a booklet on emotional recovery after a heart attack.
Men living alone are especially at risk, she says. Men who return home to a partner or family tend to do better than those with little social support. Women seem to be less vulnerable even when they’re single because they’re usually more connected to others.
Science is still trying to unravel the links between mood and heart disease. Depression can increase the risk of heart attack risk, while a heart attack can leave survivors more prone to depression.
One reason depression may be a risk factor for heart disease is it makes us less motivated to eat healthily, get enough exercise and keep taking medication.
”Depression can take away your will,” Dr Murphy says. ”You think ‘there’s no point – what difference will a walk make?’.”
While better lifestyle habits and medication can get the body into better shape, the mind might need a dose of cognitive behaviour therapy (CBT) – strategies that can help reverse negative thinking and teach how to manage our feelings better.
In a perfect world, every heart attack survivor would have cognitive behavioural therapy as part of their treatment, Dr Murphy says. Until then, the best option for anyone concerned about their mood after a heart attack is to ask a GP for a referral to a psychologist specialising in CBT. If you’re diagnosed with depression, you may be eligible for a Medicare rebate for up to six sessions with a psychologist.
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