Cardiac issues can lead to depression

The last thing cardiac patients think about during a heart attack or other serious event is their mental health. Yet, physical and mental health is strongly tied. Many cardiac patients experience depression following a heart-related diagnosis or procedure. "Conversely, many patients with depression are prone to heart disease and have a less favorable prognosis if their depression is not treated," says cardiologist Richard Daum. "The estimates vary, but as many as 75 percent of patients have neurologic impairment for up to a year or more, post-bypass or heart attack."

Dr. Daum asks each of his patients about his or her outlook on life when they come into his office. "I ask because the symptoms can be subtle. Patients who have heart issues are about three times more likely than healthy patients to develop depression, and vice versa. We don't often think of depression as coming from or leading to a cardiac event, but it can."

One of the main reasons patients feel depressed is because they worry they will not get back to their occupation, recreational activities or lifestyle they lived previous to their cardiac event. "I ask them, 'If you look back to a time when you felt 100 percent, when you were yourself at your very best, where are you now?' If they say 70 percent or less, I suspect depression. It's a normal reaction, but one I work to help them overcome."

Sometimes the depression begins in the hospital, when sleep patterns are interrupted by the sounds of machines, overhead lights and other patients. "It's a natural consequence to lose a feeling of normalcy when the patterns you are used to are disrupted. Then, when those patients go home, they find they wake up in the middle of the night, worrying or reliving their experience in the intensive care unit, even though those noises are no longer present."

Dr. Daum often prescribes medication to combat the depression, and encourages patients to develop a good sleep routine that includes:

¦ No television in the bedroom.

¦ Taking a hot bath before going to bed.

¦ Drinking warm milk before bed.

¦ Turning off the light.

¦ No reading thrillers or mysteries before sleeping.

"The biggest fear my patients have is not being able to return to a normal life. When they feel weak and they think they won't regain that strength, or that they cannot have sex, that's very scary. I cannot give a black-and-white answer to some of these questions, but I assure them with patience and time they will get back to normal. I always encourage the Lee Memorial Health System Cardiac Rehabilitation Program as a way to get back to their baseline activity. The bottom line is that it is possible to regain strength and move past a cardiac event." ¦