It’s been a couple of months since Jack’s heart attack. Physically the doctor says he’s fine, but he’s not feeling that way. His family is thrilled that he has a new lease on life, but Jack’s been gloomy. He’s lost interest in activities that he used to enjoy, and gets down right irritable when people encourage him to get back into the swing of things. He says that he just doesn’t have the energy.
Jack’s suffering from depression, a fairly common disorder among people who have a serious or long-term health problem. The Mayo Clinic reports that 30-40% of people who have heart failure develop depression, and that number jumps to 50% for those who undergo heart bypass surgery. Patients who’ve had a stroke, advanced cancer, or who live with chronic pain suffer similar rates of depression. Physical illness has been shown to trigger depression in people who otherwise have been happy in their life.
Depression is diagnosed only when a person’s mood gets down and stays down for more than two weeks. People experiencing depression can feel overwhelmingly sad, or they can just feel they’ve lost interest in pleasurable activities. For men, irritability is often a sign of depression. In addition to a melancholy mood, people often have one or more of the following symptoms:
- Sleep problems, either waking early or trouble getting up
- Weight change, either gaining or losing without trying to do so
- Fatigue, which doesn’t go away after resting
- Difficulty concentrating and/or impaired memory
- Dwelling on thoughts of worthlessness, guilt, inadequacy
- Feeling helpless and hopeless, that life isn’t worth living
In addition to these classic signs, the Harvard Mental Health Letter reports that depression can also cause stealth symptoms that masquerade as medical problems. The following somatic symptoms are particularly common among more mature adults: heart palpitations, shortness of breath, tremors, restlessness, low energy, body aches and pains, nausea and vomiting, heavy perspiration, fainting, and facial flushing. Of course, it’s essential to have a medical doctor determine if there could be a physical cause for any of these problems.
If you’re struggling with a serious illness and you have several of the above symptoms, it’s likely that you also have depression. It’s important to get treatment to improve your mood in addition to your other medical care because your efforts to regain good health can be seriously affected by the chemical imbalances depression causes in your brain. In addition to putting your physical recovery at risk, depression adds to your misery and diminishes your ability to enjoy the positive parts of your life.
One study found that patients who developed depression shortly after a heart attack were four times more likely to die within four months. The Mayo Clinic Health Letter reports that depression increases the risk of further heart problems in several ways. Depression leaves people more susceptible to having fight-flight-freeze reactions, putting additional strain on the heart due to the chronic release of stress hormones. That leads to abnormal heart rhythms, elevated cholesterol levels, increased blood pressure, inflammation, and faster blood clotting.
Depression also makes it more likely that patients will engage in unhealthy behaviors such as being a couch potato, eating poorly, smoking, and drinking too much. The discouragement that accompanies depression causes people to give up, decreasing their motivation to take their medications or to engage in relationships. The more socially withdrawn a person becomes, the further they descend into depression – furthering the downward spiral of their health.
Fortunately there are excellent treatments available that have been proven to be very successful in defeating depression. The current studies show that the most effective treatment approach is a combination of cognitive behavioral psychotherapy and antidepressant medications. Exercise is also an important ingredient in recovering from heart problems because it rehabilitates the heart muscles, reduces stress, and naturally rebalances brain chemistry.
Being diagnosed with a serious illness and starting treatment will trigger distress, but if it continues for several weeks it turns into depression. Psychotherapy has proven to be highly effective, especially treatments that focus on helping patients with serious illnesses to think more optimistically and encouraging them to seek social support.
Positive psychology effectively deals with depression by having patients write down their vision of the healthy and happy future they’d like to have after recovering from their illness. Identifying the skills patients have used to deal with other challenges in their life helps people see how to use their strengths to deal with their current situation.