Clyde Boyce survived two strokes and five operations to clear arteries around the heart. The disease that almost killed him wasn’t related to his heart, but depression. One in 5 heart attack survivors develop severe depression, four times the rate in the general population. Heart disease patients who are depressed are twice as likely to die in the following ten years than others.
Depressed heart attack survivors normally die of physical failings, as they are less motivated to take care of themselves properly and take their medication as directed. Depressed people are also more likely to smoke and less likely to exercise.
The American Heart Association recommends that cardiologists screen their patients for depression, yet only 42 percent of depressed patients received treatment. Many doctors fail to refer patients to a cardiac rehab program, which has proven to reduce depression and help prevent future heart attack or death. Two out of three heart attack survivors were referred to the program, while only 23 percent of patients ever attended a session and only five percent completed all 36 sessions. The cardiac rehab programs teach stress management, relaxation techniques, and coping skills. Half of patients who did not attend rehab died or had a heart attack.
Boyce was not screened for depression after his heart procedures. His depression got worse as bad health news continued to add up. After attempting suicide twice, he received help with medication, counseling, and a stress reduction program. Exercise helped him feel stronger and less disabled. Occasionally, he gets depressed, but now knows how to manage his fears and anxieties better.
Primary care doctors have embraced the idea of screening heart patients for depression, as recommended by the American Academy of Family Physicians. Through collaborative care, mental health nurses work with primary care physicians to adjust any medications, as well as consulting psychiatrists over the phone. Telephone care not only improved patient depression, quality of life, and physical function, it saved over $2,000 a year per patient. Keeping depression under control saves money by keeping patients healthy and out of the hospital.
Szabo, Liz. “Depression Among Heart Attack Survivors Can Be Deadly, Yet Is Often Ignored.” News. Kaiser Health News, 20 Jul 2017. Web. 6 Aug 2017.