Depression is a medical condition that leads to intense feelings of sadness or despair. These feelings do not usually go away by themselves.
Several factors can make a person feel depressed after a heart attack. The stress of being in the hospital, the fear of another heart attack, and the reality of having to make lifestyle changes can all contribute. If the person had to have bypass surgery, he or she will have to endure a long recovery period. This could include being out of work for up to six weeks.
Some symptoms are common in people of all ages with depression. These symptoms include the following: appetite problemsdecreased energydifficulty paying attention or making decisionsfeeling very sensitive emotionallyfeelings of irritabilityfeelings of sadness, despair, and emptinessinability to feel pleasureloss of motivation and withdrawal from otherslow self-esteempessimism, negativitysleeping problemsthoughts about suicide and death
There are many theories about what causes depression. Depression may be caused by any of the following: chronic illnesses, especially cancer, arthritis, heart disease, or strokecertain medications, including antibiotics and medicines used to treat acnechanges in brain chemicalsheredityhormonal changeslack of sunlightmajor stressesnegative thinking patterns
Risk factors for depression include the following: alcohol abusedrug abuse and addictionhormonal changesjob strainpersonal or family history of depressionpersonal history of a suicide attemptstress
Depression and heart attack have a complex relationship. People with a history of depression have a much higher incidence of heart attacks than people without depression. A person is more at risk for depression after a heart attack if he or she has suffered from depression in the past.
Sometimes depression is not preventable. The following steps reduce a person's risk of depression. Avoiding alcohol and illegal drugs.Avoiding cigarette smoking.Getting prompt treatment for other psychiatric disorders.Seeking effective treatment for chronic diseases.Talking with a counselor if major trauma has been experienced.
Depression can lead to suicide. The lifetime risk of suicide for a person with depression is about 15 percent. It is important to recognize and treat the condition early. Individuals should be encouraged to seek help from a physician, licensed counselor or psychiatrist if they are concerned about depression. Conversations with clergy members, trusted friends, and family members are important and very helpful, but do not substitute for the clinical care needed to treat depression.
A person who shows signs of depression after a heart attack should have a comprehensive evaluation. The evaluation may include a medical history, physical examination, and laboratory tests.
Following a heart attack, people with depression are less healthy and functional than those without depression. Recent research findings include the following: People who are depressed after a heart attack rate their physical health lower than those who are not depressed.People with depression after a heart attack report a significantly lower quality of life than nondepressed individuals.Depression significantly increases a person's risk of dying from heart disease.Depressed women with chest pain were three times more likely to smoke than other women with chest pain.Depressed women with chest pain were four times more likely to be impaired in their daily activities than women without depression.People who have depression are at much higher risk for stroke, further heart attacks, and heart disease than people who don't have depression.
People who suffer from depression after a heart attack are less likely to make the lifestyle changes necessary to decrease the risk of another heart attack. These changes include the following: getting regular exerciselowering intake of dietary fat and cholesterolreducing stressquitting smoking
Depression is not contagious and poses no risk to others. Depression often runs in families.
The two most common ways of treating depression are with antidepressant medications and psychotherapy. Often a combination is used. Occasionally a person must be hospitalized for intense treatment or for his or her own safety.
Antidepressant medications are effective in the following ways. They increase the person's ability to function in daily life.They lower the risk of suicide.They make the person feel better.
The following types of medications are used to treat depression: selective serotonin reuptake inhibitors (SSRIs), including paroxetine HCl (i.e., Paxil, Pexeva) and fluoxetine HCl (i.e., Prozac, Serafem)monoamine oxidase inhibitors (MAOIs), such as phenelzine sulfate (i.e., Nardil) and tranylcypromine sulfate (i.e., Parnate)other antidepressants, such as nefazodone (i.e., Serzone) and venlafaxine (i.e., Effexor)tetracyclic antidepressants, such as maprotiline HCl and mirtazapine (i.e., Remeron)tricyclic antidepressants (TCAs), including amitriptyline, nortriptyline HCl (i.e., Aventyl, Pamelor) and desipramine HCl (i.e., Norpramin) are not advised by many experts in patients after a heart attack or with cardiovascular disease.
Psychotherapy can help people do the following: cope better with having depressionfeel less aloneimprove relations with family, friends, and coworkerslearn about depression and how it affects themlearn to recognize and avoid situations that can bring on a depressive episodelearn to view the world and others more positively and more realisticallypositively address problems that they may be facingstop episodes of depression early by recognizing warning signs and symptoms
Antidepressants may cause mild and usually temporary side effects in some people. Following are the most common side effects: agitationconstipationdizzinessdrowsinessinsomniadry mouthnausea
An individual can help prevent relapses by living a healthy lifestyle. Following are some important parts of a healthy lifestyle: avoiding alcohol, illegal drugs, and smokingdoing regular exerciseeating a balanced diet, following the food guide pyramidfinding ways to manage stressfinding a support system for dealing with depressiongetting enough rest
Once a person has an episode of depression, he or she is at higher risk for further episodes. Any new or worsening symptoms should be reported to the healthcare provider. The provider may recommend regular visits to monitor symptoms. The provider may also order blood tests to monitor the levels of medications.
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
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