Effective treatments for depression and coronary artery disease

Depression that is linked to coronary artery disease is particularly common after a heart attack. Research has shown that about 15 to 20% of people who have to stay in hospital for heart attack treatment will develop depression afterwards. Sometimes depression will affect your emotional or physical wellbeing even months or years after a heart attack.

Health problems like heart attacks increase the risk of depression. On the other hand, long-lasting depression can also increase the likelihood of heart disease. It slows recovery from heart disease too, and can increase the risk of disease and death. There are various biological mechanisms that might make depression affect the heart directly. But specific behavioral habits that are more common in people with depression might also play a role, such as smoking or not getting enough exercise.

Options for psychological treatment of depression include cognitive behavioral therapy, systemic therapy and psychoanalysis. You can also seek psychological support or counseling. Medications known as antidepressants are available as well.

Various studies have looked into how to relieve the symptoms of depression in people who have coronary artery disease. These studies tested the benefits of psychological treatments and medications. All of the participants in the studies had serious heart problems: Most of them had recently had a heart attack or bypass surgery. Some people who had episodes of chest pain (angina pectoris) were also included.

The studies suggest that psychotherapy can relieve depression following a heart attack or bypass surgery. These interventions also improved quality of life. These studies focused mostly on a brief form of cognitive behavioral therapy. This type of therapy helps you learn how to change your behaviors and attitudes, work on current problems, and find concrete solutions. It is not clear whether psychological treatment can lower the risk of developing heart disease again over the long term, though.

Antidepressants were also found to reduce depression in people with coronary artery disease. They are often combined with psychological treatments. But the medications are usually only suitable for moderate to severe depression. Most of the studies tested one specific group of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). While SSRIs are suitable for people with heart problems, other antidepressants such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOI) are not.