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 one in five people who have to stay in hospital for heart attack treatment will develop depression requiring treatment afterwards. Many more will have milder symptoms of depression following a heart attack. The majority of people who develop symptoms of depression after a heart attack are likely to remain depressed for one to four months after leaving the hospital. Sometimes depression still affects the person's emotional and physical wellbeing five years after the heart attack.

So heart attacks and similar health problems increase the chances of developing depression. On the other hand, long-lasting depression increases the likelihood of heart disease: It slows recovery and can increase the overall risk of illness and death. There are various biological mechanisms that might make depression affect the heart. 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.

The psychological treatment options for depression include cognitive behavioral therapy and psychoanalysis, as well as support and information services. Medications known as antidepressants are also available.

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) were also included.

The studies showed that psychological support and treatment can relieve depression in people who have had a heart attack or bypass surgery. These interventions also improved quality of life. The studies focused mostly on a brief form of cognitive behavioral therapy. Cognitive behavioral therapy helps you learn how to change your behaviors and attitudes, work on current problems, and find concrete solutions. It's not clear whether psychological treatment can lower the risk of developing heart disease again over the long term.

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