Minding mental and heart health

Thursday, January 23, 2020

Here’s a question for Heart Month: Did you know that heart and mental health are like the chicken and the egg? It doesn’t matter which one came first. Help one and you help the other.  

One in 2 middle-aged men and 1 in 3 middle-aged women have some form of heart disease. Coronary artery disease, a form of heart disease, is the leading cause of death in this country. It occurs when fatty deposits build up in the arteries that supply the blood flow to the heart. Over time, this narrows the arteries, restricts blood flow, and can lead to a heart attack or stroke.  

When heart disease comes first

For people who’ve survived a heart attack, 33 percent will suffer from depression. The more severe the physical disease, the greater likelihood that the person also has developed a mental health disorder, said Mia Wise, DO and Premera medical director. 

“When people have to go from seeing themselves as someone in good health to someone who has to make lifestyle changes and take medication to manage their condition, it has a big impact,” Dr. Wise said. “Patients can feel a loss of control. They may ask themselves, ‘Why me?’ or sometimes think, ‘What’s the point? Why should I try?’”

People who have heart disease may not be able to work, climb a flight of stairs, or even have the energy to go out to dinner. These changes and losses can lead to anxiety and depression. In fact, about one in three heart attack survivors experience depression, according to the American Heart Association (AHA). Just because someone looks fine after a heart attack doesn't mean they are.      

Depression is associated with poor follow-through on treatment recommendations. That's why Premera collaborated with the AHA to create My Cardiac Coach, an app that helps address emotional well-being, connects survivors with expert advice and support groups, and tracks blood pressure and weight. 

Jennifer Leisegang, RN, case manager for the Premera Personal Health Support Program, sees this often. Up to 25 percent of the Premera members she helps are living with a chronic heart condition.

“Many of my members describe living with a chronic illness as exhausting,” Leisegang said.  “Medications and attending multiple medical appointments can cause fatigue. People can be overwhelmed by their treatment plan, getting medications and supplies, navigating our health care system, trying to maintain relationships, and handling finances. Depression can be a side effect of having a chronic illness.” 

When depression comes first

Research shows that depression is linked to heart disease. People with depression may sleep more, exercise less, eat a poor diet, and self-medicate with smoking, drinking, or substance abuse. They may have a hard time taking medications as directed by their healthcare provider. They’re less likely to do the things that keep them healthy and prevent heart disease. 

“When you’re depressed, it’s really hard to advocate for yourself,” Dr. Wise noted. “If you have heart disease and depression, you feel physically lousy and think it’s all about the physical disease, when it’s not. People believe they should be able to think their way through this. We need to change our focus.”

Hope for both

If you are concerned about yourself or a loved one, talk to your cardiologist or primary care provider. A doctor can give warning signs to watch for. Your health plan offers help managing chronic conditions. You also have mental healthcare benefits.

“Mental health and physical health aren’t separate,” Dr. Wise said. “It doesn’t matter where we interrupt this cycle, just as long as we interrupt it.”

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