Features December 2017 Issue

When There’s No “Ho Ho Ho” in Your Holiday or Any Day, Your Heart May Suffer

Chronic depression and anxiety can have as strong a negative impact on the heart as traditional risk factors, such as diabetes and hypertension.

If the candles in your menorah leave you feeling sad, or you are overwhelmed with worry that Christmas dinner won’t meet everyone’s expectations, you may be suffering from depression or anxiety. Whether you celebrate the season or not, it’s likely the holidays are only making you feel worse.

There’s good reason not to ignore your symptoms, particularly if you have heart disease.

“Conservatively, 30 percent of patients with arrhythmias, heart failure and coronary artery disease severe enough to have stenting or coronary artery bypass grafting (CABG) are at risk of experiencing anxiety or depression after their bout of cardiac illness. Today, we know that high levels of persistent depression or anxiety can aggravate an existing heart condition,” says Leo Pozuelo, MD, a Cleveland Clinic psychiatrist with a joint appointment in the Heart & Vascular Institute.

As Dangerous as Cheeseburgers?

Holiday blues

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Don’t bear the burden of depression or anxiety alone. Safe, effective treatments can improve your heart disease and your outlook on life.

Psychosocial stresses appear to impact the heart as strongly as other risk factors.

“If left untreated, feelings of depression and anxiety can be cardiotoxic. While clinicians tend to focus on diet and how many cheeseburgers you are eating, we are now also focusing on how your emotions are doing,” says Dr. Pozuelo.

The reasons for this impact are many and include increasing arterial inflammation and blood clots and disrupting hormonal balance.

But depression and anxiety also steal the impetus to get better. As a result, patients are less likely to comply with medications and lifestyle modifications and are prone to frequent readmissions and visits to the emergency department. They make less progress in cardiac rehabilitation, and efforts to reassure them they are getting better may fall on deaf ears, Dr. Pozuelo explains.

Don’t Go it Alone

If you feel you are depressed or anxious, tell your primary care physician or cardiologist.

“Certain antidepressants have proven safe and effective in heart patients, as is talk therapy. While treating these conditions may improve your heart disease in the long run, we know quality of life can improve right away,” says Dr. Pozuelo.

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