Print

Email story

Comment

Email editor

Study: Heart trouble often leads to depression

By ASSOCIATED PRESS
Published June 28, 2006

DALLAS - Dale Briggs knew something was wrong, even though his heart valve surgery had gone well. An avid reader, he couldn't concentrate on books, couldn't sleep, couldn't eat.

"I was having a lot of symptoms that I didn't even relate to depression," said Briggs, 60, of Clovis, Calif. But glancing at a list of symptoms in his doctor's office, he realized he had all of them except suicidal thoughts.

As many as half of all people hospitalized for surgery or other procedures to treat blocked heart arteries develop depression, according to a report in the Journal of the American Medical Association.

Doctors say they think the depression is brought on by the mental stress of facing serious illness, or perhaps by microscopic damage done to the brain by the surgery itself. For some patients, the depression is a new thing; for others, it may have been present beforehand.

It could have played a role in the reported suicide of a Maryland publisher and former diplomat whose body was found earlier this month after he went out sailing on the Chesapeake Bay. The family of Philip Merrill said he had undergone heart surgery more than a year ago and had become fatigued and unmotivated.

The good news for the more than 71-million Americans suffering from some type of cardiovascular disease is that not only is depression treatable, but more than half of patients respond to initial drug treatment and 80 percent eventually respond to at least one antidepressant, research shows.

Such drugs soon had Briggs back on his feet. He now helps run Mended Hearts, a support group that hopes to keep fewer heart patients from going through what he did.

Guidelines advise doctors to look for depression in heart patients, and questionnaires are available to help them do this, but specialists say not enough doctors are checking.

"It's something that's very under-recognized," said Dr. Mary Whooley, an associate professor of medicine at the University of California at San Francisco and an author of the report..

Depression is present in one of five people with coronary heart disease and in one of three with heart failure - compared to 1 in 20 in the general population who have it, Whooley wrote.

Depression raises the risk of developing cardiac problems. But even people who were not depressed beforehand can develop "situational depression" when faced with a health crisis or major surgery. "The stress of the illness is a factor," Whooley said.

Also, studies have shown that after bypass surgery, microclots can travel to a patient's brain and cause problems that can include depression, said Dr. Cara East, medical director of the clinical cardiovascular research center at Baylor Heart and Vascular Hospital in Dallas.

Few illnesses are as dramatic or frightening as heart problems, said Wayne Sotile, a Winston-Salem, N.C., psychologist who has written a book on surviving heart disease.

Sotile said hundreds of patients have told him they thought about suicide after developing heart problems.

Treating depression can have physical benefits as well, specialists say. Depressed people are less likely to exercise or regularly take their medication - things that can prevent heart problems from getting worse.

[Last modified June 28, 2006, 02:19:45]