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Depression and heart disease: Action steps
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Sharonne N. Hayes, M.D., Founder of the Women’s Heart Clinic at Mayo Clinic in Rochester, MN says that a history of depression should be considered another possible heart disease risk factor, along with high cholesterol or high blood pressure. So what can you do to reduce your risk? 

Go to cardiac rehabilitation. "This is so important, because you’re accountable to someone,” says Hayes. If your doctor recommends it, go. If you’re not referred, ask.

Manage stress. Employ relaxation techniques such as deep breathing, yoga, acupuncture, and meditation. "If you’re clenching your teeth and fists when you’re stressed, you have to teach your body to have the opposite response,” says Kathy Kastan, L.C.S.W., M.A.Ed, author of From the Heart: A Woman's Guide to Living Well with Heart Disease, and president of WomenHeart's Board of Directors from 2003-2007. "One thing you can do immediately is to breathe. Learn to breathe from your diaphragm, and do it ten times in a stressful situation.”

Exercise.  Exercising is the one thing you can be certain will lift your mood. "For people who are depressed, starting an exercise program works as well as Prozac in terms of response rates,” says Hayes.

Connect with spirituality.  "I’m not necessarily talking about a religious spirituality,” says Kastan. "Just appreciate your place in the universe and where you fit. Put yourself or your circumstances into perspective.”

Manage your anger.  Recognize what arouses your anger and avoid triggers. Look to role models to change your behavior.

Take care of yourself.  Drink water, eat healthy, get enough sleep, exercise, pamper yourself somehow, and enjoy the simple pleasures in your life.

Seek help.  "Most of us want a quick fix,” says Kastan. "We don’t want to take the time to deal with our depression — but many times, we need that extra set of ears to listen, and that extra set of hands to guide us where we need to go.”

Counseling.  Psychotherapy can be highly effective in helping you change behavior and get on track to contentedness.

Anti-depressants.   "Not everyone needs drugs, says Hayes. "But if your doctor is recommending it and you’re resisting due to the stigma of being on medication, I would encourage you to seriously consider it. Anti-depressants can be a short-term solution, and even a six-month course can get you back to feeling even-keel. SSRIs, the most commonly prescribed anti-depressants, have been shown to have some anti-platelet activity — a good side effect for women with heart disease. 

Breaking the stigma

"There’s still a huge stigma attached to mental health issues and having heart disease,” says Kastan. The goal of WomenHeart in this area is both to educate women on mental health and heart disease, and also to raise recognition of depression within the medical community. Cardiologists need to recognize the cardiac risk of poor mental health, says Hayes. "And even if it does nothing but treat depression, we need to treat the depression. It is a medical illness that needs to be treated,” Hayes says. "We certainly can’t be joyful all the time,” says Hayes. "But our goal is a happy heart — a content heart.
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