Depression correlates strongly with congestive heart failure as well as other coronary conditions. The connection is certain, but answers to the most critical questions are not: Does depression reliably predict the onset of coronary problems? And how can both conditions be more effectively prevented and treated? This article looks at research, possible responses, and ways in which home care can play a constructive role.

“Depression does predict the development of heart disease”

A 2017 literature review done by the National Heart, Lung, and Blood Institute reported that “Thirty years of epidemiological data indicate that depression does predict the development of heart disease.”

According to Jesse C. Stewart, Ph.D., an associate professor of psychology in the School of Science at Indiana University-Purdue University Indianapolis (IUPUI), “an impressive body of evidence” indicates that adults with a depressive disorder have a 64% greater risk of developing coronary artery disease, and that such patients are 59 percent more likely to have a heart attack.

The report also asks a critical question: Does depression cause heart disease in the same way as risk factors such as cholesterol, smoking, diabetes, and obesity? Clinical trials are under way to determine whether the hallmarks of depression – such as elevated cortisol, nervous system dysfunction, and inflammation – are biological triggers.

64% increased risk

of adults with a depressive disorder
to develop coronary artery disease

Broken heart icon

A 2017 literature review done by the National Heart, Lung, and Blood Institute reported that decades of data tie together depression and heart problems. But the exact nature of the connection is still being studied.

What’s the best way to treat depression in people with heart disease?

A 2018 study in the Harvard Review of Psychiatry admitted the limits of medicine in untangling the knot of heart disease and depression: “Given the overlap between cardiac and psychiatric symptoms, accurately diagnosing depression or anxiety disorders in [heart failure] patients can be challenging.”

This study said that “there is limited evidence for the efficacy of pharmacologic and psychotherapy in patients with {heart failure}. However, cognitive behavioral therapy has been shown to improve mental health outcomes in patients with {heart failure}, and selective serotonin reuptake inhibitors appear safe in this cohort.”

Simplifying the subject considerably, a 2021 Psychiatric Times article was published with this prescriptive title: “What’s good for the brain is good for the heart.”

In it, the authors assert that psychosocial risk factors (such as stress at work, stress at home, financial stress, and major life events) can be as relevant as physiological risk factors in reducing the likelihood of coronary conditions. “These 2 illnesses, recurrent depression and {coronary heart disease}” the article states, “may be driven by shared genetic vulnerabilities to stress.”

Psychosocial risk factors (such as stress at work, stress at home, financial stress, and major life events) can be as relevant as physiological risk factors in reducing the likelihood of coronary conditions.

How home care can help

As the Psychiatric Times article also pointed out, “Careful attention to structured, daily self-management plans that address both the depression and the CHD can often turn a partial responder into a responder within months.” This is where medically directed home care can play a role.

One of the positive aspects of medically directed home health care is the ability of the professional caregivers (in the case of SeniorBridge, an RN and LCSW working in tandem) to improve the psychosocial wellness of the client. For people recovering from a coronary event at home, this can be an invaluable resource.

Educational interventions. These measures are often introduced to clients or family caregivers as “skill building sessions” or “stress management techniques.” In essence, educational interventions call attention to the truths of physical and mental conditions in an attempt to inform and moderate patient and caregiver reactions; knowledge is power.

Lifestyle interventions. This may include diet, exercise, and smoking cessation practices, all of which can guide clients toward healthy living practices and improved states of mind and mood.

Social interventions. Facilitating social contact with friends and loved ones can have a significant, life-affirming effect on a client’s well being.

Family therapy interventions. Support in resolving family conflicts and misunderstandings (facilitated or mediated by an LCSW) can work wonders in creating a more peaceful, less stressful home environment.

For more information on how home care can support people with heart disease who suffer depression, here’s a short article.

The integrated care management model by SeniorBridge

Home care services vary widely in the services they provide.

SeniorBridge offers an integrated care management practice model that involves two components:

  1. Clinical care (under the direction of an RNCM/Registered Nurse Care Manager) supported by a Social Worker and a team of caregivers, based on patient’s needs and
  2. A portfolio of home care services and geriatric care management in such areas as nutrition, caregiver education, benefit coordination, transportation, and coordination with discharge planners, physicians, pharmacy, home health agencies, and care managers.

NOTE: We have full COVID-19 safety protocols in place to keep clients, families and associates safe.

For more information on medically directed home care, contact SeniorBridge.

Sources consulted:
National Heart, Lung, and Blood Institute (2017)
National Library of Medicine/NIH – Harvard Review of Psychiatry (2018)
Psychiatric Times (2021)

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