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.”