What is dangerous depression after a heart attack: the impact on rehabilitation
If an artery that supplies blood to a specific area of the heart muscle is blocked for a relatively long time, a heart attack occurs. This is a serious condition associated with ischemia and necrosis of a part of the myocardium – a muscle that actively contracts and pumps blood on the body. If a small area has suffered, the death of the myocardial region does not lead to death, but it significantly affects the health and subsequent life of the patient. He needs long-term rehabilitation to recover as much as possible after a heart attack, but the development of depression can be a serious problem. Mental health disorders can complicate the recovery process and even pose a risk of re-attack in the near future.
Artery occlusion and its consequences
The myocardium is a functionally active part of the heart that continuously contracts in a strictly defined rhythm to ensure the blood supply to all tissues and organs. For constant activity, the myocardium needs a lot of oxygen and glucose to get energy for work. Therefore, the heart has its own circulatory system – a network of coronary arteries that feed the organ. Along with other vessels of the body, the coronary arteries also suffer from atherosclerosis, they form plaques, partially narrowing the lumen, which causes poor blood supply.
If the artery is completely blocked, a certain area of the myocardium is left completely without oxygen and nutrition, due to which tissue necrosis is formed. Fortunately, a heart attack does not always kill. Rapid treatment, such as a stenting procedure (the affected artery is opened by a stent) or bypass surgery (workarounds for blood in the area of the affected artery), may limit the area of damage. In this case, the heart attack will not be so extensive, which makes the prognosis more favorable.
What is dangerous heart attack?
The development of a heart attack can reduce the ability of the heart muscle of a person to pump a sufficient amount of blood into the aorta, leads to serious impairments in health due to circulatory disorders and has a profound effect on a person’s mental state. Patients who have suffered a myocardial infarction, say that they no longer feel invulnerable and full of strength, they have a fear of death. So, the very real threat of death can induce a person to make the necessary changes in lifestyle – to quit smoking, play sports and reconsider his usual diet in order to lose weight. But a heart attack is also a serious psychological stress, shock, and in order to embark on the path of recovery, you need to talk about pep and a special mood. Unfortunately, in some patients after a heart attack develops depression, which can significantly complicate the rehabilitation process.
Why does depression form?
For many patients, significant limitations in the life of a postponed heart attack and the threat of its recurrence become a strong stressful event, which leads to an increased level of anxiety, negative emotions and depression. According to statistics, the level of depression after a heart attack is very high, ranging from 20 to 40%.
The exact cause of this phenomenon, psychiatrists can not determine, it was suggested that this is the reaction of the psyche to a very life-threatening complication. The timing of the onset is different, but it is characteristic that without treatment, depression can last for many months or even years after a heart attack, adversely affecting the health of the patient and increasing the risk of recurrent ischemia. Some researchers suggest that inflammatory or neurohormonal changes that occur during heart attack can also be part of a cascade of events leading to the development of depression.
If the average prevalence of depression in the world ranges from 7-8%, then among people who have suffered a myocardial infarction, severe depression occurs in 20-25% of cases, that is, three times more often.
Problems of rehabilitation of patients with depression
In addition to the deterioration in the quality of life associated with both the heart attack itself and the accompanying mental disorders, the development of depression can seriously inhibit recovery and the rehabilitation process. So, depressive disorders reduce the likelihood that a patient will take prescribed medications or make recommended changes in lifestyle, for example, to eat better. Because of this, rehabilitation is delayed, the risk of complications increases, including the repeated ischemic attack, which can be fatal.
People who are in post-infarction depression may feel hopelessly ill and helpless, and often believe that rehabilitation will not help them. Because of this, they show less initiative, refuse to take drugs and activities that would help their recovery. In addition, patients who are depressed often eat foods that are high in carbohydrates to feel better (seize stress), such habits after a heart attack are dangerous to gain weight and increase blood pressure, which increases the risk of a repetition of the tragic scenario. Such behavior certainly will not help rehabilitation after a heart attack, but only harm.
Post-infarction health conditions and risks of deterioration
It has long been known that depression negatively affects human health and is one of the risk factors for the development of cardiovascular diseases. Patients suffering from neurosis, having increased anxiety and signs of depression, regularly note a deterioration in the state of somatic health.Often detected arrhythmia, hypertension, headache, shortness of breath and other unpleasant symptoms. All this negatively affects the state of the heart and threatens to have a heart attack. Therefore, preventive measures and treatment of depression are important in order to prevent dangerous complications.
But if this is a patient who has already had a heart attack, his post-infarction depression doubles the risk of recurrence, while the risk of death after a second heart attack is 50% higher. Therefore, care about your own mental health should be no less active than physical rehabilitation. However, many physicians who observe people in the rehabilitation period overlook this risk factor, for the most part deal only with the problems of the physical body, rather than mental health.
Some people need to talk with a psychotherapist and non-drug therapy to eliminate post-infarction depression so that their condition improves, others need medications or a combination of them with psychotherapy. In addition, it is important to help patients return to normal life as soon as possible with minimum restrictions. Own helplessness and a number of prohibitions and restrictions also adversely affect the psyche.