Nothing new to many of us heart patients, but the American Heart Association just released a statement that heart patients should be screened for depression and treated if necessary. Studies have shown for years that depression is three times more likely in a patient post heart attack than in the general public. A co-writer of the AHA statement, Erika Froelicher, R.N., said they can now release the statement because of the "growing body of evidence that shows a link between depression in cardiac patients and poorer long-term outlook." Their findings and this statement are not surprising.
Studies show if you have an untreated depression following a heart event, you're twice as likely to have a negative health outcome. Not to state the obvious but whether you're a heart patient or not and have an untreated depression, you're less likely to follow your health care provider's mandates to: stop smoking, eat healthy, get exercise, lose weight, control your diabetes, take your medications, lower your blood pressure and cholesterol. As a patient advocate and a psychotherapist that has traveled around the country talking to heart patients for years, I have no doubt that more of us than not suffer from multi-faceted psychosocial problems following a heart event. And of course, many of those psychosocial issues may have been present before the diagnosis but following the heart event they get magnified and affect the quality of life of patients and their families.
And of course there are not just the personal costs for patients and their families. Patients that have heart disease and an untreated mental health concern impact our society and economy overall due to lost wages, disability, unemployment and increased health care costs. This is a ripple affect that eventually affects all of us.
My hope is that studies continue to evaluate the quality of life and psychosocial issues heart patients and their families' face. Those studies validate what we as patients already know and live with everyday. The hope is that these studies will help health care providers to see quantitatively that they must treat the whole patient not just the parts. Mental health issues are health issues.
My plea to health care providers is to pay attention and do the obvious: ask your patients about their overall mood, their sense of self, their family life, their work, not just the technical aspects of their presenting problem and/or recovery. Please refer patients who experience a heart event to cardiac rehabilitation. Studies show heart patients do significantly better both physically and emotionally if they go to cardiac rehabilitation. Unfortunately many patients are still not referred there and/or choose not to go because the psychosocial issues of the patient are not adequately addressed in the health care provider's office. Equally important to a patient's recovery is to be referred to a support group, such as the support groups offered in over 60 cities by WomenHeart: The National Coalition for Women with Heart Disease. If you are concerned that the patient might have psychosocial concerns, refer them to a qualified mental health professional to be appropriately evaluated and treated. Studies show that the vast majority of patients with mental health concerns who have therapy, are put on the appropriate medications or get treated with a combination of both get well. Isn't it about time that all of us recognize that the head bone is indeed connected to the leg bone and especially the heart?
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