Mental health is an important part of overall health and refers to a person’s emotional, psychological, and social well-being. Mental health involves how we think, feel, act, and make choices. Show
Mental health disorders can be short- or long-term and can interfere with a person’s mood, behavior, thinking, and ability to relate to others. Various studies have shown the impact of trauma, depression, anxiety, and stress on the body, including stress on the heart.1-3 What mental health disorders are related to heart disease?Some of the most commonly studied mental health disorders associated with heart disease or related risk factors include the following:*  Mood Disorders: People living with mood disorders, such as major depression or bipolar disorder, find that their mood affects both psychological and mental well-being nearly every day for most of the day. Anxiety Disorders: People respond to certain objects or situations with fear, dread, or terror. Anxiety disorders include generalized anxiety, social anxiety, panic disorders, and phobias. Post-Traumatic Stress Disorder (PTSD): People can experience PTSD after undergoing a traumatic life experience, such as war, natural disaster, or any other serious incident. Chronic Stress: People are in a state of uncomfortable emotional stress—accompanied by predictable biochemical, physiological, and behavioral changes—that is constant and persists over an extended period of time. *There may be other behavioral health disorders, such as substance use disorders, that are connected to heart disease. What is the connection between mental health disorders and heart disease?A large and growing body of research shows that mental health is associated with risk factors for heart disease before a diagnosis of a mental health disorder and during treatment. These effects can arise both directly, through biological pathways, and indirectly, through risky health behaviors.5 People experiencing depression, anxiety, stress, and even PTSD over a long period of time may experience certain physiologic effects on the body, such as increased cardiac reactivity (e.g., increased heart rate and blood pressure), reduced blood flow to the heart, and heightened levels of cortisol. Over time, these physiologic effects can lead to calcium buildup in the arteries, metabolic disease, and heart disease.1,6-11 Evidence shows that mental health disorders—such as depression, anxiety, and PTSD—can develop after cardiac events, including heart failure, stroke, and heart attack.5,12-20 These disorders can be brought on after an acute heart disease event from factors including pain, fear of death or disability, and financial problems associated with the event.5,16 Some literature notes the impact of medicines used to treat mental health disorders on cardiometabolic disease risk. The use of some antipsychotic medications has been associated with obesity, insulin resistance, diabetes, heart attacks, atrial fibrillation, stroke, and death.21 Mental health disorders such as anxiety and depression may increase the chance of adopting behaviors such as smoking, inactive lifestyle, or failure to take prescribed medications.5 This is because people experiencing a mental health disorder may have fewer healthy coping strategies for stressful situations, making it difficult for them to make healthy lifestyle choices to reduce their risk for heart disease.5 What groups have higher rates of heart disease from mental health disorders?Specific populations, such as the following, show higher rates of heart disease as a result of pre-existing mental health disorders: Veterans. Studies found that veterans are at a higher risk for heart disease, mainly due to PTSD as a result of combat.22-26 Women. Studies exclusively focused on women found that PTSD and depression may have damaging effects on physical health, particularly with increased risk for coronary heart disease (CHD)–related morbidity and mortality.27,28 Couples with someone who has PTSD. Comparative studies found that couples where one or both partners had PTSD experienced more severe conflict, greater anger, and increased cardiovascular reactivity to conflict discussions than couples where neither partner had PTSD. Anger and physiological stress responses to couple discord might contribute to CHD and heart disease risk within these relationships.29,30 Racial and ethnic minorities. Lastly, studies focused on racial or ethnic minority groups found that depression, stress, and anxiety due to disparities in social determinants of health,31 adverse childhood experiences,32 and racism/discrimination33-35 could place certain subpopulations at a higher risk for hypertension,32,33,35,36 cardiovascular reactivity,35 heart disease,31,34 and poor heart health outcomes.37 What can be done for people with mental health disorders?Addressing mental health disorders early by providing access to appropriate services and support to increase healthy behaviors (e.g., increased physical activity, improved diet quality, and reduced smoking) can reduce someone’s risk of experiencing a heart disease event.13,15,17,19,28,38-40 Below are some actions that health care systems, health care professionals, individuals, and researchers can take to promote heart disease prevention and support mental health. Actions for Health Care Systems
Actions for Health Care Professionals
Actions for Individuals
Actions for Researchers
Is anxiety more common than depression in patients with heart failure?studied 100 outpatients with heart failure in the United Kingdom and found the prevalence rate for anxiety and depression to be 18% and 29%, respectively [10]. The higher prevalence of symptoms of depression in our patients is likely influenced by socioeconomic factors unique to populations in LMIC.
How does heart failure cause anxiety?Thus, inflammation may be one physiologic mechanism through which anxiety and depression are associated with cardiac outcomes in HF. Changes to the autonomic nervous system are also implicated in the relationships between depression, anxiety, and cardiac outcomes.
What is a depression?Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.
Which of the following is an example eustress?Smaller challenges: The excitement of a roller-coaster ride, a scary movie, or a fun challenge are all examples of eustress. Even a particularly tough workout can be an example of this type of stress.
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