Mental health conditions and heart disease are closely linked, and the connection goes both ways.
A cardiac event can trigger depression, anxiety, or post-traumatic stress.
Taking care of both your mental health and heart health lowers your overall risk and can make recovery easier.
Many factors can impact your mental health. And what goes on in your brain affects every other area of your well-being. An example is mental health and heart disease, which research has found to be closely linked.
The relationship between mental health and heart disease goes both ways. Living through a cardiac event — like a heart attack — can cause significant mental health challenges. But living with a pre-existing mental health condition, like depression or an anxiety disorder, can also increase your risk of developing heart disease.
While a mental health professional can’t treat heart disease, they can help you protect your mental health so that your risk is lowered.
How heart disease affects your mental health
People with heart disease often experience symptoms of mental health conditions — especially right after diagnosis. Research shows that depression is especially common among cardiac patients.
Feeling down or depressed after a cardiac event (like a heart attack) is so common that it’s been given a nickname: the “cardiac blues.” It’s also sometimes called cardiac depression. This is a temporary period of low mood and other depression symptoms after a heart attack or other cardiac event. It’s estimated that 75% of people who go through a cardiac event will experience the cardiac blues.
Some signs of the cardiac blues include:
Low mood
Fatigue
Irritability
Changes in sleep (sleeping too much or too little)
Trouble concentrating
Loss of interest in activities you used to enjoy
Anxiety can also happen after a cardiac event. One review found that over 30% of cardiac patients also have an anxiety disorder.
Experiencing these feelings is a natural and human reaction to a heart attack. Having a heart attack — and working on recovering — is hard and scary. And a lot of life changes can come after going through a cardiac event.
Some reasons you might be feeling down or anxious after a heart attack include:
Shock and trauma: The experience of a heart attack can be traumatic for many people. Surgery, in particular, is inherently traumatic to your body and nervous system. So recovering from it can be just as hard as recovering from any other traumatic event. Some people develop post-traumatic stress disorder (PTSD) after a heart attack.
Fear of repeat attacks: Having one cardiac event increases your risk for another. So you might find yourself constantly worried and anxious about experiencing another event.
Identity loss: After a cardiac event, many people experience a loss of their former identity. This can be due to things like having to take time away from work or hobbies. But it can also be a more subtle change in identity, like an awareness of aging.
Decrease in activity: Especially during recovery, you may not be able to do the same activities that you used to. Decreases in physical activity and exercise can worsen mental health. And losing access to your favorite hobbies can also feel depressing.
Physical pain: If you’re experiencing physical pain and discomfort after a cardiac event, this can directly worsen mental health. Research shows that chronic pain is linked with depression and other mental health conditions.
Lack of social support: Surviving a cardiac event can make it harder to connect with people. For example, you may not be able to leave your home for a while. If you didn’t already have a strong social support network before, you may start to feel isolated.
Financial stressors: If you need to take a leave or even retire from work due to a cardiac event, you could be facing significant financial strain.
If you already lived with a mental health condition before your cardiac event, you might find that your symptoms get newly triggered or get worse.
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How mental health conditions affect your heart
The relationship between heart health and mental health goes both ways. Not only does having a cardiac event worsen your mental health, but having a mental health condition can also increase your risk of having a heart attack.
Research shows that many mental health conditions are linked to heart disease, including:
Studies show that, in many cases, these mental health conditions come before heart problems. One recent study found that having a mental health condition can increase your risk of cardiovascular disease by up to 100%.
Part of this is biological. Living with these mental health conditions, or with chronic stress, directly affects how your heart works. Studies show that these conditions can literally reduce blood flow to the heart as well as increase cortisol levels in the body. This, then, increases your blood pressure — as well as your risk of a heart attack.
Other factors are at play as well. When you live with a mental health condition, you’re also more likely to rely on unhealthy coping skills. These factors can raise your risk of heart failure.
Some people may worry that psychiatric medications might worsen their heart health. Some medications can increase your blood pressure or cause cardiac arrhythmias. But your provider will work with you to make sure that the medications you’re prescribed are safe for you and your heart. Often, the benefit of these medications outweighs the risks of leaving a mental health condition untreated.
Ways to keep your mind and heart healthy
Taking care of your heart and your mental health at the same time is possible. Simple, consistent steps can make a difference for both areas of your well-being.
Manage stress
Chronic stress is one of the main avenues through which your mental health affects your heart health (and vice versa). Learning to manage stress effectively is one of the most important skills to deal with both areas.
Exercise
Exercise is one of the best things you can do for both your heart and mental health. For your heart, exercise can reduce your heart attack risk. And research shows that getting regular physical activity can significantly reduce depression and anxiety.
Connect with people
Having strong social support can protect you from a wide variety of mental health conditions. It can also make recovery easier if you’ve gone through a cardiac event.
If you don’t have one already, prioritize building a network of people you feel like you can count on. The most important thing is to have reliable and trustworthy people in your corner.
Get regular check-ups
It’s important to stay on top of your health by getting regular physical exams. Your primary care physician (PCP) can check for any potential heart issues that may come up.
PCPs also typically screen for common mental health concerns, like anxiety or depression. Be honest with your doctor about everything you’re experiencing, even if you think it might not be connected.
Get mental health treatment
If you have developed symptoms of a mental health condition — whether they started before or as a result of heart disease — it’s important to get treatment. Mental health professionals, like therapists and psychiatrists, don’t directly treat heart problems. But they do treat mental health conditions that might be making your heart problems worse.
With your provider, you can decide if therapy, medication, or a combination of both is best for your unique situation.
Important emotional or psychological factors that can shape a person’s recovery after a cardiac event are their physical health before the cardiac event and social support. A person’s outlook on life can have a significant impact as well.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Your heart and mind are deeply connected, and taking steps to care for one also strengthens the other. By managing stress, seeking treatment when needed, and building a supportive community, you can protect both your mental and physical health.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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