How psychology can help after a heart attack
The key to recovery? Paying attention to the mind as well as the body.
That's because a heart attack can affect psychological well-being as well as physical health. After a heart attack, many people feel depressed, for example. Others feel anxious, worrying that they will have another heart attack. Still others have a hard time following their doctor's advice when it comes to eating a healthier diet, exercising more, or taking recommended medications.
Failing to address these emotional and behavioral factors doesn't just make people feel bad. It can also reduce their chances of a successful recovery. Research (PDF, 69KB) shows that even minor depression after a heart attack can significantly increase the odds of dying for years to come, for example.2 Certain patients may be at especially high risk. Heart patients with what's known as "Type D" personalities -- characterized by negativity, pessimism, and social inhibition -- have three times the risk of future heart problems than other heart patients, research suggests.3
Fortunately, treating psychological distress seems to improve patients' physical outcomes. In one study (PDF, 418KB), for example, patients who underwent treatment for depression didn't just see significant reductions in their depressive symptoms.4 They also saw promising improvements in their prognosis.
Group therapy may be especially helpful. In another study, combining group and individual therapy for heart attack patients was associated with a 23 to 33 percent reduction in their risk of having another heart attack or dying.5
How a Psychologist Can Help
If you need help after a heart attack, consult with a psychologist or other licensed mental health professional. He or she can help you identify problem areas and then develop an action plan for changing them.
More specifically, a psychologist can help in the following ways:
Educating patients on treatment compliance and healthy behaviors when they are most open to advice -- immediately after they are hospitalized;
Establishing effective communication between the patient and family members;
Facilitating a collaborative relationship among the patient, family, and health care providers; and
Conducting follow-up assessments to determine how well the patient and family are coping with recovery.
Practicing psychologists use a variety of evidence-based treatments -- most commonly therapy -- to help people improve their lives. Psychologists, who have doctoral degrees, receive one of the highest levels of education of any health care professionals. On average, they spend seven years in education and training following their undergraduate degrees.
2 Carney, R.M., Freedland, K.E., Steinmeyer, B., Blumenthal, J.A., Berkman, L.F., Watkins, L.L., et al. (2008). "Depression and five year survival following acute myocardial infarction." Journal of Affective Disorders, 109 (1-2): 133-138.
3 Johan Denollet, J., Schiffer, A.A., & Spek, V. (2010). "A General Propensity to Psychological Distress Affects Cardiovascular Outcomes: Evidence From Research on the Type D (Distressed) Personality Profile." Circulation: Cardiovascular Quality and Outcomes, 3: 546-557.
4 Davidson, K.W., Rieckmann, N., Clemow, L., Schwartz, J.E., Shimbo, D., Medina, V., & et al. (2010). "Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: Coronary psychosocial evaluation studies randomized controlled trial." Archives of Internal Medicine, 170 (7): 600-608.
5 Saab, P.G., Bang, H., Powell, L.H., Schneiderman, N., Thoresen, C., Burg, M., & et al. (2009). "The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction: The ENRICHD experience." Journal of Psychosomatic research, 67 (1): 45-56.
Revised October 2011