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Don't let anyone ever tell you...

denisePA
0 Recommendations

That depesssion & anxiety are not a part of heat disease. Are you kidding me? If anyone told them they had an EF of 23 they would bottom out just like I did. Add to that this invisible set of symptoms that accompany CHF/dilated cardiomyopatly/a-fib and I'm telling you the day before being diagnosed with these things I was not feeling lower than dirt.

I mentioned this to an office nurse who said "I have never heard anyone getting depressed over heart disease" I wanted to choke her, my mouth had to have fallen open as I gaped at her with contempt. I had contemplated getting myself a second opinion and her remarks made that decision much easier. I later found out she was NOT a nurse, she was hired to take pt's back to the rooms/and take BP's & EKG's.No medical training what so ever other than on the job..

I live in a one horse town so there are no physical support groups but I network when I can online and read as much as I can on the subject. I do have an ongoing rx from my DO for klonopin but I reserve that for night time use because I have a gene that can easily lead me into an addiction/love affair with these pills so I have grown up and self monitor my own behavior which in itself is a good feeling because I am doing it with ease.

I guess my point is that if you are newly diagnosed and no one brings this topic up, it is a reality, and I bet you dollars to donuts that we all have it to some degree.

Don't suffer, get help..

denise

Explore topics in this discussion:

Exercise Cancer Heart failure Surgery Klonopin Beta blockers Anxiety Stent Stress Heart disease Diabetes Weakness Memory Pacemaker Heart attack Depression Mental health

26 replies

martzj

Hi denise,

You are absolutely right that anxiety and depression can come before, during and after heart attack........The medical community, especially the cardiac specialties are not up to speed on this aspect yet, so you'll need to remain proactive. And that is a healthy thing to do anyway. Keep listening to your body and going in directions you feel may help you heal.

Welcome!!! Glad you are here. Doctors don't have the time or expertise for long term assistance to women during heart attack recovery...which can take weeks to years. Feel free to bring anything that is distressing you here......somebody has always been there too and may have real help to offer in the form of practical advice, a sympathetic ear.

Hope you had a lighter day today,
Jaynie

Ecksunbeam

Dear Denise,

When you're ready to beat up that knows nothing big mouth let me know. I'm coming along. In addition, depression is the most widely treated illness in the United States for ALL reasons. So, what does she know? What an idiot!

My experience has been that our doctors do not prescribe meds for other than 'just' the heart unless we tell them we might need something else. My cardio wants me to ask my PCP to handle everything but heart meds.

Don't be afraid to ask.

May the Blessings Be!

Sherrie

joy2day

Wayne Sotile's book Thriving with Heart Disease has a chapter that is subtitled "85% of Heart Disease Patient Suffer From Depression. Why Do You Think You are Different?"

Like Sherrie says, most cardios seem to want to focus solely on the physical heart.

AlaskaGirl

Holy Cow! I can't believe educated medical people telling patients that they don't know of anyone with heart disease (cancer; diabetes, etc.) not dealing with depression! That is asenine!(sp????) It's just another thing patients are not educated about and that can have dire consequences. It is a major component of life-threatening disease of any type and you have to deal with it head on. I always talk about this when I have speaking engagements on Heart Health and it shocks the audience to hear it. I've been there, done that and it is a difficult issue to deal with. Wow! AlaskaGirl

Kennarina

Alaska Girl, this dim bulb who told Denise that was NOT a medical person, although you probably recall that even Dr. Sharonne Hayes at Mayo last year told us that cardiologists receive very little training in mental health issues, so even educated medical people can be very uninformed about depression.

My own cardiologist, who is a whizbang heart guy, admits freely that he is just a "mechanic" whose fascination is with the organ itself and fixing it when it's broken. One time, he mused aloud during our visit that maybe patients suffer depression after a heart attack because many of them are put on beta blockers. I had to smack him upside the head a few times (figuratively, not literally!) and say: "NO! It's because they've had a frickety frackin' HEART ATTACK!!!" I like to think it's our role to help educate them! Lucky them. There can be a lot of misunderstanding, embarrassment and even shame about depression however. But if we don't talk about our depression, then how are they to learn? We wouldn't be reluctant to talk about our broken arm, or certainly about our cardiac event.

Thanks Karla/Joy2Day/New Bride for that reminder re Wayne Sotile's book, which I just HAPPENED to have on my desk today! (HEY! By the way, how was the WEDDING?!?!)

Here's how Dr. Sotile starts his chapter called "Deal With Depression" -

****

"To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades one's self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others, but also the ability to be peacefully alone with oneself."

Denise - you're right on: "don't suffer - get help!" is great advice. Hard to do for some of us, but so important.

XOXOXO

http://www.myheartsisters.org

denisePA

Hey guys thanks for all the input & support I know that by having these discussions amongst us that people that are afraid to ask or thing depression is a sign of weakness are being helped greatly. That was my goal, to share my story and to open up the lines of communication.

Simple concept yet so important...

Blessings to you all and I'm going to look for that book right now.. one of my favs is Marc Silver MD Success with Heart Failure touches on a wide array of subjects.

denise (who has found a new home here online!!)

GraceAnnStewart

Gosh, I really never experienced depression until my heart attack. I know I've had anxiety but not to the degree after the MI. It has been 10 months, I have resolved a lot of issues in my life, and have become educated in cardiac issues as well as the mental issues. I see both a cardiologist and a therapist regularly. I feel like I am not depressed anymore and am cutting out one drug at a time. But realize it does take time.

Heart hugs,
GraceAnn

tickers

This is one of the most accurate and profound description of depression I have ever read....gonna order the book. Thanks Kenneria...

"To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades one's self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others, but also the ability to be peacefully alone with oneself."


My cardio guy was very honest with me when I discussed the depression issue with him......He told me, he focuses on the physical issues of the heart...the tests, the meds....his confidence in making the muscle better impressed me......and he encouraged me to seek other help with my therapist for the mental and emotional issues I am faced with.

I was kinda put off by this at first......but medicine has become such a specialty-focused occupation, it makes sense....and my attitude of "hurry up and fix this....1 stop shopping" just doesn't work. I'm not a car going in for major repairs....

denisePA

I ordered a copy of the book yesterday, I use halfdotcom for nearly all my book purchases. My book was 94 cents & marked brand new. Shipping is always set at 3.99 but if you opt to buy a couple more books even from different sellers, you get a discount.

My doc does not deal with the depresssion/anxiety which is NOT debilitating but merely new, but she is aware that if I FEEL better than I don't have anxiety as much. So she trys to make my pill cocktail one in which I am not feeling like sluggo all day long and that IMO is helping. When I feel like ME then the woe is me is on the back burner.

Keeping busy & active helps as well so I grab every minute I can frm a good day, but I have to remember when to say when so I don't get to the point of exhaustion.

Having DCM has taught me that I'm not very nice to myself, I don't give myself enough down time, I don't sit with a good book or put my feet up and take a nap. All the relaxation tapes I own could be utilized more, what about a dedicated 1/2 hour every afternoon, in a dark room, with some cool music & a soft candle or insence. I should waken that inner hippy in me that went to sleep a few years ago..

Have a good day girls.. denise

denisePA

that should be incense (but you knew that)

and yes I still keep a boom box for tapes but I have alot of CD's as well, some with visuals..

martzj

My very first followup visit 4 weeks after extremely fragile status from massive HA, 41, I was still unable to drive, still very ill and still barely hanging on until I was stable enough to go in for LAD stent. (RCA had been stented open during emergency angio....but there were so many problems during the procedure the RCA barely got stented and LAD approach kept putting my heart in more danger. It was decided, after 3 hours on table, to wait for 2nd stent. So, LAD remained almost 99% blocked another 4 weeks and I could barely walk, think. l was desparate for information on what was going on with my heart, my future. When the cardio finally got to me, I told him I had been feeling deeply depressed, like I had an anvil in my chest...and the nausea was ferocious and nonstop so I was gagging, couldn't get food down.

Cardio: "You have nothing to be depressed about and your diet is terrible." End of story. I was scheduled for stent #2 and sent back into full time work force within 6 days, with no diminshment of the above symptoms and extremely fragile, damaged, weak.

13 years later, I haven't experienced any enlightenment in this area from any of my doctors. For the most part, they are a vast body of clueless practioners on the realities of heart attack impact on the whole human body system. As far as I can tell, doctors still view the heart as just another disjointed body part. There doesn't seem to be any real grasp of long term permanent damage or of the consequences of living with a heart that can no 'talk' to all its cells and muscle groups reliably because they have died and been converted to fibrous scar tissue.

shelleylynn

How incredibly stupid and uncaring can people be. When life altering news like this gets dropped on you it perfectly normal and I would think, expected that people fall into some sort of depression and certainly anxiety! Been there! You should have choked her, that is one thing that might have made you feel better!
Hang in there....Shelleylynn

primetimelady

In general people can be ignorant... until it happend to them.

denisePA

I was speaking to an old friend on thursday and she mentioned that she was taking a course for medical records transcribing, she stated they were in the "heart" just that past week and learned that depression can often preceed a cardiac event.

Now imagine that... a medical decoder learning what we had to go through in order to bring light to the topic, yet somewhere, somehow the ball is being dropped in the training of the hands on medical personal. Whether or not they learn it, is questionable, I do not recall this in my training as a nurse, but I do know that with any life altering event, that emotions are super charged and with the heart, I'm nearly postive that the biochemical alterations are responsible for the increased anxiety/depression.
Plus the plain old fact that life as we once knew it is forever changed. The fragile balance between life & death has to make to think or you would not be human for crying out loud.

to all of us adrenaline junkies.. take a break..

denise ;)

Twndd

Denise,

I too have DCM for almost 9 yrs. During this time I have been treated for clinical depression. Gee, I wonder why our whole world is turned upside down with info, tests, new meds to take.

I recently saw my cardiologist cause I am trying to figure out whether to get an ICD or not. His response in the five minutes he saw me was of course you need on cause NOW the insurance companies will pay for one. Not cause I really need one.

My EF started at 10 percent also. Why didn't they suggest the ICD then. Oh gee, the insurance company wouldn't pay for it...

The end comment of my cardiologist was "I am glad I don't have your heart". Now there is compassion for you and he had to move to the next patient cause he sees 70 patients a day!!! Also, lunch was there as the drug salesman was there pushing drugs. Something that drives me nuts!

You will be depressed of course. Your whole life has changed and people can't see your heart so they don't understand what you are really feeling both physically, emotionally or mentally!

Knowledge is power. Keep reading and finding out whatever else destresses you cause that is the major problem with heart disease.

Take care and keep posting when you need to. I needed to myself today. I am having a meltdown day.

Remember one thing it is about YOU not everyone else!! Do what is good for you!!

Keep your chin up. I do have that book also.

Donna

playsmart

Denise, I have had IDCM for over 5 years & was doing well till last spring. In June I had a pacemaker replaced with an ICD.I was told I have CHF with an EF of 25. Now I am depressed, anxious , & angry most of the time. I just started therapy & it does help to talk to someone. That's why I love this site -everyone is so supportive & there is a wealth of information out there. Strange that we have to get our info from the internet rather than from our doctors who are getting paid very well for treating us at times like we are on line at Target. I have asked for help numerous times and was told that as time went by ,I would get back to my old self. I was also told that any drugs for my mental state might interfere with my heart meds. Thanx to some great people on this site, I decided to see a therapist. Now I am going to pick up that book tomorrow.
Hang in there & keep posting. It helps to share with people who are in the same situation, Playsmart

maternalcaregiver

I kinda see this discussion as opposite of me...if that makes sense. I was hospitalized 4 weeks ago with unstable angina..but my cath was "clear"...so the inpatient cardio basically laughed at me..told me I was menopausal and just "stressed" at 41 yo. He even leaned over my bed to shake hands to congratulate me on my "good coronary health". Well needless to say I ALMOST "bought it"..and figured I was just a fruitcake..and I left the hospital with contined CP, nausea, and elevated BP. I saw my regular cardio..who did my stress test in 2008, negative of course..on October 7, and he explained MICROvascular disease..and treated me accordingly. What do you know..I'm not to baseline..but I can at least now walk and talk w/o SOB, and the CP is now intermittent. He said this pretty much diagnosed me with MICROvascualr disease..and all the more need to be aggressive to delay potential future coronary events. I see him for 3RD visit after hospitalization..on 11/4/09..for another F/U and repeat echo. So, yes it is a little depressing to know I'm following in my Dad's footsteps..and I too have CAD. But I know there are things I can do to help myself..and thank goodness I have a cardio who does'nt blow my concerns off. In a sense I was much more depressed when I was told I was "normal" ..and all of these sx. were just "in my head ". ( my cardio could'nt see me inpatient because he changed practices recently and is under a "restrictive covenant". I told him NO HOSPITAL for me...unless he is able to round and participate actively in my care..which will be 10/2010. )
Hope this makes sense !!!

Elizabet

Hi Denise,
I guess I'm getting used to people who are in awe of the fact that depression and heart disease are common companions. Seems weekly I'm talking about this very issue with a cardiologist or patient.

Many are behind on the literature because they either
(1) don't want to know the stats for fear that they won't know what to do with their patient or...

(2) are behind on the literature because they are not interested or slack

Please know that this important information is getting out. here's the study:

Screening for Depression in Patients With Coronary Heart Disease (Data from the Heart and Soul Study)
American Journal of Cardiology, Volume 96, Issue 8, October 2005, pages 1076-1081.

This is the article that revealed the findings and need for an assessment for depression. called the PHQ-9 and PHQ-2.
the "Patient Health Questionnaire" with 9 questions and 2 questions - are 2 screenings for depression in existing patients.

The study does admit that an obvious hurdle is getting busy cardiology practices to administer the assessment) which is usually administered by therapists.

I administer some of these for some of the "in touch practices" but not enough... and I do understand their challenge - I wish more patients like you would keep talking about this issue to your doctor.

I also know of many practices that try hard to get services for their patients, and I've got to say it's a shocker to hear such a comment from someone working in the field.

Just as info: This assessment was developed and funded by the MacArthur Initiative on Depression in Primary Care. It was first introduced in primary care and is now slowly filtering in to cardiology.

http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/p hq9/

You don't need me to tell you that what you feel is very real, i just want you to know that this information IS in front of cardiologists all the time. And and this study was just the one that began pushing the PHQ-9 assessment.

Please take good care,

Lisa
www.lisahollandphd.com

sternum

You ladies have me thinking here:

It has been a month short of 2 years since my first heart attack (Christmas Day 2007) and so much has happened since then. The lovely fast recovery and exercise program I was on. Only to learn a couple of months later that Heart Disease was far from finished with me. (It had only just begun).

One walk up a hill brought out a whole new set of problems. I failed two stress tests before a nasty blockage was found and dealt with. You probably know the routine --- "We'll just do as many by-passes as necessary to clean everything up. You are still relatively young and have a lot of living to do" So just as I was enjoying a steady recovery from the by-pass x 4 all hell broke loose, my world turned upside down and I knew nothing would ever be anywhere close to normal again.

The sternum removal, the antibiotics and pickline, the vaccum cleaner :), a room mate with a superbug which ended up putting me in isolation for 3 weeks and then the muscle flap being done. All that sort of knocked the wind out of my sails. The care team just did't seem to know why I would be somewhat snappy occasionally and blew my top when I found out they were giving me asprin even though I had this huge red bracelet saying "NO ASPRIN" Then to top off the whole thing I was physically incapable of crying. Sobs tore everything apart. Now that ticked me off and I really wanted to let something fly. And again, I couldn't. All I could do was watch the cars come and go in the parking.

Even when I came back to my own town and our hospital, I was still in isolation for another week. Each of my doctors just commented that I had been through hell the last two months and told me what a remarkble woman I was blah blah blah. I just wanted to go home to my own little house and breathe and hug my friends and learn to live again. When I asked my Doc about feeling so blach, he looked at me and said he would be worried if I didn't have a problem with depression. That would mean I was just stuffing it down and getting ready for a stress and angziety related heart attack. So he prescribed something and told me to remember that my life would be a rollercoaster ride from here on in. Acknowledge it, work with it and never deny it was there and never stuff your emotions down. They will come to the surface one way or another. We get to make that choice.

This forum has been invaluable in enabling us to keep our emotions and sanity on an even keel. I am truly grateful for that. If I seem to be a bit warped in some of my descriptions, that is my way of dealing with any given challange. Indeed depression comes in all shapes and sizes, but with heart disease and open heart surgery, come it will. Remember these are just the facts without any emotional overtones. Today is a very good day.

Why can't I say things in 20 words or less. If you slogged through this, thank you. You have done your good deed for the day. ;) :D

Be blest --- Gloria ----

denisePA

Gloria I don't mind reading your posts, never apologize for being "wordy". I tend to be the same way.

Lisa I have sent that information on to my sister who works with depressed folks daily since she has her own practice. It was interesting to me as I bet it will be to her.

Girls,I do believe that some of my mood changes are indeed a biochemical reaction as in the fight & flight type thing that goes on internally when you are confronted with fear or shock, etc.

And then I think the whole deal about life never being as it once was after you are diagnosed with certain heart ailments, not everyone mind you will change forever some will heal and go on with life as my husband did, although I am sure if he were 100% honest he would say he thinks about it now and again. He just does not need to talk about it like I do. And then the final thing that I belive influences my mental status are the meds.

Going back to my original post, I was just in awe of this office nurse who so matter of factly said heart disease does not make you depressed and that NO ONE has ever told her that. I bet others felt her to be cold & unaproachable so maybe she was being truthful and no one did ever speak to her about it, but even that is a shame, she's the frontline for the doctor, this is another reason why I sought another group.

Be well, Denise

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