A team effort – your heart and your mind

15 July 2023

Struggling with your mental health after a heart event is normal. It is not uncommon for people to experience anxiety, depression, and stress – there is even a name for it, the ‘cardiac blues.’  

But did you know it can go the other way too?

People with some mental health conditions may have an increased risk of coronary heart disease. Some reports say that mental health conditions could double the risk of developing a heart condition. In fact, cardiovascular disease is the most common cause of death in people with some mental health conditions.  

With approximately 3 million people in Australia living with depression or anxiety it is a link we need to explore.

What do we mean when we say ‘mental health’?

Mental health is the way we feel, think and act. Mental health is more than just the absence of mental illness.  

Your mental health affects nearly everything in your life – including how you think about your work or study, your relationships with friends and family, and yourself. It is actually really common to have times when your mental health is low. It is estimated that 1 in 2 people experience struggles with their mental health at some point during their life.  

If your symptoms are concerning or prolonged, a doctor may diagnose a mental health condition. The most common of these are anxiety and depression.

Mental health and heart disease – what is the link?

So how are heart disease and mental health conditions linked?

There are a few possible explanations such as changes in our bodies that happen with some mental health conditions (biological changes), changes in the way we act or our choices (lifestyle factors), or some medicines taken to treat mental health conditions.

Biological changes

Depression, anxiety and stress can cause changes over time throughout the body. This can include increased heart rate, raised blood pressure and calcium build up in arteries.

Mental health conditions are often accompanied by increased cortisol levels. Cortisol is an essential hormone your body produces that has many important functions including how your body reacts to stress. Having too much cortisol in your blood over a long period of time can lead to high blood pressure and higher than normal levels of blood glucose. It may also increase levels of cholesterol and triglyceride fats in your blood and cause changes that lead to the build-up of deposits or plaques in your arteries. This build-up can lead to atherosclerosis, a condition which makes it harder for your blood to move through the vessels as they become stiffer and less flexible, narrower or blocked.

Some mental health conditions can also cause over-activation of your autonomic nervous system. This is a system in your body that helps control your body's normal functions, including breathing, digestion and regulating your heart rate and blood pressure.

Some researchers have also reported an increase in platelet reactivity in people living with mental health conditions. Put very simply, this means that their blood may clot more easily. This increased clotting ability can lead to dangerous blood clots that can cause a heart attack or stroke.

Lifestyle factors

Living with a mental health condition may also lead to lifestyle factors that may put people at greater risk of heart problems.

People living with a mental health condition are more likely to smoke and drink alcohol, and are less likely to engage in daily exercise. They are also less likely to visit their doctor for general health checks – such as blood pressure and cholesterol testing.  

These factors are all also important risk factors for developing cardiovascular disease.

Medicines

Some medicines used to treat mental health conditions may also affect heart health. Researchers have found links between some antidepressants and antipsychotic medicines and an increased risk of atrial fibrillation, stroke and heart attacks.

These medicines have also been linked to other serious arrhythmias, which is a change in the rhythm of your heartbeat.

Can I do anything about it?

If you’re concerned about how your mental health may affect your heart health, there are some things you can do to help.

The first thing to do is speak to someone. Your doctor is a great place to start as they can help with your concerns about both your heart health and your mental health.

You can change your habits. Trying to change everything at once is overwhelming though, so change one thing at a time. Start slow and build your way up – a 15 minute walk per day can turn into a 30-minute walk in no time!  

Make sure you keep taking all of your medicines as prescribed by your doctor. If you have concerns about how your medicines are affecting your heart or mental health, speak to your doctor about these concerns.

The steps to taking care of your heart will also help with your mental health – it's a win-win!

Keeping yourself and your body healthy is a team effort!

If you are struggling with your mental health, you can reach out to Beyond Blue or Lifeline. If you’ve had a heart event and are struggling with your mental health, you can contact the Australian Centre for Heart Health.