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About 30 per cent of patients recovering from a heart attack suffer from depression that may benefit from treatment. Women, people who have been depressed before, and people who feel alone and without social or emotional support are at a higher risk for feeling depressed after a heart attack.
The American College of Preventive Medicine recently reported on the favourable results of their integrated approach to treating patients with depression following heart attacks. The researchers combined standard medical treatment for depression with yoga, exercises, stress management and nutritional counselling. The result was a ‘surprising’ improvement in the depression levels of patients treated with such wholesome measures.
Luckily, Indian culture traditionally placed a great emphasis on family and emotional support from friends and relatives and it would not be surprising if the post-heart attack depression levels in the Indian population were lower than in western societies. But, the recent improvement in the economy and the resultant incorporation of western values brings in independence and emotional estrangement. While there are tangible benefits from adoption of such attitudes, there are remarkable negatives too.
The current emphasis and necessity for nuclear families, reduces the emotional safety net that was present in our traditional society. The result is the impaired ability of individuals to deal with adversities in life. Heart attack is an adversity that can be daunting to some individuals and result is serious depression. Most patients who suffer from depression after heart attack recover quickly. It is only a minority that goes on to develop serious depression needing specific medical treatment.
What are the signs of depression?
Depression is a medical illness, like diabetes or high blood pressure. The symptoms of depression can include the following:
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Feeling sad or crying often (depressed mood)
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Losing interest in daily activities that used to be fun
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Changes in appetite and weight
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Sleeping too much or having trouble sleeping
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Feeling agitated, cranky or sluggish
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Loss of energy
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Feeling very guilty or worthless
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Problems with concentrating or making decisions
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Thoughts of death or suicide
The above symptoms can last for varying lengths of time. In many patients, these symptoms resolve in one week or two weeks and in a vast majority by three months. In a minority of patients with depression, the symptoms may last more than three months and such patients may require specific and comprehensive treatment for the condition.
Patients with depression and their families need to recognise the need to identify and seek treatment early for depression. Depression is the result of chemical imbalance in the brain that takes away the mental tools required to handle adversity. There is no need to feel stigmatised with a diagnosis of depression and treatment can cure the condition in 80 to 90 per cent of patients.
Depression not only follows heart attacks, but also heart bypass operations. Provision of adequate emotional support to the patient and help from friends and relatives to restore the patient and family to their normal lives as quickly as possible is an effective way to reduce chances of serious depression. Meditation techniques, enrollment in a cardiac rehabilitation program, involving the mind in favorite activities or hobbies could all help in reducing the chance of serious depression.
It is, therefore, important to not let any notion of stigma prevent a person suffering from depression get the necessary help. More education of the public health consumer is the need of the hour to enable easier and timely access to such care.
Dr G Balachander
Cardiologist
Illinois, USA
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