Let’s have a heart-to-heart about heart health and mental health.
Across Canada, 2.6 million adults aged 20 plus live with a diagnosis of heart disease. This means that heart disease affects a staggering 1 in 12 (1).
Simply put, heart disease is an umbrella term that covers a variety of conditions that impact the structural components of the heart and how it works. Peeking under this umbrella, we see disorders affecting the rhythm of the heart (arrhythmias), flow of blood to the heart (coronary heart disease), ability of the heart to pump blood (heart failure), and more (2;3).
For many of us, when we think of heart disease, our minds quickly jump to the physical challenges that accompany such a diagnosis and must be managed daily. We may bypass what it means for a person’s mental health, which also has implications for quality of life (2). However, the stats put the spotlight back on this issue and why it needs to be discussed. Take for example atrial fibrillation (a type of arrhythmia), coronary heart disease, and heart failure, it’s estimated that nearly 40% of all people diagnosed with these three conditions experience anxiety and depression (2;4-6). That’s almost half! But what can be done for these folks specifically?
A recent systematic review looking at psychological therapies, which aim to help people think, feel, and behave more positively, may have some answers (2).
What the research tells us
From mindfulness to motivational interviewing, psychological therapies within the review were diverse, but cognitive behavioural therapy was the focus of most included studies.
The review found that compared to no psychological therapies, for example just receiving usual medical care, engaging in psychological therapies can hold mental health benefits for people with heart disease.
More specifically, it appears that in people living with heart failure or coronary heart disease, psychological therapies are likely to moderately decrease anxiety and depression. Additionally, they may moderately improve aspects of quality of life related to mental health like thinking or mood. That said, these therapies may have limited or no impact on aspects of quality of life related to physical health like fitness. Unfortunately, at this time, the review is unable to comment on whether people with atrial fibrillation (aka irregular heartbeat) can also benefit, because no eligible studies were found relevant to this population. More research is need in areas where there is a lack of information in the literature and where the evidence is of lower certainty (2).
Just like physical health, mental health should be a priority. People living with heart disease can work with their healthcare team to develop a comprehensive treatment plan that considers their personal concerns, wants, and preferences, as well as the variety of treatment options that aim to tackle them. Psychological therapies of interest, their cost (which can be partially or fully covered by provincial/extended/private insurance plans), and how to access them can be part of this discussion.
