What's the Link Between Afib and Depression?

Having a heart condition that can make you dizzy, short of breath, and more likely to have a stroke, sets the stage for anxiety and depression to develop. That's the case with atrial fibrillation, or afib, as it's also known. But the link between afib and depression may go the other way, too, according to new research.

Findings from a new study presented in March 2018 at the American Heart Association scientific meeting show that people with symptoms of depression have a higher risk of developing afib.

In the study, led by Parveen Garg, MD, assistant professor of clinical medicine at the Keck School of Medicine of the University of Southern California in Los Angeles, people who scored highest on a clinical screening test for depression and were taking antidepressant medication had more than a 30 percent higher risk for developing afib than people with normal test scores and people who were not taking medications for depression.

While afib has been associated with other mental health disorders like anxiety and stress, this is one of the first studies to explore the specific link between depression and afib.

“We know that afib accounts for nearly 15 percent of all U.S. strokes, and annual costs for afib treatment alone exceed $6 billion,” says Dr. Garg. “Considering 20 percent of adults report prevalent depressive symptoms in representative U.S. data samples, it will be important to confirm in future studies if this large population of people with depressive symptoms is at increased risk for afib.”

RELATED: 10 Ways to Reduce Stress With Afib

Take Care of Your Mental Health for Overall Well-Being

Whether depression or afib comes first remains unclear, notes John Day, MD, a cardiologist specializing in the treatment of afib at the Intermountain Medical Center Heart Institute in Salt Lake City. “At this point, researches can’t say which one causes the other — only that there appears to be an association,” says Dr. Day.

Research supports this statement. A study published in October 2018 in Experimental Gerontology found that older adults ages 65 to 104 with a self-reported history of afib had more than a 40 percent increase of suspected depression. In this study, conducted in Poland, the association between depression and afib was stronger than the associations between depression and heart failure, diabetes or coronary heart disease.

Day stresses the importance of doctors identifying and treating people who have depression. By doing so, health care professionals can help improve a person’s mental health and well-being, while at the same time lowering their risk of developing afib and other heart-related conditions.

“Oftentimes, when your heart is out of rhythm, there may be something in your life that is also out of rhythm or amiss,” says Day. “It’s all linked — your emotions, relationships, and what you think about,” noting that nonmedication options like yoga and exercise may also help people deal with stress, anxiety, and depression.

When to Get Help

Depression is a common yet serious mood disorder that affects how you feel, think, and handle daily activities like working. To be diagnosed with depression, symptoms must be present for at least two weeks. According to the National Institute of Mental Health, in 2016, an estimated 16.2 million adults in the United States had at least one major depressive episode over the past year. That number represented 6.7 percent of all U.S. adults.

Dealing with depression can be challenging, but the good news is that there are many people who can help. Some primary care doctors use mental health screening tools to identify potential mental health problems. Primary care doctors can prescribe medications for conditions like depression and anxiety. However, depending on your problem, they may refer you to another member of the mental health team for specific medications or other forms of therapy.

A psychiatrist is a medical doctor who specializes in diagnosing, treating, and preventing mental health and emotional problems. Psychiatrists can prescribe medication and often see people with serious mental illnesses such as major depression or post-traumatic stress disorder (PTSD). You usually need a referral from your primary care doctor to see a psychiatrist.

Psychologists can provide different types of psychotherapy or “talk therapy.” Licensed social workers can also provide talk therapy and are often covered by health insurance plans. Because licensed social workers are generally less expensive than clinical psychologists and trained to work with a variety of clients, they are sometimes the preferred mental health provider within health insurance plans.

The many ways to treat depression include:

  • Increasing physical activity
  • Mind-body practices like yoga
  • Medication
  • Psychotherapy

Notably, some of these same strategies can also help you deal with afib.

Afib is the most common type of arrhythmia and is caused by a disorder in the heart's electrical system. An arrhythmia is a problem with the speed or rhythm of the heartbeat. Doctors diagnose afib by using family and medical history, a physical exam, and a test called an electrocardiogram (EKG), which looks at the electrical waves your heart makes. Treatments for afib include medications, procedures like a catheter ablation, and lifestyle changes.

If you’re concerned that you may have afib or are experiencing an irregular heartbeat, make an appointment with your primary care provider. You will likely be referred to a cardiologist for a comprehensive exam. From there, you and your health care team can develop a plan of action that’s right for you.

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