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  • Brittany Montes, Psy. D.

Heart Health and Mental Health

Cardiovascular disease is the number one cause of death for adults in the United States (American Heart Association, 2021). As a result, cardiovascular health has become the primary focus for many medical providers. Culturally, cardiovascular health and disease have become major plot lines in our favorite television shows and movies. We can find new articles about heart disease in our newspapers, magazines, and social media feeds almost daily.

To further advance efforts to improve cardiovascular health across the country, President Lyndon B. Johnson established Heart Health Month in February 1964. As a person who suffered a heart attack himself, President Johnson created Heart Health month in an effort to increase awareness of cardiovascular disease and its potentially deadly impacts (American Heart Association, 2021).

Recently, more and more research has been published regarding the relationship between one’s mental health and one’s cardiovascular health. However, in a culture where mental health remains heavily stigmatized, it can be hard to fully understand that connection.

Depression and Heart Health

The relationship between cardiovascular health and depression is complicated and often overlooked. However, it is absolutely vital that medical and mental health providers, as well as patients, understand the cyclical relationship between the two.

Research has found that individuals who do not have a history of depression often experience a depressive episode after experiencing a heart attack or being diagnosed with heart disease (Ziegelstein, 2023). Generally, cardiac patients are more likely to experience depression than patients in other specialties (Weiss & Molitor, 2011). Conversely, individuals who have historically experienced depression tend to develop cardiovascular disease at higher rates than their non-depressed peers (Ziegelstein, 2023). Specifically, studies suggest that individuals with depression may be as much as 2 times more likely to develop coronary artery disease (Weiss & Molitor, 2011).

Further, individuals who experience clinical depression also experience lower rates of recovery and hold increased odds of dying from cardiac complications (Ziegelstein 2023). This may be the result of attitude changes, mood swings, fear of the future, decreased confidence, apathy, and guilt/shame associated with unhealthy habits that many patients experience in the wake of a heart attack (Ziegelstein, 2023).

To further complicate matters, symptoms of depression and cardiovascular disease often overlap. For example, fatigue, low energy, and poor sleep are symptoms of both depression and cardiovascular disease (Ziegelstein, 2023). This can create fertile ground for misdiagnosis, especially if an individual presents to a mental health provider without also presenting to their medical providers to rule out underlying medical concerns. For my own practice, I always recommend that my patients undergo full physical evaluations to make sure that their emotional symptoms are not the symptoms of medical concerns. Unfortunately, assuming that symptoms are primarily the result of depression could contribute to worsening cardiovascular health over the long term.

Stress, Anxiety, and Mental Health

We’ve all heard the worn-out phrase “you’re going to stress yourself into a heart attack or stroke.” But is there any truth to this remark? Generally, speaking, the answer is yes-stress and heart health are intricately related to one another.

The experience of stress often results in individuals engaging in unhealthy behaviors (I.e. smoking cigarettes, decreased physical activity, overeating, unhealthy dieting, and failure to take medications) which are known to contribute to declining cardiovascular health (American Heart Association, 2021). Furthermore, chronic stress leaves the body in a state of near-constant nervous system activation which leads to elevated blood pressure, rapid breathing, increased heart rate, and decreased circulation (American Heart Association, 2022). These are all known factors that increase one’s risk for heart attack, stroke, and other heart diseases.

Research has also indicated that one’s thoughts, attitudes, and emotions can accelerate the onset of cardiovascular disease (Weiss & Molitor, 2011). It is likely that this is the result of predisposing genetic factors, hormonal changes, and unhealthy coping strategies that can accelerate one’s cardiovascular decline.

How can you manage the mind-body connection?

Generally speaking, happy people tend to have healthier levels of fibrinogen and cortisol, which leaves them less vulnerable to developing cardiovascular disease (Weiss & Molitor, 2011). But how do you improve your emotional functioning so that you can enjoy healthy cardiovascular functioning?

Weiss and Molitor (2011) state that individuals should attempt to reduce their stress whenever possible. Additionally, individuals should identify 1 habit at at time (i.e. starting with exercise) to focus on rather than attempting to change multiple habits simultaneously. Focusing on a single habit at a time increases one’s chances for success, which contributes to better cardiovascular functioning over the long term. Finally (Weiss & Molitor, 2011) recommends that individuals pay close attention to their mental health functioning. Rather than ignore your symptoms, seek mental health care at the first sign of distress.

Similarly, the American Heart Association (2021) recommends that individuals work to increase their social support system to assist in reducing symptoms of anxiety and depression. Further, it is recommended that individuals identify at least 1 stimulating hobby to assist in distracting from stressful environments and reduce chronic stress and anxiety. Finally, the American Heart Association (2021) recommends that everyone practice relaxation strategies such as mindfulness, progressive muscle relaxation, and diaphragmatic breathing.

About the Author

Dr. Montes is a licensed clinical psychologist and co-owner of Cognitive Behavior Therapy Center in Chesapeake, VA.


American Heart Association. (2021, June 21). Stress and heart health. Retrieved February 21, 2023 from

American Heart Association. (2022, November 14). U.S. commemorates 57th consecutive American Heart Month in February. Retrieved February 21, 2023, from

Weiss, S., & Molitor, N. (2011). Heart disease: How to practice prevention. American Psychological Association. Retrieved February 21, 2023, from

Ziegelstein, R. (2023, January 5). Depression and heart disease. Depression and Heart Disease l John Hopkins Medicine. Retrieved February 21, 2023, from

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