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How heart patients can combat post-operative depression

Depressed Man

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For heart patients, post-operative depression can become a most unwelcome complication of heart surgery.

Approximately 20 percent, or one in five, of all heart patients fall victim to depression after undergoing heart surgery.

Unfortunately, a bout of post-operative depression is much more serious than just a bad case of the blues. Post-operative depression in heart patients is linked to prolonged emotional and physical recovery and reduced quality of life.

It’s also associated with post-operative complications and is an indicator of greater risk of future cardiac events or death from a cardiac event.

In addition, depression in post-operative heart patients is linked to cognitive problems such as memory impairment or the ability to think and learn.

However, for post-operative heart patients suffering from depression, there is hope. According to results from a new study, post-operative heart patients may benefit from cognitive-behavioral therapy or CBT and supportive stress management.

Led by Kenneth Freedland, Ph.D., of the Washington University School of Medicine in St. Louis, Missouri, researchers followed 123 post-operative heart patients who experienced some type of depression within one year of heart surgery.

All participants in the study had undergone a coronary artery bypass graft, or CABG, surgery. For the study participants were divided into three groups, each receiving different types of care as follows:

1. Group 1 – Traditional Care

Of the 123 study participants, 40 participants underwent traditional post-operative care supervised by physicians.

2. Group 2 - CBT

A second group of 41 participants received CBT. Cognitive behavior therapy is a common type of therapy used with people suffering from a variety of mental health concerns including depression, anxiety disorders, eating disorders, sleep disorders, phobias, personality disorders, or substance abuse.

It’s also widely used to help people cope with the stress associated with illnesses, grief, or some other type of trauma. The goal of CBT is to help patients respond in a more effective manner to situations which are difficult or challenging.
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It can be very effective in helping persons manage stress levels, such as those which may be experienced by post-operative heart patients. For purposes of this study, participants in the CBT group received 12 weeks of CBT therapy with a 50 to 60 minute session each week with a mental health professional.

3. Group 3 – Supportive Stress Management:

The remaining 42 study participants received supportive stress management assistance. As with the CBT group, this group underwent 12 weeks of therapy with a mental health professional. The goal of these sessions was to help the participant improve their ability to cope with stressful situations.

Participants’ depression levels were assessed at the beginning of the study and again at months three, six and nine. Researchers found that participants who received CBT or supportive stress management experienced greater remission rates from their depression as compared to patients who only received traditional post-operative care.

Participants in the CBT group fared the best with 71 percent reporting remission from their depression after only three months. By the ninth month, 75 percent of all CBT participants reported remission from depression. Likewise, the stress management group also experienced remission from their depression, with 57 percent reporting remission at month three.

These numbers are a sharp contrast to those participants who received traditional post-operative care. Participants who did not receive CBT or supportive stress management only reported a 35 percent remission from depression by the ninth month.

Not only is post-operative depression linked to a poorer outcome, depression can interfere with every aspect of a person’s life. The results for participants receiving CBT and stress management were significant compared to those receiving only traditional care.

While not every heart patient experiences post-operative depression for those who do, CBT or supportive stress management may well make a difference in the quality of life.