Depression and CHD/CVD: A Surprising Balance
Depression and CVD are both common mental and physical illnesses. However, the degree to which these two conditions are interconnected is surprising, like two sides of a coin. Therefore, according to my research, if you have CVD, depression is often not far behind. However, this does not mean that one should use one’s CVD as an excuse for their depression; instead, in my opinion, recognizing this connection allows one to understand both conditions more deeply. This way, while being prepared for the potential of depression following a CVD diagnosis may not ultimately help one entirely avoid it, they can, however, can avoid blaming themselves for it, as that only digs the hole deeper. In this article, I focus on the surprisingly deep connection between CHD/CVD and depression and how it should be monitored throughout one’s lifetime.
Depression, according to the article, Depressive Disorder (Depression) by WHO, “is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods” (World Health Organization, 2023). Also, 264 million people worldwide suffer from depression, which ultimately represents about 3.8% of the global population (World Health Organization, 2023).” Therefore, as it is so common, socially, depression can impact one’s behavior and daily life in a similar way to CVD because “depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends, and community. It can result from or lead to problems at school and at work” (World Health Organization, 2023). However, while my research focuses on CVD, it is essential to remember that “depression can happen to anyone. People who have lived through abuse, severe losses, or other stressful events are more likely to develop depression” (World Health Organization, 2023). But what about the number of people who experience it with CVD? Is there a connection?
CVD, according to the British Health Foundation’s article, Global Heart & Circulatory Diseases Factsheet, “around 640 million people are living with heart and circulatory diseases across the world – this number has been rising due to changing lifestyles, an ageing and growing global population, and improved survival rates from heart attacks and strokes – and will continue to rise if these trends continue” (British Heart Foundation, 2025). Therefore, CVD is more common than depression, but further research indicates that these two are related, and the threat of getting CVD and experiencing depression increases as time goes by.
People with CHD (congenital cardiovascular disease) also experience depression and anxiety even in childhood. The article, About Congenital Heart Defects by the CDC states that “congenital heart defects affect how blood flows through the heart and out to the rest of the body. Congenital means they are present at birth. Heart defects can vary from mild (a small hole in the heart) to severe (missing parts of the heart)” (CDC, 2024). Even children with CHD experience these symptoms.
The article, Mental Health Disorders in Children With Congenital Heart Disease, discusses how “All youth with CHD had significantly higher odds of anxiety and/or depression or ADHD. Children aged 4 to 9 years with simple CHD had ∼5 times higher odds (odds ratio: 5.23; 95% confidence interval: 3.87-7.07) and those with complex single ventricle CHD had ∼7 times higher odds (odds ratio: 7.46; 95% confidence interval: 3.70-15.07) of diagnosis or treatment for anxiety and/or depression. Minority and uninsured youth were significantly less likely to be diagnosed or treated for anxiety and/or depression or ADHD, regardless of disease severity” (Gonzalez et al., 2021). Therefore, in conclusion, the article states that, “youth with CHD of all severities have significantly higher odds of anxiety and/or depression and ADHD compared to those without CHD. Screening for these conditions should be considered in all patients with CHD” (Gonzalez et al., 2021). However, this trend is not limited to childhood and is often experienced by those who survive into adulthood.
As adults, according to the article, Anxiety and Depression in Adults With Congenital Heart Disease, “Adults with congenital heart disease (CHD) are more vulnerable to psychological distress compared to healthy peers, which is understandable given additional challenges faced across the lifespan. Although depression has received prominent focus in the field of cardiology, elevated anxiety symptoms also warrant attention. Within the general global population, the prevalence of anxiety disorders is slightly higher than that of depressive disorders” (Kovacs et al., 2024). Therefore, if one has depression and CHD, it can follow one throughout life. This is why the article, People Born With Heart Defects Need Lifetime Mental Health Care, Report Says highlights how “the scientific statement from the American Heart Association – an analysis of the most current research – is ‘an urgent call to action’ to integrate medical and psychological care for people born with heart defects and the first to summarize the psychological and social challenges they face.’ This is because ‘It's completely understandable to have a psychological reaction to living with a congenital heart defect,’ Adrienne H. Kovacs, chair of the group that wrote the statement, said in a news release. Kovacs is a clinical psychologist who specializes in working with people who have CHD. The condition presents numerous challenges throughout the lifespan and may include unexpected news – such as a person realizing they can no longer physically manage the demands of their job, or learning that there are significant risks to pregnancy. Many have tremendous resilience in the face of such challenges, she said, but "at the same time, we want to normalize psychological reactions and increase the prevalence of care for psychological well-being to help people with CHD experience a full and healthy life” (American Heart Association News, 2022). As one can see, there is a deep connection between depression and CHD, which has only been recognized in recent years. Hopefully, more awareness will lead to less self-guilt over not only one but both illnesses that go so deeply hand in hand.
In my personal experience, growing up, I was an undeniably anxious child, and I admit that I still am as an adult. But when I was sad or when the bleakness of my situation ever got the best of me, I was taught to distract myself until it went away. This could be via video games, drawing, reading, or any other activity, as long as those feelings were avoided. This retained the comfort of those around me and kept me from falling into the endless pit of depression at an earlier age. Although at the time, growing up with CVD, it was treated as if I were the problem, and depression was my duty to cover up for the sake of preserving my environment. However, looking back at it all, I see that the depression was always there, like a wolf looking over my shoulder, and I was confusing myself by distracting myself from it rather than facing it. Because, perhaps, like the CVD, if one looked directly at it, they would only see the darkness and be swallowed by it. Maybe this is true. But, since CVD and I are stuck in it for the long run, and so too is the threat of depression, especially as I grow older, it is more likely than not that I should figure out a better way to manage it by coming to understand it, and, by doing so, come to some sort of peace with the situation.
Perhaps this could help others, too?
In this case, it should be remembered that people with CHD, or broader CVD, often experience heightened stress thanks to painful memories, treatments, and surgeries. Ironically, the symptoms of depression frequently coincide with those of CVD without depression, so it can be difficult to distinguish one from the other. These can include: exhaustion, lethargy, confusion, breathlessness, and slow movement, among others. So, how does one know where one begins and the other ends?
Short answer, without a professional opinion, it is very difficult, if not impossible, to do so. I am not a medical professional, but I, personally, would recommend going to the doctor if you feel like your heart is in trouble. Then they can suggest ways to manage the symptoms because oftentimes fixing the cardiac problem alleviates or lightens depression and vice versa.
However, sometimes it is not so simple. For example, two years ago, I lost three of the main things I hung onto, which kept me from falling into a pit of depression because they gave me hope. While someday I will discuss the first two, the last one, my angel, Milo, my cat I adopted when I worked in China, passed away while I was on vacation from, ironically, a congenital heart condition. In China, I was treated horribly by my work and in public, so Milo was my only little light at the time. Losing him so soon truly broke my heart. Furthermore, all of these things happened within a few months. Without them focusing on avoiding depression, I fell into the depths of it and am still trying to pull myself out. Granted, it didn’t help that these three lights in my life were ended directly because of my CVD and the illness in general.
At least, as a result of all of this, I finally got the hint to begin writing this blog and writing stories about illness to increase awareness.
So, in this case, as one can see, CHD and depression, or the potential of it, are linked throughout their life, and given that CHD is a type of CVD, CVD and depression are also linked. I wrote an earlier article about CVD and depression and intend to delve into it more deeply at another time. However, I should point out that the fact that depression is linked to CVD does not mean one should give up and let it win by using this extra layer of difficulty as an excuse. Instead, my next article will dive into tips on how to manage depression if you have CVD.
Stay tuned for Wednesday!
Keep ticking, everyone!
Reference list
American Heart Association News (2022). People Born With Heart Defects Need Lifetime Mental Health Care, Report Says. [online] www.heart.org. Available at: https://www.heart.org/en/news/2022/07/14/people-born-with-heart-defects-need-lifetime-mental-health-care-report-says.
British Heart Foundation (2025). Global Heart & Circulatory Diseases Factsheet. [online] Available at: https://www.bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-global-factsheet.pdf.
CDC (2024). About Congenital Heart Defects. [online] Congenital Heart Defects (CHDs). Available at: https://www.cdc.gov/heart-defects/about/index.html.
Civieri, G., Shady Abohashem, Grewal, S.S., Wesam Aldosoky, Qamar, I., Hanlon, E., Choi, K.W., Shin, L.M., Rosovsky, R.P., Sandeep Chandra Bollepalli, Lau, H.C., Antonis Armoundas, Seligowski, A.V., Turgeon, S.M., Pitman, R.K., Tona, F., Wasfy, J.H., Smoller, J.W., Sabino Iliceto and Goldstein, J. (2024). Anxiety and Depression Associated With Increased Cardiovascular Disease Risk Through Accelerated Development of Risk Factors. JACC Advances, 3(9), pp.101208–101208. doi:https://doi.org/10.1016/j.jacadv.2024.101208.
Gonzalez, V.J., Kimbro, R.T., Cutitta, K.E., Shabosky, J.C., Bilal, M.F., Penny, D.J. and Lopez, K.N. (2021). Mental Health Disorders in Children With Congenital Heart Disease. Pediatrics, [online] 147(2), p.e20201693. doi:https://doi.org/10.1542/peds.2020-1693.
Kovacs, A.H., Koen Luyckx, Thomet, C., Budts, W., Enomoto, J., Sluman, M.A., Lu, C.-W., Jackson, J.L., Khairy, P., Cook, S.C., Shanthi Chidambarathanu, Alday, L., Mette-Elise Estensen, Mikael Dellborg, Berghammer, M., Johansson, B., Mackie, A.S., Menahem, S., Caruana, M. and Gruschen Veldtman (2024). Anxiety and Depression in Adults With Congenital Heart Disease. Journal of the American College of Cardiology, 83(3), pp.430–441. doi:https://doi.org/10.1016/j.jacc.2023.10.043.
World Health Organization (2023). Depressive Disorder (Depression). [online] World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/depression.
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