Depression may be a normal response to a heart attack, but don't "tough it out" or you could slow recovery.

A heart attack is no laughing matter, so it's not unusual for depression to set in after surviving one. In fact, according to the American Academy of Family Physicians, feeling depressed after a heart attack is common. After all, you've had a shattering experience. Add to that time spent in the hospital, weeks of recovery and the stress of having to make lifestyle changes, and it can all be overwhelming.

"A heart attack itself can trigger depression," says Dr. David Smith, FACC, Central Bucks Specialists. "It shows how our minds and bodies are intimately linked." Dr. Smith's interest in depression stems from his desire to improve outcomes among his patients. "As doctors, we want to do all we can to help patients recover. If we miss the signs of depression, we haven't covered every base."

Left untreated, depression can make recovery even harder. It can even increase the risk of a second attack because patients may not stick with their rehab program or follow through with lifestyle changes necessary to recover fully.

"Depression can double the risk of a heart attack, even in people without a cardiac history," warns Dr. Smith. Don't feel like you have to tough it out - get treatment.

Current treatments such as medication, psychotherapy or changes in lifestyle can be very effective. Eighty to ninety percent of patients who are treated for depression recover. Dr. Smith stresses the importance of exercise for energy, regaining a sense of control, and losing extra weight and keeping it off. Exercise can also lower blood pressure and reduce cholesterol levels.

The Cardiac Rehab Program at Doylestown Hospital can help recovering heart patients stay connected and on track to recovery. It offers close supervision from an expert team of certified exercise physiologists, registered dieticians and registered nurses who specialize in cardiac care.

"Patience is key," says Dr. Smith. "Improvement in mood can take weeks and may be subtle at first. The important thing is to stick with any treatments prescribed and not to give up."