Having both depression and heart failure can worsen the symptoms of both conditions. Managing mental health conditions with therapy, medications, and lifestyle changes may improve outcomes in people with heart failure.

People who live with chronic conditions also frequently experience mental health conditions. Among people with heart failure, depression and anxiety are common.

The conditions share some symptoms and underlying mechanisms. The association can also be bidirectional, with depression contributing to heart failure and vice versa.

Managing mental health conditions like anxiety and depression may help improve not only mental health, but overall health outcomes in people with heart failure.

Living with chronic conditions can sometimes impact the mental health of people, their families, and their caregivers. For example, heart failure can be linked with depression.

Several studies have shown that a significant portion of people with heart failure also live with depression, with estimates ranging from 9% to 60%, depending on the study.

Depression and heart failure may also share some risk factors and physiological mechanisms, including inflammation, heartbeat irregularities, and functioning of the neuroendocrine system.

This means that many of the same biological changes at work that lead to heart failure may also occur with depression.

Experts believe that people with depression could be more likely to develop chronic conditions, including heart disease.

Similarly, living with a chronic condition like heart disease can increase the risk of depression. People who have both conditions are more likely to have more severe symptoms of both.

Heart failure can also coexist with anxiety. A 2018 research review suggests that depression and anxiety disorders, including generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and panic disorder, are the most common mental health conditions among people living with heart failure.

Some research shows that mental health conditions may lead to a less favorable outlook for people with heart failure.

Specifically, depression and anxiety in people with heart failure are associated with:

  • a lower likelihood of following treatment
  • worsened functioning
  • an increase in the number of hospitalizations
  • a higher risk of mortality

Many of the behavioral attributes of depression may also lead to worsening heart failure symptoms.

For example, depression can cause fatigue, problems with concentration, and a lack of motivation. These symptoms can make it hard to follow lifestyle recommendations like eating a balanced diet and getting regular physical activity.

They may also lead to increased use of alcohol and tobacco.

These all can contribute to the main risk factors for heart failure, specifically atherosclerosis, coronary artery disease, and obesity.

The relationship goes both ways, however. Heart failure symptoms like fatigue, weakness, and shortness of breath may also contribute to depression.

Therefore, there may be a cycle where each condition makes the other worse.

Some organizations recommend depression screening for all adults with cardiovascular disease. If you have a condition like heart failure, you could consider asking your doctor about screening for depression.

Among the symptoms of depression are:

  • a sad or empty mood
  • a feeling of hopelessness
  • loss of interest in pleasurable activities
  • fatigue or lack of energy
  • problems sleeping
  • changes in appetite

There are other symptoms, and you don’t need to have them all to get a formal diagnosis.

If you have symptoms that you think may be related to depression, you can discuss your experiences with a healthcare professional, such as a family doctor or psychiatrist.

Some studies suggest that treating depression may help improve the quality of life and outcomes in people with heart failure.

For example, a 2017 review of studies found that cognitive behavioral therapy (CBT), a type of talk therapy, improved quality of life and depression scores initially after sessions and 3 months afterward.

A large cohort study published in 2024 also found that, with mental health treatment, people with coronary artery disease or heart failure who also lived with anxiety or depression were much less likely to:

  • experience rehospitalization
  • visit the emergency department
  • die from any cause

Some ways to manage mental health while living with heart failure include:

  • Speak with others: Sharing your feelings in a support group for people with depression may help you manage the condition. You might also want to express your feelings to loved ones so they can offer support.
  • Participate in talk therapy: CBT is a one-on-one form of talk therapy. It can help you reframe ways of talking and thinking that improve your mental health and offer strategies to improve your quality of life.
  • Increase physical activity: Physical activity can help reduce stress and anxiety. It may also improve self-esteem and offer a break from negative thoughts.
  • Consider medications: If you need additional support, your doctor may recommend antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are one option that appear to be safe for people living with heart failure.

Caring for your mental health can help improve your quality of life while you’re managing a chronic condition like heart failure. Given the links between the two conditions, treating depression may also improve health outcomes in people with heart failure.

Mental health and chronic illness are closely linked. People living with heart failure are more likely to experience depression or anxiety, and these mental health conditions may worsen physical health.

Treating mental health conditions like depression with lifestyle changes, talk therapy, or medications may contribute to better overall health outcomes.

Remember, you aren’t alone. Consider reaching out to a healthcare professional or a close friend if you need support.