For years, doctors thought the connection between mental health and heart health was strictly behavioral – such as the person who is feeling down seeking relief from smoking, drinking or eating fatty foods.

That thinking has started to change. Research shows there could be physiological connections, too. The biological and chemical factors that trigger mental health issues also could influence heart disease.

“The head-heart connection should be on everyone’s radar,” said Barry Jacobs, Psy.D., a clinical psychologist and director of Behavioral Sciences at the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa. “It’s not just being unhappy. It’s having biochemical changes that predispose people to have other health problems, including heart problems.”

Depression and Other Issues

Many forms of mental health issues can affect heart disease. There’s the temporary state of depression or a more severe, clinical case. You can also have varying levels of anxiety and stress, just to name a few of the most well-known problems.

Research does not firmly link stress and heart disease, but there’s a growing belief that it’s an additional risk factor, and maybe even more dangerous than some others, said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women's Health at NYU’s Langone Medical Center.

“Stress can increase hormones like adrenaline and cortisol, and can impact your blood pressure and heart rate,” she said.

Heart, Stroke Patients Must Be Wary

Having heart disease or stroke can cause anxiety or depression. It is important to handle these in a healthy way.”

“It’s not just that they want to smoke and eat,” Dr. Jacobs said. “They don’t have the energy to get out of bed and go to rehab and do the things they need to regain their physical health.”

It makes sense that someone might think, “I just had a heart attack, I should be depressed.” But minimizing their sadness, and dismissing it, could start them down a slippery slope.”

What should be done?

Start by discussing how you are feeling, both physically and mentally, with your healthcare provider. He or she will be able to help, or refer you to the most appropriate care or provide the best place to start.

You should monitor yourself and your loved ones, especially those dealing with heart disease or stroke.

“Doctors are going to say, `Are you still smoking? How are you doing with your diet? Are you checking your blood pressure? How’s your mood been? Are you enjoying the same things that used to give you enjoyment?’