Many women are worried about a link between stress and heart disease. Stress is known to contribute to heart problems and the risk of death. Emotional upset, especially anger, is the “trigger” reported most often for a heart attack. People with more stress and worries also have more problems after a heart attack.

Depression is another risk factor for heart disese. In fact, women who are depressed are twice as likely to develop heart disease than those who are not. Depression is common in both women and men after a heart attack.

• What is stress?
• How does stress affect my heart?
• How can I manage my stress or depression?
• How do I know if I have stress or depression?

What is stress?

Stress refers to the body’s response to change. Not all stress is bad. The most important thing is to manage stress properly. People often feel stress in response to job troubles, arguments with family or friends or social isolation. All people feel stress sometimes but people react to stress in different ways. For example, some people might feel a lot of stress when driving, while others might find driving relaxing.
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How does stress affect my heart?

Stress can have several effects on your body. When you are under stress, your muscles tense, your blood pressure rises, and your heart beats faster. This makes your heart work harder. There is a link between developing heart disease and the factors that often cause stress. No one knows if stress directly causes heart disease but stress can change chemicals in your body that contribute to heart disease. Stress may contribute to high blood pressure, high cholesterol, smoking, overeating, and lack of exercise, which can lead to heart disease

Stress is a greater concern for people who already have heart disease. People with heart disease may experience chest pain when they are under stress. Also, if you have clogged arteries, your heart may not get the extra blood it needs during stress. This may lead to inadequate oxygen levels in your heart.

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How can I manage my stress or depression?

Good health habits can have a protective effect against stress and depression. Regular physical activity relieves stress and depression and lowers the chance of heart disease.

Taking part in a stress management program may decrease the chance of more heart problems for those who have heart disease. By attending stress management programs, you can come up with new ways of facing everyday challenges.

Some ways you can lower your stress include:

• Taking a deep breath—this helps your muscles relax.
• Closing your eyes and resting
• Thinking of relaxing things
• Exercising or taking a walk
• Eating right—limit foods with fat, sugar and salt
• Talking to a friend about your troubles
• Changing the things that cause you to stress
• Focus on the good things in your life!

If you find yourself feeling down or "blue" for a long time, talk with your doctor about how to get help. Keep in mind that help from family, friends, and other heart patients can help. Exercise is a great way to help you reduce depression as well as stress. Check with your doctor before taking any over-the-counter remedies.

Ask your health care team or doctor for addtional suggestions about how to manage your stress or depression.
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How do I know if I have stress or depression?

Signs of stress and depression are very similar and may include:

Stress	Depression
Change in sleeping patterns, such as inability to sleep or a need to sleep too much	Inability to sleep, early-morning waking or oversleeping
Mood swings	Persistent sad, anxious or “empty” mood
Feeling angry, afraid, nervous or helpless	Feelings of hopelessness, pessimism
Crying frequently	Feelings of guilt, worthlessness, helplessness
Lack of energy	Decreased energy, fatigue
Unusual eating patterns, such as eating too much or a loss of appetite	Appetite and/or weight changes
	Loss of interest or pleasure in hobbies and activities
	Difficulty concentrating
	Restlessness, irritability

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