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But when the corporal scales of mind and body are unfavourable tipped, depression may result. Statistics cited in Time Magazine, February 2003 state that once you have a heart attack your risk of dying from cardiovascular disease is four to six times greater if you also happen to suffer from depression. Heart disease also worsens if it occurs alongside depression. Research conducted has shown that depression is linked to an increased tendency of the platelets to aggregate and this thus produces obstructions in the arteries.

Furthermore depression is often associated with increases in steroidal hormones, which elevate blood pressure, and damages cells in the arteries. Acute stress is also a precipitating factor in bringing about a heart attack, since high levels of stress hormones are signalling a "fight or flight" reaction - the body's metabolism is diverted away from the type of tissue repair needed in heart disease.

Often untreated
Depression often goes unrecognised and by consequence untreated. The symptoms of depression may also overlap with those of heart disease and it may make it harder to take medications needed to carry out the treatment for heart disease.

What must be noted, nevertheless is that individuals who have strong social support structures tend to keep their heart rate and blood pressure low and thus maintain better health, perhaps also as a consequence of more positive attitudes. Furthermore the mediating influence of such systems need not only take the form of friends and family, help and advice is also readily available via support organisations.

Often obtaining valuable information about depression and related illnesses already forms a substantial part of the healing process, since one can begin to investigate the foundations of their problems, whether medical or psychological in nature or more often than not, both.

Talk therapy
Ongoing research is investigating whether psychotherapy or talk therapy used in the management of depression also reduces the risk of a heart attack. When in doubt it is always best to adopt a holistic approach. Treatment of depression in the context of heart disease should be managed by a mental health professional that is in close contact with the practitioner providing the heart disease treatment.

Considering that factors directly related to heart attacks are the most common causes of emotional distress, aspects of the patient’s mental state often affect mortality. Dr David Jankelow, a Johannesburg cardiologist himself admits that busy clinicians spend more time focusing exclusively on the medical and physical aspects, thus resulting in subtle psychological aspects being overlooked.

He goes on to say that mood has a startling effect on the prognosis after a myocardial infarction. Thus the patient who is even mildly depressed is at a higher risk of complications in the months after the event. He therefore advocates that patients suffering with post-myocardial infarction depression should be identified early so that they can be monitored more closely and encouraged to follow treatment recommendations.

Diet and exercise
It is evident that rehabilitation and intervention programmes are beneficial in the long run, so as to facilitate the new demands of one's life and health. Aspects such as diet and exercise are both linked to the control of heart disease and depression.

Those more spiritually inclined say that the heart is the centre of the soul and one's being, so take heart and at all times be aware of the interconnection between your mind, emotions and body to prevent unnecessary heart ache.

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