Mental health was a big topic of conversation at AHA21, a fitting topic when pandemic related stress, clinician burn out, and depression seem to be at an all-time high. As a graduate student myself, I was interested in attending sessions that touched on depression, wellness, and work-life balance topics. A Health and Tech panel session titled, “Mental Health and Cardiovascular Disease,” addressed how depression and languishing mental health can heighten the risk of cardiovascular diseases and cardiovascular events. This is because chronic stress activates our sympathetic nervous system and promotes changes in heart rate, blood pressure, and stress hormone levels. While there is a diverse array of known factors that influence depression, clinicians are now taking on the challenging task to measure how mental health contributes and modulates cardiovascular health outcomes.
Clinicians often connect patients with resources and educate patients about chronic disease self-management. However, when patients are coping with chronic physical conditions, mental health conditions can go unrecognized and may further impact health outcomes. As stated in the panel conversation, an astonishing 22% of people with heart disease struggle with depression as well. Properly identifying patients with depression is particularly important as mental health challenges that accompany traumatic health crises can interfere with cardiovascular disease treatments, often managed with lifestyle changes and adherence to strict medication regiments. Clinicians who are willing to attain mental health training to recognize mental health symptoms may provide more useful resources to patients. For example, routine mental health screening during visits were discussed to be a powerful tool that can help clinicians assess depression and anxiety symptoms and facilitate patients getting comprehensive assessment and specific resources that may improve overall health outcomes.
Digital solutions may also be effective tools for managing mental health and heart-healthy behaviors in the future. There is biotechnology in the works that may help patients track physiological reactions to daily stressful experiences, and individual step count and heart rate variability data may one day help clinicians make better informed decisions. One digital intervention program in the works in the works is Happify Heart and Mind, tailored to address lifestyle changes that would benefit individuals with heart disease risk factors. Clinical trial data presented at this session showed that depression, anxiety, and overall wellbeing was improved in patients who used Happify compared to traditional psychoeducation. The take-away question to walk away with after this session is to reflect on who would benefit the most from digital solutions. While scientists can leverage technology to touch on the complex relationship between mental health and cardiovascular health, these solutions need to be adapted to cross the digital literacy divide. Patients who face social inequities would stand to benefit most from personalized and adaptable comprehensive interventions, and clinicians can help connect the most underserved patients with digital resources and support programs.
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Jessica Monterrosa is a PhD Candidate in Environmental Health at the University of California, Irvine studying the effects of air pollutants on the innate immune system. In her free time, she volunteers as a content creator and infrastructure manager with the science communication organization The Biota Project. https://www.thebiotaproject.org/. Twitter: @MacrophageJess