Is there a connection between heart health and mental health?
According to Mass General Brigham investigator Christopher Celano, MD, the answer is yes, and the link is stronger than many people realize.
The term “heart disease” refers to a range of conditions, including coronary artery disease, heart attack, stroke, and heart failure, that affect millions of people each year and remains the leading cause of death in the United States.
Celano's research focuses on developing and implementing interventions that promote well-being and support healthy behavior change in patients with heart conditions.
He has served as a principal or co-investigator on multiple research projects studying health behavior promotion and collaborative care models to better identify and treat depression and anxiety in people with heart disease.
Learn more about his work in the Q&A below.
Q: What’s one thing most people misunderstand about heart disease?
A: One thing many people don’t realize is how strong the relationship between the heart and the brain is.
Over the past few decades, there has been a lot of research demonstrating that how we are feeling mentally, both positively and negatively, can affect how our hearts function and the likelihood of developing heart disease in the future.
Christopher Celano, MD
Depression increases the risk of developing heart disease, and for individuals with heart disease already, depression increases the risk of having another heart problem in the future.
As a result of this, the American Heart Association identifies depression as a risk factor for poor cardiovascular health outcomes following an acute cardiac event, such as a heart attack.
Though that can sound scary, the good news is that we have many safe and effective treatments for depression.
Additionally, some studies have found that treating depression appropriately (with either medications or therapy) actually eliminates the increased risk of poor outcomes that depression causes.
So, depression treatment can improve both your mental health and your heart health!
Q: If you could bust one heart-health myth, what would it be?
A: I would probably bust this myth: “I don’t have heart problems, so I don’t need to do anything to take care of my heart.”
While it is good to engage in healthy behaviors such as physical activity, having a healthy diet, or taking medications regularly, when you have been diagnosed with heart disease, it is even better to develop healthy habits before you develop heart disease.
This can help you strengthen your heart while it is very healthy and can reduce your risk of developing heart problems in the future.
Q: How does your research translate into better care for patients?
A: Our work focuses on two areas:
(1) Developing programs to identify and manage depression and anxiety in patients with heart disease (called “collaborative care”)
(2) Developing programs to promote well-being and engagement in healthy behaviors. Both areas have important clinical implications.
Depression and anxiety are very common in individuals with heart disease and are associated with worse mental and physical health outcomes.
Though effective treatments for these problems are available, depression and anxiety are frequently unrecognized and untreated.
Collaborative care programs utilize a team of clinicians who help to screen for and offer treatments for depression and anxiety disorders that are delivered within a patients’ existing care, helping people with these disorders to access care more easily.
Our second line of work focuses on helping people to engage in behaviors that are important for heart health.
These programs involve helping people to set health behavior goals and to perform activities to enhance well-being, such as engaging in meaningful activities or writing a letter of gratitude to someone.
Since both health behaviors and well-being are associated with better heart health, we hope that these programs can help people to be healthier both physically and mentally.
Q: What question about the heart is your research still trying to answer?
A: Though we have preliminary evidence that our programs are helpful, we are still trying to learn how helpful they are for individuals with heart disease and other chronic medical conditions.
We also are still trying to figure out how our programs work, for whom they work best, and how we can use these programs to enable people to develop healthy habits that they can keep doing for long periods of time.
Q: Has your research changed how you take care of your own heart?
A: That’s a great question. Yes, it has! Since starting this work, I take more time to recognize, appreciate, and savor the positive things in my life. I also have started to exercise regularly and watch what I eat more regularly.
Recent research from Dr. Celano and colleagues:
- Effects of exercise training on motivation in patients with heart failure with preserved ejection fraction: Results from the randomized controlled Ex-DHF trial
- A text message intervention to promote physical activity in midlife: The MASTERY randomized pilot trial
- An adaptive text message intervention to promote psychological well-being and reduce cardiac risk: The Text4Health controlled clinical pilot trial
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