Mental Wellbeing: Depression and Anxiety

You are not alone. As many as one in five people with heart failure experience depression or anxiety.

Why is this happening?

Being diagnosed with heart failure requires major changes to your daily life. It is natural to feel:

  • Worried that something serious could happen suddenly
  • A loss of control over your health
  • Sadness or grief about physical limitations
  • Difficulty relaxing or feeling constantly “on edge”

Accepting these emotions instead of fighting them is the first step toward managing them.

The Challenge of Diagnosis

Depression causes symptoms such as low energy, fatigue, poor concentration, and physical discomfort. Because these overlap with heart failure symptoms, depression can be missed or dismissed as “just part of the illness.”

When depression goes untreated, it can lower quality of life and make it harder to keep up with medications, appointments, nutrition, and daily self-care.

Understanding Depression

Depression is more than feeling sad. It is a medical condition that affects mood, thinking, energy, and motivation.

Common signs of depression include:

  • Persistent sadness, emptiness, or hopelessness
  • Loss of interest or pleasure in activities you once enjoyed
  • Low energy or feeling slowed down
  • Changes in sleep (sleeping too much or too little)
  • Changes in appetite or weight
  • Difficulty concentrating or making decisions
  • Feelings of guilt, worthlessness, or being a burden

Depression is not a personal weakness, and it is not something you have to “push through.” Treatment can help.

Understanding Anxiety

Anxiety is often overlooked. It is a “fight or flight” response that your body activates to protect you—even when there is no immediate danger.

Common signs of anxiety include:

  • Shortness of breath, dizziness, or lightheadedness
  • Racing heartbeat or sweating
  • Nausea or upset stomach
  • Tingling or numbness in the hands or feet
  • Persistent worry or fear that feels hard to control

Is it Heart Failure or Anxiety?

Because fatigue and shortness of breath can occur in both conditions, use this general guideline:

Heart Failure Symptoms

The Trigger: Usually worsen with physical exertion.

The Relief: Often improve with rest.

Anxiety / Depression Symptoms

The Trigger: Can occur at any time, even while resting.

The Relief: May improve with movement or distraction.

Always discuss new or worsening symptoms with your doctor or heart failure care team.

Treatment Options

There are effective ways to feel better. Talk to your doctor about:

  • Cognitive Behavioral Therapy (CBT): A form of talk therapy shown to improve coping, mood, and outcomes in people with heart failure.
  • Medication: Many antidepressants, including SSRIs, are generally considered safe for people with heart failure.

When to Seek Help Right Away

Please seek immediate help if you or a loved one experience:

  • Inability to function day-to-day (not eating, bathing, or getting out of bed)
  • Feeling hopeless or like life is not worth living
  • Thoughts of self-harm or suicide
  • Talking about being a burden or wanting to disappear

If you are in immediate danger, call 9-1-1.
If you are in the U.S., you can also call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7.