Several studies have show the fear, anxiety and depression are the most common responses to one’s heart disease upon returning home from a hospitalized event.  It should be noted that depression is not just simply “feeling down or sad” but an accumulation of various symptoms which would lead to the diagnosis of depression by a physician.  Many feelings of despair and hopelessness in the initial phases of any illness can be normal.  The human spirit also sustains a “blow” when an illness strikes and requires time to heal.  For instance, when a heart attack occurs, it takes the heart muscle approximately 5-8 weeks to recover, but studies show it takes about 8-12 weeks to emotionally recover! 

 The grieving process consists of anger, fear, denial, and finally acceptance.  Negative feelings after a major medical event (such as a heart attack or open-heart surgery) is likely due to the grieving process, which is a normal and natural method of coping.  In these cases, the individual is grieving over the loss of the previous state of health.  It is necessary to complete the grieving process to move on to accepting one’s current state of health and new stage in life.  By the time the individual and family feel more comfortable to plan for the future, the grieving process has been completed.  Everyone completes this cycle in a different time frame. 

          Some signs of inappropriate coping are daily; loss of interest or pleasure in all or most activities, significant weight loss or weight grin, insomnia or excessive sleeping, fatigue or loss of energy, feelings or worthlessness or excessive or inappropriate guilt, diminished ability to think or concentrate, sudden unexplained outbursts of crying, recurrent thoughts of death (not just fear of dying), and/or a specific suicide plan.  Those who are angry and irritable may also not be adapting well. 

         Not all of these symptoms can always be attributed to maladaptive coping mechanism or depression.  For instance, someone who has congestive heart failure will, because the nature of his or her illness chronically fell fatigues, sleep a lot and may have excessive weight loss.  Some cardiac medications can also bring on some of these symptoms. 
 To help in assisting one through the coping stages of an illness it is important that the individuals get concise, informative facts about their illness.  A course of rehabilitation and expectations should be mapped out so that the patient does not place unrealistic expectations on him/herself causing frustration and helplessness when those unrealistic expectations are not met.  Cardiac rehabilitation programs are specifically set up to aid the individual to realize their full potential following a cardiac event.  As a patient, you should ask and insist on obtaining coping/rehab information.  Having written information is very helpful so it can be referred back to from time to time if necessary.  Additionally, it is important to involve family or other support persons to help you recovery.  A speedy and effective recovery is difficult if it’s done solo.  If you don’t have family or friends who can help, agencies like the Senior friendship Center or home health Agencies may be able to lend assistance or offer other resources for help.  There are many support groups for various cardiac problems, which are free and very beneficial. 

           It’s important to establish good communications with your physician or his/her nurse.  They are resources available to your to whom you may voice your concerns regarding the symptoms you may be having or to reinforce any education you may have received.  Any hobbies practiced previous to the cardiac event should be resumed as soon as cleared by the physician.  Resist the temptation to sleep during the day for any length in time.  A good nights sleep is essential to cope with tomorrow’s problems! 
 Of course for some individuals these simple suggestions may not be enough and especially for those who have thoughts of harming themselves, professional help should be strongly considered. 

          Adjusting to a new way of life, saying good bye to the “old” lifestyle can be a difficult transition for many… to help yourself… turn to family, friends, physician for the support you need so you can say to this new lifestyle… “I CAN Cope”