If you or a loved one has had a heart attack, then you probably already know that you should be on the lookout for depression, which often occurs after going through this serious health crisis.

But you should also watch out for another serious mental health problem—post-traumatic stress disorder (PTSD).

PTSD? The same problem that’s common among combat veterans and victims of sexual assault?

Yes, it’s true, according to a recent study by researchers at Columbia University Medical Center in New York City.

A DAMAGED HEART CAN LEAD TO A TROUBLED MIND

Heart attacks and PTSD aren’t two health problems that you might normally link together. But the recent analysis showed that among people who had had a heart attack one month to 10 years earlier, 12% showed significant signs of PTSD and 4% met the full criteria for a PTSD diagnosis. It’s important to diagnose and treat PTSD—especially in these cases—because the research also revealed that patients who had had heart attacks and developed significant signs of PTSD had twice the risk for recurrent heart attacks or death compared with people who had had heart attacks but did not have significant PTSD symptoms.

“What’s interesting,” said Donald Edmondson, PhD, assistant professor of behavioral medicine at the university and the study’s lead author, “is that the severity of the heart attack wasn’t associated with PTSD—it was each person’s own reaction to the heart attack that made the difference.”

While the study didn’t look at whether it’s possible to have PTSD after a heart attack without also having depression, Dr. Edmondson said that people who have PTSD usually have depression, too.

HOW DO YOU KNOW IF YOU HAVE PTSD?

It’s not unusual to feel stressed after you have a heart attack—after all, it’s a traumatic event. But how intensely you worry and how long you worry can determine whether or not you have PTSD, Dr. Edmondson said. His questions to ask yourself:

  • Do you avoid traveling far from your doctors and/or engaging in strenuous activity, such as running or having sex, even if you’ve been told it’s medically safe to do so, because you’re afraid that you might have another heart attack?
  • Do you have very clear memories of the most distressing aspects of your heart attack, and are you unable to make them go away?
  • Do you have vivid nightmares in which you relive the worst moments of your heart attack?

If the answer is yes to at least one of those questions and you’ve been feeling this way for at least one month, then ask your doctor to screen you for PTSD.

TOP TREATMENTS

Dr. Edmondson noted that there are two main treatments for PTSD—psychotherapy and/or drugs (particularly antidepressants called selective serotonin reuptake inhibitors, or SSRIs). Patients can try either or both—though most research shows that using a combination is the most powerful treatment.

Dr. Edmondson assured me that, while the duration of therapy depends on the severity of the condition, many patients are successfully treated after just two to four months.