Understanding the Cardiac Blues: Emotional Recovery after a Heart Event

Having a heart attack or other major heart event can be traumatic, physically and emotionally. For many older adults, there’s not only a physical recovery, but an emotional and mental one too.

This period of feeling down or depressed after a heart event is known as the cardiac blues. You can experience mild depression symptoms like irritability, sadness, or fatigue. Often it’s caused by feeling physically exhausted, lingering trauma from the medical event, and the sudden loss of a sense of invulnerability. 

A case of the cardiac blues is usually short-lived and goes away after a few weeks of being at home and getting back into your routine. According to a 2022 study in Frontiers in Psychiatry, the cardiac blues can affect as many as 66% of people. But about one in five of those adults go on to have more severe depression. 

Learn the signs of cardiac blues, as well as how to recognize if your symptoms are getting more serious and professional help is needed. 

Key takeaways

• The cardiac blues are a common, but temporary, emotional response to a recent heart event.
• The cardiac blues is different than clinical depression, where symptoms don’t go away, or they get worse.
• Talk to your cardiologist about your symptoms and seek help from a mental health therapist if the “blues” are too much to cope with or are affecting your daily life.

How ‘cardiac blues’ compare to clinical depression

It can feel like an emotional rollercoaster as an older adult transitions from the controlled environment of the hospital to home recovery. But there’s a difference between normal cardiac blues and major depression. 

The cardiac blues are usually short-lived and can fluctuate from day to day. One day, you might feel fine and hopeful for the future, and the next day feel anxious or discouraged about your progress. You might have a temporary lack of interest in the hobbies you used to enjoy. 

These mood changes are a normal response to having a major health event like a heart attack. The cardiac blues tends to go away on its own after a few weeks. 

Major depression typically lasts longer, doesn’t change from day to day, and can significantly interfere with everyday life. Healthcare providers usually diagnose major depression if these more intense, persistent symptoms of depression last two weeks or longer.

Here is an overview of the key differences between the cardiac blues and the warning signs of more serious cardiac depression:

Cardiac blues

• Is temporary and improves within a few weeks
• Mood can fluctuate
• Symptoms are mild and you’re able to manage daily tasks
• Symptoms gradually improve without treatment

Major depression

• Lasts two weeks or more with no improvement or symptoms worsen
• Persistent low mood most of the day, nearly every day
• Symptoms are more severe and daily activities can feel difficult and unmanageable
• Symptoms stay the same or get worse without treatment

If your symptoms are gradually improving, they’re likely due to normal cardiac blues. But if you’re not feeling better after a few weeks, or your symptoms are getting worse or interfering with daily life, it’s time to reach out for professional support sooner rather than later.

Common cardiac blues symptoms

If you’ve had a heart event or a recent heart procedure, you might not be feeling like yourself. Emotionally, you might notice signs of the cardiac blues such as:

• Mood swings like fluctuating sadness, worry, guilt, or anger
• Irritability
• Crying
• Not being interested in the things you used to enjoy
• Isolating from others

There can also be physical signs of cardiac depression, including:

• Feeling tired
• Waking up early, or other problems sleeping
• Changes in appetite
• Disinterest in sexual activity

Unfortunately, feeling sleep deprived and having sleep disturbances can worsen both your emotional symptoms and your ability to cope with them.

Changes in thinking can also happen with the cardiac blues. Some signs to look out for include:

• Confusion or forgetfulness
• Difficulty concentrating
• Having nightmares
• Feeling down about yourself
• Concern about your place in the home and the role you play
• Feeling bad about the future

A sudden hospitalization or an emergency heart procedure can be frightening. At the same time, some older adults might already be at risk for depression, which can play a role in how intense your cardiac blues symptoms can be, and how long they last. It can also be a combination of the two — a traumatic event plus an underlying mental health condition — that triggers the cardiac blues.

When to seek help for feelings of depression after a cardiac event

While many older adults can experience the cardiac blues after a heart event, it’s important to understand when your feelings of sadness turn into something more serious, like major depression. You should seek professional guidance if:

• Your symptoms are lasting longer than a few weeks
• Your feelings of sadness or anxiety are getting worse
• You’re starting to lose interest in almost all your activities
• It’s becoming harder to function in daily life
• You have thoughts of harming yourself

If you notice any of these signs, start by reaching out to your cardiologist, who is already familiar with your medical history. They can help figure out if your symptoms are related to physical reasons. Your cardiologist can also refer you to a therapist or other mental health professional.  

When speaking with your provider, it’s helpful to tell them:

• When your symptoms first started and when they began worsening
• How your symptoms affect daily life
• If you’re having any physical symptoms like appetite changes or sleeping problems

Taking steps to feel better not only can help you mentally, but it can also improve your physical recovery and your risk of future heart problems. 

Regaining emotional wellness after heart surgery

After a serious heart event, your emotional recovery is just as important as your physical recovery. While the cardiac blues can be a normal and temporary phase for older adults, persistent sadness, anxiety, or feelings of hopelessness that don’t resolve on their own are worth taking seriously. Speaking with a therapist — especially one who understands the emotional weight of a major health event — can be an important part of your recovery.

Sailor Health makes it easy for older adults to access that support. Our therapists are experienced older adults themselves, with a real understanding of what life looks and feels like after a serious health event. Sessions are available by phone or video, so mobility limitations or distance from care are never a barrier. 

Most Sailor Health patients pay $0 out of pocket through Medicare, and there's no long waitlist — you can connect with a therapist and begin as soon as 24 hours after. It’s easy to get started - we check your coverage, and you answer a few questions that help us match you to a credentialled counselor who fits your needs and preferences.

Cardiac Blues & Recovery FAQ

Is it normal to feel angry or irritable after a heart procedure?

Yes, anger and irritability can be common after a heart procedure because of fatigue, a change in lifestyle, and physical discomfort. 

Do the cardiac blues happen after every type of heart surgery?

No, not everyone who has a heart surgery will have the cardiac blues. Many factors are at play, including being predisposed to depression, the severity of the event, and your own individual emotions. 

Should I talk to my cardiologist or a therapist about my mood changes?

You can talk to either your cardiologist or a therapist about your mood changes. You might start by connecting with your cardiologist about your symptoms, and they can refer you to a therapist. 

How long do the cardiac blues usually last?

For most people, symptoms of the cardiac blues get better in a few weeks. But if they continue, or get worse, it’s important to reach out for professional help. 

References

1. Jackson, A. C., Rogerson, M. C., Amerena, J., Smith, J., Hoover, V., Alvarenga, M. E., Higgins, R. O., Le Grande, M. R., Ski, C. F., Thompson, D. R., & Murphy, B. M. (2022). Unraveling the Complexity of Cardiac Distress: A Study of Prevalence and Severity. Frontiers in Psychiatry, 13, 808904. https://doi.org/10.3389/fpsyt.2022.808904. https://pmc.ncbi.nlm.nih.gov/articles/PMC9009040/
2. Cleveland Clinic. (n.d.). Emotions & Mental Functioning.https://my.clevelandclinic.org/departments/heart/patient-education/recovery-care/surgery/emotional-mental
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