The connection between mental health and heart health

It’s February American Heart Month.

A few weeks ago, as I was completing my physical, my doctor asked me, “When was the last time you had an echocardiogram?”

I had an extremely stressful year and didn’t want to think about doing anything more. But my family has a history of heart disease and I knew that getting this simple test was the right thing to do for my health.

I went downstairs to the radiology department, script in hand. When the radiologist called me without much of a wait, I thought I’d at least get out of there quickly. But the echo took much longer than usual. After about 45 minutes, we were thankfully done. I didn’t give the test a second thought.

That evening, when the results appeared on my portal, I was shocked to find that the echo showed an irregularity. I immediately wondered if this could be related to the excess stress caused by the stress I had experienced over the past year when I made a major change in my life.

It turns out that a Study 2025 from the American Heart Association Journal, Traffic, showed that people living with depression and anxiety are more likely to have a heart attack than people without them.

I wanted to know more, so I reached out to the experts for answers.

The relationship between mental health, stress and heart disease

According to the findings of the 2025 study, participants who were depressed and anxious had more activity in the amygdala, the area of ​​the brain associated with stress. They also showed signs of an overactive nervous system and higher levels of CRP, a protein linked to inflammation in the body. All of these stress-related symptoms increase the risk of heart disease.

“When people are stressed, they have higher levels of stress hormones like epinephrine, norepinephrine, and cortisol, so heart rate and blood pressure can increase,” said Nieca Goldberg, MD, FACC, a cardiologist at NYU Langone and a member of HealthyWomen’s Women’s Health Advisory Council.

Elevated cortisolalso known as the stress hormone, can cause belly fat, which can then lead to higher triglycerides, glucose, higher blood pressure and other risk factors for heart disease. Stress also causes inflammation in the body, which promotes plaque buildup in your arteries. To put it simply, having a mental health disorder like depression or anxiety can increase stress, which then affects your heart health. It’s like a domino.

And the more mental health problems you have, the more likely you are to have a heart attack. THE Traffic study said that people who have both depression and anxiety have a 32% higher risk a major cardiovascular event than those with only depression.

This is partly because when we are dealing with multiple mental health issues such as anxiety, depression and PTSD, it becomes very difficult to deal with them. Goldberg said that when we can’t cope, we tend to make poor lifestyle choices like smoking, drinking alcohol, being sedentary, eating highly processed foods or not being motivated to take prescription drugs. Over time, this can lead to increased heart rate and blood pressure, decreased blood flow to the heart, and increased cortisol levels. These symptoms eventually cause calcium build-up in the arteries, metabolic disease and heart disease.

Women and heart disease

Around perimenopause and menopause, estrogen, a hormone that helps protect your heart, drops. The hormonal changes and physical symptoms of menopause can affect your emotions, and women are more prone to anxiety and depression during this time. Add in caregiving and career pressures, and it’s no wonder midlife women are often overwhelmed. In fact, middle-aged women are 84% more likely to experience anxiety and 41% more likely to experience depression than men of the same age.

But these statistics become even more alarming. Women struggling with depression are twice as likely to experience sudden cardiac death. And black and brown women, who often have uncontrolled hypertension and diabetes, have even higher rates of cardiovascular disease than white women overall.

It is important to note that not all heart disease is linked to mental health or stress. Some of these are genetic or may be caused by environmental factors or other medical conditions. Even so, Goldberg said, “No matter what form of heart disease or condition you have, reducing stress and having a better outlook on mental health really helps outcomes.”

Here’s what you can do to reduce your risk of stress-related heart disease

Samuel Sears, Jr., Ph.D.psychologist, professor and head of innovation research at East Carolina Heart Institute, suggested cognitive behavioral therapy to help with depression and anxiety, which in turn can lower your stress level. “Therapy allows patients to discuss feelings, identify thoughts and change actions that cause distress,” Sears said.

In addition to depression and anxiety, lack of sleep can also increase anxiety because your brain isn’t working as well as it should. That’s why Goldberg emphasized that one of the best things you can do for your health is to sleep well. “People who have disrupted sleep or sleep apnea syndrome have higher blood pressure and higher rates of heart arrhythmias,” he said. These symptoms often lead to heart disease.

Goldberg also recommended downloading meditation apps to improve your overall mood and relax your breathing. Healthy diet with fresh fruits and vegetables, staying hydrated, stopping smoking and 150 minutes per week aerobic exercise are other ways to reduce stress-related heart disease.

Tai chi, qigong and yoga are gentler options that combine physical, mental and spiritual benefits, improving your overall health.

If you’re still having trouble managing your anxiety, it may be time to talk to your doctor about taking antidepressants, including SSRIs, to relieve symptoms. Research shows that taking antidepressants reduces ER visits and hospitalizations for heart disease.

It’s important to talk about your mental health

Unfortunately, there is one more stigma around mental health, and people often fear being judged if they talk about their feelings during a doctor’s visit. But Sears emphasized that it’s important to talk about our feelings. “Emotions are part of the human process and should be welcomed and open,” he said. If left untreated, they will persist and potentially cause more health problems down the road.

Goldberg acknowledged that cardiologists typically don’t address mental health issues because they’re pressed for time. But, if you’re struggling, it means it’s important for you to be proactive and stand up for yourself.

Both Sears and Goldberg suggest starting the conversation with these openers:

• I worry about my stress and how it might be affecting my heart.

• I’m looking for a complete plan. What advice do you have for managing stress?

• What other specialists can I involve in my care to complete my health plan?

Create a mind and body care team

Together with your cardiologist, consider creating your own mind-body team that includes the following health care providers:

• Nutritionist
• Psychologist
• Physiotherapist
• Exercise specialist

Once you’ve created your team, make sure they’re talking to each other. Communication is the best way to create a comprehensive health plan.

The bottom line is that talking about your mental health can improve your heart health. “Emotions are human. Just let them rip,” Sears said.