Well Worth It: Heart Help Really Helps!

Welcome to another Well Worth It – articles about proven, data-driven studies that you may not hear much about in the main-stream media (usually because of a lack of profit-driven PR). Be sure to forward the Well Worth It information along to anyone you think might benefit!

Recent news that we reviewed here at Doc Gurley about the role of depression and heart disease has left us feeling, well, profoundly sad.

SAN ANSELMO, CA - MAY 21:  In this photo illus...
Image by Getty Images via Daylife

Depression is shockingly associated with increased rates of heart disease. THEN, after heart disease develops, depression has a hugely increased risk of heart failure. THEN, after heart failure is established, depression is profoundly associated with death in the next 2-3 years – at rates of 53% dead. All these studies also showed that treating the depression with anti-depressant medicines had no effect. So is there any good news in these recent revelations?

If you have a loved one with risks for heart disease, or one who already has a diagnosis of heart disease, here’s one study worth noting (and then using to get coverage!) – a recent study in the Archives of General Psychiatry showing that Cognitive Behavioral Therapy (CBT) after bypass surgery has profound impacts on treating depression and preventing depression relapses.

Wahoo! Keep in mind: CBT=cheap; bypass=$$$ X lots and lots.

The lead author told the Medscape interviewer, “This study provides good evidence that if you can refer bypass patients with depression to a qualified cognitive-behavior therapist or, failing that, a supportive stress-management program, this can be very helpful in treating depression and preventing relapse.”

Are we talking about hours and hours of pricey one-on-one therapist time? Au contraire:

“Forty participants in the CBT group received 12 weeks of therapy consisting of weekly 50- to 60-minute sessions with a psychologist or social worker that assisted patients in identifying problems and developing cognitive techniques to overcome them. The remaining 42 patients received 12 once-weekly supportive stress-management sessions, in which a social worker or psychologist counseled the patient about improving his or her ability to cope with stressful life events.”

Anti-depressant medication prescription wasn’t a part of this study – so some patients were on it and some weren’t, based on their regular doctor’s assessment. “In fact, approximately 50% of patients in all 3 study groups were on some type of antidepressant medication.”

So how effective were these two non-drug approaches? “Remission of depression at 3 months occurred in a higher proportion of patients in the CBT [Cognitive Behavioral Therapy] and SSM [Supportive Stress Management] groups than in the usual-care group. These differences narrowed at 6 months but widened again at 9 months, with 73%, 57%, and 35% remission rates for CBT, SSM, and usual-care groups, respectively.” Reporting those same numbers in a different way means that depression relapses occurred in 65% of “usual care” patients, 43% of stress management patients, and only 27% of cognitive behavioral management patients at nine months.

“The take-home message from this study is that the usual care for depression that is often provided to patients after bypass surgery just isn’t good enough.”

CBT (Cognitive Behavioral Therapy) is, compared to mega-expensive bypass surgery, flat-out cheap. Given the high stakes when it comes to depression and heart disease, combined with the lack of other effective treatments, it’s definitely a Well Worth It intervention.

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