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Depression and Pulmonary Hypertension

Medically reviewed by Steven C. Pugliese, M.D.
Written by Aminah Wali, Ph.D.
Updated on September 7, 2021

Living with pulmonary hypertension (PH) comes with many challenges, including the possibility of developing clinical depression. Depression is a serious mental disorder, and chronic illness can negatively affect health and quality of life. It’s important to understand why depression might occur in people with PH and how to effectively manage it.

The Relationship Between Depression and Pulmonary Hypertension

PH affects blood flow through the heart and lungs. This causes many complications, such as dyspnea (breathing impairment) and right side heart failure. People living with PH can experience increasing difficulty performing daily tasks independently, which in turn negatively affects their quality of life.

The weight of a PH diagnosis and its physical symptoms can impact a person’s mental health. “I try to remain emotionally positive about my health issues, but when I’m struggling, it’s not easy,” one member of myPHteam wrote.

“Just can’t keep my emotions together today. I’m really tired and feel beaten by my pulmonary arterial hypertension,” expressed another member.

These stressors can result in depression and anxiety. The development of depression has been most studied in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension, which are the most common forms of PH. Depression has also been frequently observed in people with related lung diseases, such as chronic obstructive pulmonary disease (COPD).

Symptoms of Depression

Depression includes changes in behavior that last for more than a few weeks. There are many symptoms of depression, including:

  • Intense feelings of sadness or hopelessness
  • Sleeping more than usual or having difficulty sleeping
  • Lack of interest in hobbies and activities
  • Fatigue and sluggishness
  • Poor concentration
  • Suicidal thoughts

Because depressive symptoms are experienced by most people at some point in their lives, it can be difficult to distinguish depression from typical feelings of sadness. However, if a feeling is new and persists for several weeks after a diagnosis of PH, it is more likely to be evidence of depression. Follow up with your health care provider to explore a possible diagnosis.

How Is Depression Diagnosed?

People with PH may be evaluated for symptoms of depression using the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire-9. Both of these clinical tools consist of a series of questions designed to learn if a person is experiencing persistent depressive symptoms. The results from each questionnaire must be evaluated by a doctor to confirm if a person is experiencing a depressive disorder or another related mental health issue.

How Common Is Depression Among People With Pulmonary Hypertension?

Feeling depressed is a shared experience among many people living with PH. “It’s very common to have depression when we are dealing with diseases,” wrote one myPHteam member.

“Hard to feel good about things sometimes,” lamented another member.

The prevalence of depression and other mental disorders among people diagnosed with PH has also been explored in clinical studies. Depression is a common comorbidity, meaning it often occurs with PH. As many as 53 percent of people with PH also experience depression, although the exact rates vary from study to study. Findings also suggest that depression is more prevalent in people with PH relative to the general population.

Managing Depression While Living With Pulmonary Hypertension

Although dealing with depression is undeniably challenging, there are many approaches that people living with PH can take to help manage their depression and improve their quality of life.

Medication

Antidepressant medications may be prescribed by a doctor to help manage depression, and they are effective treatments for many people. “I suffer from depression off and on. My doctor prescribed an antidepressant called duloxetine, and it has helped,” shared a member of myPHteam. Because many people also take medication to manage their PH, communication between a primary care physician and mental health practitioner is important to determine the safest treatment options and minimize unwanted side effects.

Therapy

Psychotherapy, also called talk therapy, may be used by mental health practitioners to help manage chronic diseases. This approach involves spending time with a professional who can help find solutions to challenges faced by a person living with PH. Cognitive behavioral therapy — a particular type of psychotherapy that is often used to treat depression — focuses on tackling negative thinking patterns in order to arrive at helpful solutions.

Many people with PH benefit from having a trusted mental health professional they can work with on a long-term basis.

“If you don’t have a psychiatrist, get one,” urged a member of myPHteam. “You will need one through this journey of pulmonary hypertension.”

Mindfulness

Another technique used to help manage depression is practicing mindfulness, a concept rooted in Eastern philosophy. Mindfulness involves making a conscious effort to be present in the moment and accept your current state of being. This can involve meditation or prayer, as is the case for several members of myPHteam:

  • “I have been doing Transcendental Meditation twice a day since I was 40 years old.”
  • “Tell them it is your prayer or meditation time. I have walked and prayed a lot over the years.”
  • “I used coping skills and prayer.”

There is no one right way to practice. Mindfulness is very personal and should be practiced how it works best for you.

Lifestyle Changes

Other lifestyle changes can help people with PH manage symptoms of depression. Joining a social support group, such as the myPHteam community, can be invaluable for improving outlook. Light exercise might improve symptoms of heart disease, and it can also boost your mood.

“I have started walking more and exercising,” shared a member of myPHteam.

As with any treatment, consult your doctor about planned physical activity to make sure you’re managing your PH as safely as possible.

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension, more than 37,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Are you or a loved one dealing with depression and pulmonary hypertension? Share your experience in the comments below or start a conversation by posting on your Activities page.

Updated on September 7, 2021
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Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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