Much research shows a relationship between mental stress and a risk of heart attacks. During times of stress, the body releases hormones, such as adrenaline (epinephrine), that speed heart rate, raise blood pressure, and may cause spasms (constrictions) of the coronary arteries. Nonetheless, stress is not considered a direct cause of heart attacks. Instead, it is a possible contributing factor.
A number of studies link depression with heart attacks, although doctors are not sure exactly how depression might increase the risk. One possibility is that people with depression are less likely to make efforts to control other risk factors—for example, quitting smoking, eating a healthy diet, exercising, and taking cholesterol or blood pressure medication. Another possibility is that depression causes changes in the body, including a rapid heart rate, high blood pressure, abnormal heart rhythms, faster blood clotting, and higher insulin and cholesterol levels, which increase the risk of heart attacks.
Treatment options for depression include cognitive-behavioral therapy, antidepressant drugs such as selective serotonin reuptake inhibitors (SSRIs), and physical activity. In fact, studies show that treating depression in people who have had a heart attack decreases their risk of a second attack.