Psychological symptoms often diminish quality of life for heart failure patients. These must be recognized and treated for both the physical and psychological health of the patient. An Oct. 1, 2007, report in "The British Journal of General Practice" states that psychological distress is common in those with heart failure. These symptoms now are being recognized along with better-known symptoms of heart failure, such as shortness of breath, ankle swelling and fatigue.
Depression
Depression is a major issue for many patients with congestive heart failure. Heart failure can cause depression due to chemical changes in the body, lack of exercise and changes in life circumstances due to a loss of independence. A May 2008 opinion titled "Psychology and Cardiology: Do Not Forget the Heart Failure Patient" indicates that 40 percent of people with heart failure admit to having depressive symptoms. Other patients suffer mild sadness as they struggle to cope with a frightening diagnosis and daily inability to perform the tasks they used to master without difficulty.
Depressive symptoms should be reported to the treating physician, who can prescribe medication or counseling. It is important for heart failure patients to seek emotional support from loved ones and not feel as though they must be strong at all times.
Anxiety
The second most common psychological symptom noted in heart failure is anxiety. This may be due to the stress of the illness itself or extraneous factors such as being unable to meet perceived family expectations. Anxiety also may be resultant to diminished levels of blood oxygen. Low blood oxygen can cause anxiety and panic that worsens over time, often leading to depression.
Feelings of anxiety in the patient with heart failure should be reported as medication and therapy are widely available. The Heart Failure Society of America also recommends that patients seek out new activities in which they can participate to allay anxiety and other psychological problems.
Delirium
Severe congestive heart failure can cause delirium, particularly in elderly patients. This usually is due to low blood oxygen, but low blood pressure and heart failure medications also can contribute. This delirium usually comes and goes but may be constant during stage IV heart failure. The patient may talk "out of her head," refuse to eat or take medicine and accidentally harm herself if not closely monitored. Some cases of delirium can be treated with oxygen or drugs.
