Q. Several months ago my husband had open heart surgery. His doctor told him he could return to normal activities. But that has not happened. He seems to be increasingly depressed. He is moodier, distant, unwilling to talk. Is this normal behavior after heart surgery?
A. It is not uncommon for people to feel depressed after a heart attack, cardiac surgery, or newly diagnosed heart disease. Statistically, approximately 15 percent of patients with cardiovascular disease and 20 percent of patients who have had coronary artery bypass surgery experience major depression.
According to the National Institute of Mental Health [NIMH], cardiac-related chest pain (angina) and heart attacks are closely linked with feeling of sadness or hopelessness. Researchers do not know why this occurs: it may result from the fear of the unknown or from feeling more physically vulnerable.
In many instances the depression will be temporary; however, if your husband’s condition is preventing him from returning to normal activities, then it should be treated. Common treatments for depression include cognitive behavior therapy [CBT], a type of talk therapy that helps people change negative thinking styles and behaviors. Anti-depressant medications also may be of help. Your husband should talk to his physician about possibly adding one of these medications at least on a temporary basis.
Cardiac rehabilitation, geared to each individual’s abilities, helps build a heart patient back to his or her pre-cardiac functioning by providing regular physical exercise to increase strength and endurance. Regular exercise has long been recognized as a means of reducing depression as well as creating a healthier life-style. Even a daily, brisk walk may have a positive impact on alleviating depression.
Q. Two years ago my husband was injured repairing our roof and has not been able to return to work as a machine operator. His fall caused severe pain, but in the last year, he doesn’t complain much about pain. Now he’s not interested in doing anything and complains of depression. We have a limited income, and I would like him to get Social Security disability benefits. I don’t think he qualifies anymore on physical pain. Can he get benefits for depression?
A. Social Security Disability is a replacement for wages an insured worker has lost because he is too sick to return to work. A disabling impairment can be either physical or mental or a combination of both. In your husband’s case, it sounds as if his claim should be based on depression.
The first step in preparing for his disability claim would be to have him evaluated by a competent psychiatrist or psychologist. This may include psychological testing to determine the nature and severity of his emotional problems. It is important to understand that to support a claim for disability your husband must be so impaired that he is unable to perform his past work and depending on his age, any other work that he may be able to do. Second, he must establish the type of impairment he has, the severity, and his limitations for working. A conclusion about his depression must be based on medical documentation from a qualified psychiatrist or psychologist, not simply his complaints about how bad he feels.
Given the fact that your husband initially injured himself in a fall from the roof, it would also be a good idea for him to have a neurological examination. It is possible that there is a physical component to his condition, such as a brain injury, which might explain the emotional changes he is experiencing.
After you have decided to file for these benefits, it is probably best to meet with a lawyer who specializes in Social Security Disability.
• • •
Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to firstname.lastname@example.org. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.