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Having a heart attack increases the risk of depression, especially among people who perceive themselves as socially isolated. Can cognitive behavioural therapy help? As you might imagine, it's pretty depressing to have a heart attack, and in fact about 30 per cent of people who've had one have significant depression. And a risk factor for depression in this situation is feeling socially isolated, without much support around you from friends or relatives. It turns out that if you have the lot – a heart attack, depression and perceive yourself to lack social support, your chances of having serious complications or another heart attack are higher. If that's so, then fixing up the depression and the support should help. Well, maybe. A trial involving nearly 3000 people just after a heart attack giving them cognitive behavioural therapy – which is a technique for restructuring negative thinking – has found that while it was good at relieving the depression, it didn't prevent subsequent heart problems. People who were given antidepressants were helped more but that part of the trial wasn't placebo controlled, so the results are less reliable. It doesn't mean the story about depression being bad for the heart is not true, nor that cognitive behavioural therapy isn't much cop. It's probably just that once you've had a heart attack, it's hard work to prevent further events.
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