Cardiac Psychology: A Creative Field to Address Heart Disease

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Carrie Steckl earned her Ph.D. in Counseling Psychology with a Minor in Gerontology from Indiana University – Bloomington in 2001. She has spent over ...Read More

It’s a vicious cycle: heart disease can lead to depression or anxiety, which can in turn increase a person’s risk for another cardiac event. That’s why an inventive blend of cardiology and psychology shows so much promise for cardiac patients.

Cardiac psychology – also known as psychocardiology or behavioral cardiology – focuses on addressing the mental health needs of cardiac patients as a way of breaking the vicious cycle described above. If we can help people with heart disease achieve emotional wellbeing, perhaps we can reduce their risk for another cardiac event.


This creative field of medicine was first suggested in 1996 when Robert Allan and Jeffrey Fisher co-authored “Heart and Mind: The Practice of Cardiac Psychology.” Since then, the field has grown to include the disciplines of psychiatry, social work, and nursing in addition to cardiology and psychiatry.

Most experts in the field recommend cross-training for those in traditional disciplines so providers can offer a more holistic approach to their heart disease patients. Another option is to form interdisciplinary teams to work with cardiac patients who also experience mental health challenges.

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The American Heart Association (AHA) supports the idea of addressing mental health and heart health together. In fact, in 2008, the AHA recommended that every heart patient be screened for depression based on findings that heart patients are three times as likely to be depressed as the general population. If that wasn’t enough, cardiac patients who are depressed are at least twice as likely to have a second cardiac event within a few years of having the first event compared to patients who are not depressed.

Anxiety is also a significant risk factor for future cardiac events – heart patients who experience anxiety are twice as likely to die within three years of a cardiac event than those without an anxiety diagnosis.

Another reason to address heart health and mental health together is that their link seems to be bidirectional, for better or worse. What does this mean? We already know that mental health problems are linked to cardiac problems and vice versa. But did you know that strong psychological health is tied to better heart health and that a healthy heart is linked to better mental health? Now that’s a pretty potent motivator to pay attention to mental health as much as our cardiac wellbeing.

I’m encouraged by the field of cardiac psychology. Many hospitals are offering cardiac support groups as well as individual treatment with cross-trained social workers. And the AHA has a wealth of information on its website about how to manage stress and improve emotional wellbeing. To get started, see its page on stress management.


Elejalde-Ruiz, A. (February 5, 2014). Using the mind to help with healing: ‘Vicious cycle’ of cardiac illness, mental distress. Chicago Tribune (Online Kindle Edition).

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