The relationship between mental health and heart health is uniquely intricate. For instance, a person who has a sudden event, such as a heart attack, may experience this as a traumatic event, and the thought of it happening again can be very frightening, Smolderen says. “All the alarm bells go off and you’re immediately in confrontation with mortality. It’s a wake-up call people aren’t expecting.” However, any cardiac diagnosis can make a person feel vulnerable, she says.
A heightened and chronic “fight-or-flight” response—a physiological reaction to a perceived threat—is common in people who have depression or anxiety, especially for people who have prior trauma or PTSD. “What we see often is when this fight-or-flight system takes the upper hand, as opposed to the ‘rest and digest’ part of the autonomic nervous system, and it may cause strain on our body systems over time,” Smolderen says.
Chronic stress indeed impacts the entire body, causing the heart to beat faster, respiration to change, and blood pressure to rise. “All the physiological systems that are involved are exactly the ones that also are being treated by a cardiologist. And that is unique about cardiology and cardiovascular disease,” Smolderen adds. “We also know from research that if people are able to work on their stress regulation, it benefits their cardiovascular health directly.”
In addition, in people who are experiencing chronic stress, making healthy lifestyle choices is so much harder, Smolderen says. When we feel chronically stressed, we may resort to smoking, overeating, and sedentary behavior. Our sleep may be disrupted and we have difficulty keeping up with medication regimens.
The American Heart Association (AHA) says more research is needed to fully understand the connection between mental health and heart health. But in a 2025 scientific statement it published in its journal, Circulation, it addressed the importance of treating such conditions as anxiety, depression, and PTSD to improve quality of life and long-term health. The AHA suggests regular mental health screening for people who have cardiovascular disease or are at risk for it.