Emotional Challenges

Common Emotional Reactions Following a Diagnosis of Heart Disease:

  • Many people experience different reactions or changes in mood and emotions at the time of, or shortly after, a heart disease diagnosis. This experience can be considered part of the normal and appropriate emotional reaction to a life-threatening event.
  • Emotions which are common after a heart disease diagnosis include:
    • Loss of interest, withdrawal
    • Becoming tearful/crying easily
    • Feeling “short-tempered”
    • Sleep problems or bad dreams
    • Changes in appetite
    • Changes in sex drive
    • Confusion, forgetfulness or difficulty focusing
    • Intensive preoccupations that are difficult to clear/take away from your mind
  • Changes in your mood that may require further assessment by a professional include persistent irritability, tearfulness, loss of pleasure in usual activities, feeling sad often, withdrawal from others, and challenges with sleep, appetite or sex drive.
  • The good news is many of these emotional reactions typically resolves within the first 2–3 months after the heart event.
  • If you find that your mood is not improving, it is important to get support as your emotional concerns could be major depression or anxiety.

Major Depression:

  • Did you know?
    • The prevalence of depression is four times higher in patients with heart disease compared to adults without a heart disease diagnosis.
    • For patients with heart disease, 1 in 6 patients will start their cardiovascular rehab program with symptoms of major depression.
    • The risk is higher for individuals with a previous history of mental health concerns, lack of social support/loneliness, and those living with multiple medical comorbidities.
  • Symptoms of major depression could include:
    • A profound feeling of sadness
    • Lack of interest or enjoyment in most activities
    • Thoughts of self-harm or suicide


  • Did you know?
    • For patients with heart disease, 1 in 4 patients will start their cardiovascular rehab program with heightened levels of anxiety.
    • While symptoms may lessen with time, research suggests about 50% of patients experience symptoms of anxiety up to 1-year after having a heart attack (myocardial infarction).
  • Symptoms of anxiety could include:
      • Feeling irritable, fatigued, restless or wound-up
      • Difficulty controlling feelings of worry
      • Feelings of “being out of control” or “of impending doom”
      • Elevated heart rate, heart palpitations, sweating or trembling
    • If you find that your mood is not getting better over time, that you are feeling stuck with these feelings, or are worried that you may be experiencing depression or anxiety, it is important to get help.

Tips to Lessen Symptoms:

  • Speak to a healthcare provider: Some people may have questions and benefit from speaking to a healthcare provider to get correct and complete information about their health.
  • Speak to family or friends: Share your worries with a family member, friend or healthcare provider.
  • Community services: Learn about community and social service resources that can help with home care, transportation and provide social engagement opportunities.
  • Get active: Enjoy physical activity and exercise.
  • Keep a journal: Keeping a journal can help keep track of emotional experiences
  • Practice mindfulness and/or meditation

Where to find help:

  • If you are experiencing emotional challenges after a heart disease diagnosis, speak to your Exercise Therapist, family doctor, or someone on your healthcare team (cardiologist, nurse practitioner, pharmacist), or call a local health-crisis line.
  • Treatment could include:
    • One-on-one counselling (virtually or in-person)
    • Group counselling (virtually or in-person)
    • Meditation (virtually or in-person)
    • Medications

Activities to promote wellbeing:

  • There are several other activities you can do to promote well-being. These activities may include:
    • Practice gratitude. Reflect on positive events with friends and family members and expressing gratitude to others. Some people benefit from keeping a gratitude journal.
    • Think about your strengths and resources. Think about how you have approached similar situations or challenges successfully in the past, and how you can apply past positive experiences to your current situation.
    • Experience enjoyment. It is important to regularly schedule activities that you enjoy.
    • Find meaning in the things that you do. Some people may find it meaningful to volunteer, read a book, clean a room, or complete a creative task, like woodworking, photography or painting.
    • Practice calmness. Consider ways to practice calmness, such as deep breathing exercises, or listening to relaxation music.


  • Mindfulness can help us achieve calmness as well. Mindfulness is a practice of learning how to be fully present in the moment, and aware of your thoughts and feelings without judgement.
  • Mindfulness can be practiced anywhere and at any time, but best to start in a quiet, comfortable position.
  • Try a moment of relaxation.

Want more information:

  • Speak to your Exercise Therapist or healthcare team.
  • Watch our Mental Health & Covid19 Considerations Presentation
  • Look for activities and programs offered by your local community centre, such as mindful meditation, yoga, guitar classes, or other recreational or social activities you may enjoy.
  • Adult Resources:
    • ConnexOntario (1-866-531-2600) – 24/7 helpline for addictions and problem gambling. Can offer contact information for local services, including crisis lines.
    • IN CRISIS (1-833-456-4566)
    • 211 Ontario – provided information and referral for community, government, social and health services, including mental health. Call 2-1-1 or 1-877-330-3213, or chat live over the web at www.211ontario.ca
    • Wellness Together Canada – free online resources, tolls, apps, and connection to trained volunteers and qualities health professionals
    • Togetherall – 24/7 an anonymous community of peer support, trained practitioners available 24/7, self-assessments and resources.
    • Bouncebackontario.ca (1-866-345-0224) or email bb-referral@cmha.yr.on.ca – offers a free, guided self-help program for people aged 15+ who are experiencing mild-moderate anxiety, depression, or feeling low, stressed, worried, irritable or angry. Offers phone coaching, skill building workbooks and online videos.
    • AbilitiCBT – an internet-based CBT program (OHIP covers 10 sessions), designed to help address anxiety symptoms related to the pandemic. CBT stands for Cognitive Behaviour Therapy.
    • MindBeacon – an internet-based CBT program, free to Ontarians CBT stands for Cognitive Behaviour Therapy.
  • Consider mindfulness apps, such as Calm or Headspace