When Edward Richardson, 50, learned he needed bypass surgery, it wasn't his heart that was troubling him -- it was his head.
"I kept hearing a saw. I couldn't go to sleep. I kept hearing this saw and, 'OK, your chest is going to be cut open,'" Richardson said. "I mean, it was a strange thing where my mind was playing tricks on me."
Depression is three times more common among people who have had a heart attack, compared with the general population, according to a report released by the American Heart Association.
Because depression can have lasting consequences for a patient's recovery, including an increased risk of future heart attacks and hospitalization, and even an increased risk of mortality, the American Heart Association now recommends depression screening for people suffering from heart disease.
The Bluhm Cardiovascular Institute at Northwestern Hospital in Chicago was already ahead of the curve with an innovative program, requiring heart patients to see not only a cardiologist, but a psychologist, as well.
"We know the mind and the body are connected. And patients with a chronic medical illness have increased risk of experiencing a poor quality of life, depression, anxiety and emotional distress," Northwestern Memorial Hospital psychologist Kim Lebowitz said.
Richardson began behavioral treatment before surgery. In therapy, Lebowitz asked him to discuss his fears and taught him breathing and relaxation techniques. Before long, he was no longer hearing that saw.
During his recovery, Richardson continued the breathing and relaxation exercises, which reduced his need for pain medication.
"Dr. Lebowitz said it's a fear that everyone goes through. It manifests itself in different ways," Richardson said. "After a few sessions, it was determined that there are some things that you just cannot control and you need to relax and leave that alone."
Richardson's wife, Carolyn Nelson, was shocked by her husband's transformation after a few sessions.
"Before he came in to talk to Dr. Lebowitz, he was very uptight," she said. "By the night before the surgery, he was so calm, I was like 'What's the matter with you?' And he actually was laughing and singing on the way to surgery."
While there are no official studies on the Northwestern program, cardiac patients are doing so well that even the heart surgeons are impressed.
"With some behavior modification, we get a much better outcome and a lot of those complications, I think, are decreased," said surgeon Dr. Richard Lee.
Eight weeks after surgery, Richardson said he's doing great.
"It was extremely helpful to me," he said. "You don't go in with an idea that you're defeated, that this is something you can't control or have no say in. Your mind is at ease and you can go in joking."