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Heart failure

Bad days, anxiety and depression

Not everyone with heart failure has 'bad days' nor should people expect necessarily to feel anxious or depressed because they have heart failure. Those we talked to responded to having heart failure in various ways; some were stoical, some were philosophical, some talked about their condition with humour, but most people with heart failure at some time or other had experienced what they called 'bad days' as well as some anxiety and depression.

Many people described having a 'bad day' as needing to rest and take things easy after which they would feel better. Some couldn't account for their bad days or said that bad days could happen if they had done too much the day before. There were also those who said that their bad days were caused by the pain they associated with having angina.

 

Describes how he feels when he's having a bad day.

Describes how he feels when he's having a bad day.

Age at interview: 64
Sex: Male
Age at diagnosis: 63
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Well I feel pretty good, in fact some days I'm not so good. I have days when I feel wrong and I don't always feel right. You have these days when you don't always feel one hundred percent and for what reason I don't know, whether I've been doing something, too much previous like too much walking about, or doing something I shouldn't be doing and it's caught up with me, I think sometimes there's a little bit of that. 

Can you describe what it feels like, what you feel like when you're not right?

Well that's very difficult. Now a lot of people say what do you feel like, if you said to the doctor he wouldn't understand, I just don't feel well. And you feel in your mind you don't feel well, there's nothing physically or there's no pain you just feel you don't feel well in yourself, there's something, I can't describe it. People ask you and I couldn't tell you, I just don't feel well. It's different if you've got angina you say I've got a pain down my front, or I've got this, that and the other, but with [this] when you feel wrong, you feel wrong. 
 

Vivienne experiences bad, exhausting days less often than she did before her ICD was fitted.

Vivienne experiences bad, exhausting days less often than she did before her ICD was fitted.

Age at interview: 61
Sex: Female
Age at diagnosis: 60
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On bad days I feel pretty bad but on good days like today, you know, I feel good, I just wish all my days were good days. I wouldn’t like to, I wouldn’t like it to start going worse again and me feeling the way I did before but I just get so annoyed when I can’t do things, you know. I’ve aged as well, I’ve must have aged about ten years and not only do I think that seeing photos of myself a year ago, can’t believe it and my daughter’s even said, you know, that I have yeah. But just, I was looking at photos last week and I just could not believe the way I’ve really, really aged and since my illness. 

Have you…

And I look at people, a lady across the road and she’s the same age as me and I see her going out wearing her heels and doing this that and the other and I think, “Oh god, if I hadn’t been poorly I’d be like that, I’d be,” you know, [laughs] you know I wish sometimes.

How often do you have those bad days now since your..?

Not as often as, every day was bad so now I can’t even say once a week, just occasionally, I know.

How do you feel when you have those bad days?

I feel exhausted when I get up on a morning when I wake my, when, when I open my eyes, just feel exhausted and don’t want to do anything [I: OK] But I usually make myself extremely tired and a bit down and…

OK. So it’s the tiredness that gets you?

Yeah even, but even on a good day I have a job coming down stairs on a morning, I have to come down like a baby, you know what I mean? Things like that, trivial things but nevertheless, different to the way I used to be.
Many people said they had become more anxious since having heart failure and that the condition itself played on their minds. Others talked about feeling more anxious when things went wrong with friends and family. Several people who had experienced bouts of depression which were out of character thought that the depression may have been a side effect of their medication; one man described how he felt before a change of medication improved this. A woman who described feeling very low after leaving hospital said that she had eventually re-discovered her motivation and had started to feel better in herself.

 

Describes how he felt depressed for a time until his drugs were changed.

Describes how he felt depressed for a time until his drugs were changed.

Age at interview: 81
Sex: Male
Age at diagnosis: 79
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Well, not really. I kept wondering what I could do, I was having all the tablets and the nurse was making adjustments up and down of various ones without deleting them because she wasn't in that situation to do that, and I was just suffering you know up and down. Obviously I had reasonable days but it was just a state that I was in, but when I felt good I'd go for a walk, but sometimes I didn't feel up to walking, and I'd just say that it's just like feeling, well with a sort of dose of flu. If you have a dose of flu, for those days you've got the flu you can't do anything. Well these were trailing over the whole of the year in dribs and drabs. And I knew everyone was trying to do their best and I was explaining, and whether or not people believed me, or whether they thought 'well don't be silly old chap, you know you're 81 and you know you've got a weak heart, what do you expect, do you expect to run around like a 20 year old!'. So I was held back a little bit by that thought, that you know 'alright I have to put up with some of this', but then I started to say, well 'do I have to put up with it - where's this quality of life?  All right I'll take it that I'm going to suffer this and I'm going to suffer that', but surely not that I don't want to eat anything on occasions that I had, that I couldn't sleep and I was on sleeping tablets.  I spent days without sleep and this was all running together, I was feeling rough, I wasn't sleeping, I wasn't eating, and it was just going on and the year went so quickly and really I could just write last year off.

Well I felt like saying well what's worth living for because I couldn't do anything. I used to look at the... television and then I would just walk away and then I would get up and walk in and come and sit down and then I'd feel... I'd get up like this and do this, do this sort of thing it somehow calmed, it describe any more than I just felt like a zombie! That's all I can say.

 

Describes how she took a few months to recover from a setback.

Describes how she took a few months to recover from a setback.

Age at interview: 59
Sex: Female
Age at diagnosis: 55
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I actually took a long time to get over this.  I think emotionally I was really knocked for six at this setback and for the next three or four months really I functioned certainly, I was off sick from work but I did housework, I went shopping you know, as usual. But I'd certainly lost something, I'd certainly lost my umph, which we couldn't even find under the settee, we looked. My motivation and you know, I think I was just a bit down really and you know, just wondered if it is worth carrying on really like this. And I sort of sat and ate and fiddled around and gained weight and felt generally miserable. But thankfully, after Christmas I actually found my umph again somewhere, it sort of came back and my motivation came back but I actually felt well again, I think. I actually felt better than I'd probably felt for the last 3 years, which is very interesting. 

 

Some said their emotions were closer to the surface since having heart failure and one or two mentioned being more short-tempered with their partner. Others said they cried more easily and were unable to watch weepy films or television programmes without getting upset. A woman described how she empathised with others more and had become more aware of 'life' since having heart failure. Someone else wondered if his heightened sensitivity to life was due to his medication.

 

Says he gets upset more easily now than before he had heart problems.

Says he gets upset more easily now than before he had heart problems.

Age at interview: 65
Sex: Male
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Another thing is if you're watching a weepy film. I find and have found since my first heart attack tears will come to my eyes very, very easily. But it's nothing to be ashamed of. Some people will say well men shouldn't cry. To hell with it, if you feel like a cry have a cry. It is possibly the best medicine, it'll be better than any of the medication that I'm taking now, to have a cry, get it off your chest and go back to normal.Yes I will cry. I don't very often, I will certainly often have tears in my eyes if something weepy is on television. Particularly shall we say in a children's hospital situation that they're showing at the moment. You see a little baby with a condition that it would be bad enough for an adult to go through, that little baby, consider what that mother is going through, it doesn't bear thinking about. And yet these people do this, they get through it.

But you find you're more affected by that now?

I'm certainly more affected by something of that nature now than I ever was yes. I always used to think that I was the macho man that you know I didn't cry, no I went in head down, knuckles, knuckles to the front. Don't believe it - women are stronger than men! 

 

She looks at life differently since having heart problems.

She looks at life differently since having heart problems.

Age at interview: 55
Sex: Female
Age at diagnosis: 53
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I think it can make you more aware of life and how fragile it is. The fact that you could one day that you're fine and you're at work or out somewhere and then the next day, basically you're nearly dying. And you don't know whether or not you're going to recover.  It can make a difference that way and you do look at life a different way. And you can get a little bit upset over certain things that you see on the television or that's happened to other people, definitely. And you think more about it then than you would have thought before it happened to you. So it can't be a bad thing really.

It's almost as if it sort of sensitises you?

Yes, definitely. It can't be a bad thing to think more like that so no, it is quite a shock and I think it does make you think more, definitely, yes.

 

Says he has become more emotional since his heart failure.

Says he has become more emotional since his heart failure.

Age at interview: 49
Sex: Male
Age at diagnosis: 46
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I don't think so, I think the only thing which I should have mentioned which I haven't and I think it is down to the drugs, I tend to get emotional, that's the thing I forgot to mention... I tend to get emotional over the daftest things you know, don't watch Bambi for goodness sake, it's terrible!  I think it's because, this is going to sound really stupid because I have no spiritual feelings whatsoever we've established that, but it's like I've sort of woken up and smelt the coffee, and... everything around you has a lot of value, and the daftest things upset you - you see a pregnant women and it's wonderful, it really is, it brings me to tears, so blame the drugs I do, that's the answer to that one. So yeah probably overly emotional. 

Though some took each day as it came and did not dwell on the future, many found this hard to do. They worried about how their family would manage if they died and about their own state of health and whether their condition was getting worse. Many found the uncertainty of life with heart failure particularly hard to cope with.

 

Vivienne says that on a bad day she feels exhausted and worries about many things including dying in her sleep.

Vivienne says that on a bad day she feels exhausted and worries about many things including dying in her sleep.

Age at interview: 61
Sex: Female
Age at diagnosis: 60
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I’m frightened about the future. Because I live on my own, I often think one night I don’t, I just felt bad but it was when there was a bug going around and I just thought I wasn’t going to wake up, I thought I was going to go to sleep and not wake up. But that’s because, that was a one off but I do feel frightened about the future. I do think sometimes will I go to bed and not wake up. There’s so many things I’m worried about to do with my girls really. Like for example, I own this house and I’ve got, I think, less than five thousand I owe on it, it’s something like three thousand and when I die, my youngest girl is going to come and live here, sell her house and give half the proceeds to her sister so they both get, you know, an equal share but I’m thinking, I don’t want any friction between them or anything like that although this has been agreed and I’m thinking, should she come and move in with me now and live now and sort things out like with the house, so many things, you know, I worry about. How long am I going to feel like this for, will I get worse, when will I get worse, what will I be like when I’m worse, when I die, will I die of a heart attack or will I die of fluid on me lungs or, with my illness, how do you, when you die how do you die with it, you know.

I do worry about, not all the time or anything like that but you know, I might be laid in bed one night and then I’ll be thinking all sorts. Will I be here to see the grandkids, you know, maybe get married or that type of thing.


 

Last reviewed April 2016.
Last updated July 2014.

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