Living with heart failure can be challenging, both physically and emotionally. After a diagnosis, you may experience a range of feelings.

It’s common for people to feel fear, frustration, sadness, and anxiety. Not everyone experiences these feelings, and they may come and go, or linger. For some people, the medications used to treat heart failure can result in depression. For others, living with heart failure has a significant effect on their ability to manage psychological and emotional stress.

There are different types of heart failure, including systolic, diastolic, and congestive. But no matter what type of heart failure you’re living with, the mental health risks are similar.

Here are six things you need to know about living with heart failure and your mental health.

There’s a known relationship between mental health and living with a chronic health condition. The National Institute of Mental Health reports that having a chronic illness such as heart failure raises the risk of depression.

According to a 2015 study published in the Annals of Behavioral Medicine, up to 30 percent of people living with a cardiac condition experience depression.

Mental health and heart disease are tightly linked, says Ileana Piña, MD, MPH, who is Detroit Medical Center’s national director of heart failure as well as director of cardiovascular research and academic affairs. In fact, she notes that more than 35 percent of patients who have heart failure meet the criteria for clinical depression.

If you have a history of depression, finding out you have heart failure can exacerbate any preexisting symptoms.

The number of new factors you need to cope with after a heart failure diagnosis can take a toll on your emotional and mental health, says L.A. Barlow, PsyD, a psychologist at Detroit Medical Center.

“There are major lifestyle changes that occur when someone is diagnosed with heart failure, and that typically leads to depression,” Barlow adds. She says that life can feel more limited. People may also have difficulty sticking to their treatment plan and depend more on a caregiver. And medications such as beta-blockers can also worsen or trigger depression.

The early signs of a mental health issue like depression are often seen by family members first.

Barlow says one common sign is a loss of interest in things that used to bring a person joy. Another is a “lack of daily functioning,” or, in other words, a reduced ability to manage different aspects of life on a day-to-day basis.

Since living with heart failure can lead to a wide range of emotions, it can be difficult to determine when these behaviors indicate a deeper mental health concern.

That’s why she encourages anyone with a chronic condition like heart failure — especially a recent diagnosis — to have an initial mental health evaluation. This can help prepare you for all the emotional aspects that are often linked with chronic disease.

“People tend to internalize these feelings and don’t know how to manage them properly,” she explains.

“Internalizing the emotional toll these chronic illnesses carry can certainly lead to depression and other mental health issues. Having an evaluation with a mental health professional might help you navigate and understand the life changes that will come along with such a diagnosis.”

If you think you’ve noticed signs of a mental health condition — whether it’s depression, anxiety, or something else — it’s important to contact your doctor right away.

Barlow says getting an early diagnosis is key to the effective treatment of mental health issues and heart failure.

“Early intervention can help you make lifestyle adjustments and receive the proper mental health evaluation and treatment plan for the emotional concerns that come with a chronic disease like heart failure,” she adds.

Undiagnosed or untreated depression or anxiety may impact your ability to follow a treatment plan for heart failure.

For example, it may affect your ability to stick to taking your medication as needed or making it to your healthcare appointments, explains Piña. That’s why she says cardiologists should try to identify mental health issues, and particularly depression and anxiety, as early as possible.

Plus, the Cleveland Clinic notes that lifestyle habits often linked to depression — such as smoking, inactivity, drinking too much alcohol, poor dietary choices, and missing out on social connections — can also have a negative effect on your heart failure treatment plan.

As you adjust to living with heart failure, it’s important to know that you’re not alone.

Barlow says there are support groups, individual mental health professionals, and some mental health professionals that specialize in helping people with chronic diseases.

Since a chronic illness can take a toll on your entire family unit, Barlow says close family members and caregivers may also want to seek out support groups and mental health experts. These types of groups are beneficial for everyone involved. The American Heart Association is a great place to start.

If you’ve been diagnosed with any type of heart failure, you may be at increased risk for certain mental health conditions, such as depression. Talk to your doctor if you’re concerned about how heart failure is affecting your emotional and mental well-being. Your doctor can provide guidance about how to find a counselor or other mental health services.