Depression is common in patients with cardiovascular disease (CVD) and is associated with higher mortality and morbidity. Patients with CVD and depression have worse outcomes than those without depression. There is a graded relationship between the severity of depression and the risk of mortality and cardiovascular events. Depression may be a marker for more severe CVD, but a causal relationship is likely. Both CVD and depression can cause each other, and depression is a major driver of quality of life. Depression after an acute cardiac event is often an adjustment disorder that can improve with comprehensive cardiac management. Additional strategies for managing depression in CVD patients include cardiac rehabilitation, exercise, cognitive behavioral therapy, antidepressant medication, and disease management programs. Depression is also linked to anxiety, social isolation, and poor adherence to medical treatment. Screening for depression is important in CVD patients, with tools such as the Patient Health Questionnaire (PHQ) and the Beck Depression Inventory (BDI) being commonly used. Depression in CVD patients requires specific intervention due to its impact on prognosis and quality of life. Pharmacological treatment with antidepressants, particularly SSRIs, is effective but must be carefully managed due to potential cardiac risks. Combined approaches, including psychotherapy and medication, are recommended for managing depression in CVD patients. Further research is needed to clarify the pathophysiological mechanisms and optimal management strategies for depression in CVD.Depression is common in patients with cardiovascular disease (CVD) and is associated with higher mortality and morbidity. Patients with CVD and depression have worse outcomes than those without depression. There is a graded relationship between the severity of depression and the risk of mortality and cardiovascular events. Depression may be a marker for more severe CVD, but a causal relationship is likely. Both CVD and depression can cause each other, and depression is a major driver of quality of life. Depression after an acute cardiac event is often an adjustment disorder that can improve with comprehensive cardiac management. Additional strategies for managing depression in CVD patients include cardiac rehabilitation, exercise, cognitive behavioral therapy, antidepressant medication, and disease management programs. Depression is also linked to anxiety, social isolation, and poor adherence to medical treatment. Screening for depression is important in CVD patients, with tools such as the Patient Health Questionnaire (PHQ) and the Beck Depression Inventory (BDI) being commonly used. Depression in CVD patients requires specific intervention due to its impact on prognosis and quality of life. Pharmacological treatment with antidepressants, particularly SSRIs, is effective but must be carefully managed due to potential cardiac risks. Combined approaches, including psychotherapy and medication, are recommended for managing depression in CVD patients. Further research is needed to clarify the pathophysiological mechanisms and optimal management strategies for depression in CVD.