Postmenopausal women with negative personality characteristics are at an increased risk of psychological disorders, yet little is known about the mechanism underlying the relationship between type D personality and psychological distress in postmenopausal women with coronary disease. This study assessed the mediating roles of perceived social support and self‐perceived burden in the relationship between type D and psychological distress based on the equity theory and stress‐buffering model. Demographic characteristics, type D, psychological distress, perceived social support, and self‐perceived burden were completed by 335 participants with self‐reported questionnaires using a cross‐sectional design in Southeast China. The results revealed that perceived social support and self‐perceived burden both separately and serially mediated the relationship between type D personality and psychological distress. Effective intervention strategies aimed at improving perceived social support or reducing self‐perceived burden may be beneficial in reducing psychological distress.