Depression Can Break Your Heart

How Depression Can Impact Your Body

The public health impact of depression and heart disease, both separately and together, is enormous. Depression is the estimated leading cause of disability worldwide, and heart disease is by far the leading cause of death in the United States. Approximately one in three of Americans will die of some form of heart disease.

Research over the past two decades has shown that depression and heart disease are common companions and what is worse, each can lead to the other. It appears now that depression is an important risk factor for heart disease along with high blood cholesterol and high blood pressure.

Other Ways Depression Can Affect You

Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Depression may also result in chronically elevated levels of stress hormones, such as cortisol and adrenaline, and the activation of the sympathetic nervous system (part of the "fight or flight" response) which can have deleterious effects on the heart. The first studies of heart disease and depression showed that people with heart disease were more depressed than healthy people. While about one in six people have an episode of major depression, the number goes to one in two for people with heart disease. Furthermore, other researchers have found that most heart patients are not treated for depression. Doctors tend to miss the diagnosis of depression and even when they treat it they often treat it with sedatives which may make the depression worse.

Psychological distress may cause rapid heartbeat, high blood pressure, and faster blood clotting. It can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a constellation of symptoms and often serve as a predictor of and a response to heart disease. Depressed individuals may feel slowed down and still have high levels of stress hormones. This can increase the work of the heart. When patients are caught in a fight or flight reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.

Exercise is another potential pathway to reducing both depression and heart disease. Exercise is related to fewer depressive symptoms in observational studies and appears to be as efficacious as psychotherapy in patients with mild depression. Exercise, of course, is a major protective factor against heart disease as well.