We’re all familiar with the well-known risk factors that can lead to heart disease, such as high cholesterol levels or a family history of heart problems. What’s less known, however, is the effect that depression can have on heart health.
About one in 10 Americans age 18 and older has depression, and it affects nearly twice as many women as men.
“Thanks to the benefits of research and expanding clinical experience, we continue to learn more about the relationship between depression and heart disease, including the role depression plays before and after a heart attack or other cardiac problems, particularly in women,” says Christina Adams, MD, a cardiologist at the Scripps Women’s Heart Center.
Here are six informative facts about how depression can affect the heart.
Though the reasons are not fully understood, researchers know that even mild forms of depression and its symptoms increase the risk of a heart attack and heart disease. One source of concern is that you may be less likely to follow your treatment plan if you're suffering depression.
Depressed women are more than two times likely to experience sudden cardiac death than women who are not depressed. In fact, the American Heart Association now recommends screening all heart patients for depression.
Just as depression can raise the risk of heart disease, the opposite appears to be true: heart disease can raise depression risk.
Following a heart attack, cardiac event or heart surgery, it is not unusual for patients to experience depression. Studies show that up to 33 percent of heart attack patients develop some degree of depression, according to the American Heart Association. Moreover, people with depression have a lower chance of recovery and a higher risk of another serious cardiac event or even death after a heart attack. This is most likely due to a combination of physiological and psychological factors.
“When a person is feeling stressed, the body releases more of the stress hormone cortisol, which has been linked with an increased risk of heart disease and heart attacks,” Dr. Adams says. Additionally, people with depression may have especially sticky platelets (the cells that cause blood to clot), high glucose levels and increased inflammation levels, which are all risk factors for heart disease.
It’s hard to maintain a heart-healthy lifestyle when you’re depressed. “The symptoms of depression, including feeling tired and having a lack of interest in activities, can make it challenging for people to take care of themselves and make healthy choices,” Dr. Adams says.
To make matters worse, people may try to deal with their depression through comforting but harmful behaviors, such as smoking, drinking alcohol or overeating. In fact, women with high levels of depression are more likely to be obese or smoke.
Depression may be difficult for cardiologists to diagnose, especially since the many physical symptoms that accompany heart disease may overshadow the psychological symptoms of depression. In addition, some symptoms of depression, such as fatigue, sleeping problems and low energy, can also be symptoms of heart disease. That’s why it is important to choose a physician who understands the role of depression in heart disease and considers your mental health and emotional wellness along with your heart health.
In most cases, depression can be successfully treated through cognitive therapy, medication or a combination of both. As people with depression begin to feel better, they may find they have more energy and are more motivated to make lifestyle changes that can improve their heart health. Physiological risk factors, such as increased stress hormones, also tend to improve.
If you suspect you or a loved one may have depression, or you experience “blue moods” that last for more than two weeks, seek help from your physician or health care professional. You and your heart will benefit.