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Mood Disorders Can Break Your Heart

Research over the past two decades has shown that mood disorders 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. A study conducted in Baltimore, MD found that of 1,551 people who were free of heart disease, those who had a history of depression were 4 times more likely than those who did not to suffer a heart attack in the next 14 years. In addition, researchers in Montreal, Canada found that heart patients who were depressed were 4 times as likely to die in the next 6 months as those who were not depressed.

Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Depression also may 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 harmful effects on the heart.

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 1 in 3 Americans will die of some form of heart disease.

There are multiple studies indicating that heart disease can follow depression. 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. People with depression may feel slowed down and still have high levels of stress hormones. This can increase the work of the heart. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.

Regardless of cause, the combination of depression and heart disease is associated with increased sickness and death, making effective treatment of depression imperative. Exercise is potential pathway to reducing both depression and risk of heart disease. Exercise, of course, is a major protective factor against heart disease as well.

Source: National Institutes of Health