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Depression May Contribute to Early Heart Disease

More About Depression

Depression is a depressive disorder that involves a person's body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns. It is not the same as being unhappy or in a "blue" mood, nor is it a sign of personal weakness or a condition that can be willed or wished away.

People with a depressive illness cannot merely "pull themselves together" and get better. Treatment is often necessary and many times crucial to recovery.

There are three primary types of depression, including major depression (clinical depression); manic depression (bipolar disorder); and dysthymia (dysthymic disorder).

Major depression, also known as clinical depression or unipolar depression, is classified as a type of affective disorder or mood disorder that goes beyond the day's ordinary ups and downs, becoming a serious medical condition and important health concern in this country.

The onset of depression is occurring earlier in life than in previous years, with women nearly twice as likely than men to develop major depression.

The following are the most common symptoms of major depression. However, each individual may experience symptoms differently. Symptoms may include:

  • persistent sad, anxious, or empty mood
  • loss of interest in activities once previously enjoyed
  • excessive crying
  • increased restlessness and irritability
  • decreased ability to concentrate and make decisions
  • decreased energy
  • thoughts of death or suicide, or suicide attempts
  • increased feelings of guilt, helplessness, and/or hopelessness
  • weight and/or appetite changes due to over- or under-eating
  • changes in sleep patterns
  • social withdrawal
  • physical symptoms unrealized by standard treatment (i.e., chronic pain, headaches)

For a diagnosis of major depression to be made, an individual must exhibit five or more of these symptoms during the same two-week period. The symptoms of major depression may resemble other psychiatric conditions.

Because depression has shown to often co-exist with other medical conditions, such as heart disease, cancer, or diabetes, and other psychiatric disorders, such as substance abuse, or anxiety disorders, seeking early diagnosis and treatment is crucial to recovery.

Always consult your physician for more information.

[Feburary 7, 2007] New research indicates that depression, especially its physical signs, such as fatigue and loss of appetite, may contribute to thickening arteries, an early sign of cardiovascular disease.

A picture of a stressed-out woman holding her hand to her head

The new findings were published in the Archives of General Psychiatry.

Previous research has suggested that negative emotions like anxiety and anger can increase the risk for heart disease. But in the new study, depression - and its physical symptoms - was the emotional linchpin to early signs of heart disease.

"In other studies, anxiety, depression, anger, and hostility have all separately been linked to future risk of heart disease," says lead researcher Jesse C. Stewart, Ph.D., a member of the psychology department at Indiana University-Purdue University Indianapolis.

But the problem with those studies was that they did not look at these negative emotions together. And since their symptoms can overlap, it has been hard to tell which emotion plays the most important role in heart disease, Dr. Stewart says.

Early Stage Heart Disease Studied

For the study, Dr. Stewart's team looked for emotional links to heart disease among 324 men and women with an average age of 60.6 years old.

To determine early signs of heart disease, the scientists examined carotid artery intima-media thickness, which is a measure of the inner layers of the arteries and is related to early stage heart disease. Measurements were taken at the start of the study and again three years later.

"We found that mild to moderate depressive symptoms were associated with greater progression of subclinical atherosclerosis [hardening of the arteries] - greater increase of the artery wall," Dr. Stewart says. "In contrast, anxiety symptoms, hostility, and anger were not at all related to a change in the blood vessel thickness."

In addition, analysis showed that only the physical symptoms of depression predicted the progression of atherosclerosis. And it appears that the symptoms of depression exist before the signs of atherosclerosis, Dr. Stewart says.

Antidepressants May Help

Dr. Stewart is not sure why depression has this effect. "Depression has been associated with some physiological changes, including in the immune system. These physiological changes probably explain this association," he says.

The study also found that the 5 percent of study participants taking antidepressants fared better than those with depression who were not taking the drugs. "They had significantly reduced progression of atherosclerosis," Dr. Stewart says.

But, because the sample was so small, it is not possible to make a definitive statement about the value of selective serotonin reuptake inhibitors (SSRIs) in reducing atherosclerosis, Dr. Stewart says. "There is intriguing evidence that SSRIs may be associated with reduced progression of atherosclerosis," he says.

Dr. Stewart thinks the study findings may help in treating and preventing heart disease.

"Identifying the harmful aspects of emotion could lead to the identification of people who are at risk for heart disease due to their tendency to experience negative emotions and who may benefit from psychological and pharmacological intervention," he says. "Identifying these harmful aspects could also lead to the development of more focused and potent interventions."

Consider Both Physical and Mental Symptoms

Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City, notes that depressed people are less likely to take care of themselves and have more risk factors for heart disease.

"People who are depressed don't adopt a healthy lifestyle," says Dr. Goldberg, a spokeswoman for the American Heart Association and author of The Women's Healthy Heart Program. "They overeat, smoke more, may drink more. In addition, people who have depression have platelets that are more likely to clot."

Dr. Goldberg thinks doctors should pay closer attention to depression and other psychological factors that can affect patient health.

"For too long, the medical system has amputated the head from the rest of the body," she says. "It is important for us to consider the psychological aspects of our patients' lives, because that is an important factor in our care of a patient."

Always consult your physician for more information.

  
 
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