Studies have found a connection between depression and heart disease. Two conditions that can significantly impact a person’s well-being and dramatically reduce their quality of life. Depression can manifest in a variety of symptoms that take a toll on both a person’s physical and mental health, leaving them feeling hopeless,unmotivated, and fatigued.
Heart disease, on the other hand, can cause immense physical strain, limiting a person’s mobility and daily activities, and can also lead to emotional distress due to concerns about mortality and lifestyle changes. Understanding if depression increases the risk of heart disease is needed to promote overall health.
How Common is Depression?
Depression is a common mental disorder. There’s an estimated 5% of adults around the world, or roughly 280 million people, experience depression. Women are affected more than men, with women having a 6% prevalence compared to 4% in men.
But these are just general numbers, and depression can hit anyone at any age and at any time. Even older adults are susceptible, with 5.7% of people over 60 years old also experiencing depression.
Depression can have serious consequences. As explained by the American Association for Suicidology, about two-thirds of people who die by suicide are battling depression at the time of their death.
What is Heart Disease?
Heart disease (also known as Cardiovascular disease) is a general term for conditions that affect the heart and blood vessels. Although there are many different types of heart disease, the most common one is coronary artery disease (CAD).
CAD happens when the arteries that supply blood to the heart become narrowed or blocked. It usually occurs due to a buildup of plaque, a fatty substance that can harden and restrict blood flow. So, when the heart doesn’t get enough blood, it can lead to chest pain, shortness of breath, and even a heart attack.
Some common causes of heart disease:
- High blood pressure
- High cholesterol
- Smoking
- Diabetes
- Overweight and obesity
- Unhealthy diet
- Physical inactivity
So, Does Depression Increase the Risk of Heart Disease?
Yes, unfortunately, depression can also significantly increase the risk of heart disease aside from the mentioned causes above. And there’s a wealth of research supporting this connection.
One clinical review of depression and its link to cardiovascular disease (CVD) showed that people with depression are more likely to develop CVD later in life and may have a higher mortality rate, and vice versa. Those with CVD are more prone to depression than those who are not. Additional support strategies for depressed cardiac patients include cardiac rehabilitation, exercise programs, cognitive behavioral therapy, antidepressant medication, or a combination of these approaches.
Looking beyond adults, the American Heart Association (AHA) in 2015 highlighted the increased risk of early-onset cardiovascular disease in teens with depression and bipolar disorder, calling the doctors to monitor these patients and take preventive measures closely.
More studies further solidify this connection. Research presented at the American College of Cardiology meeting found that developing depression after a heart disease diagnosis doubles the risk of death for those patients.
They looked at the medical charts of nearly 25,000 patients for almost ten years after they were diagnosed with heart disease. They were surprised to find that a much higher percentage (around 15%) developed depression compared to the usual rate of 7.5% to 10% in the general population.
Even more concerning, out of those who got depression after their heart diagnosis, half of them didn’t survive the study period. This is in contrast to the 38% mortality rate for those without depression. This means having depression on top of heart disease doubles the risk of death for these patients.
Similarly, a study published in the Journal of the American Heart Association showed that young adults with depression or poor mental health days had a higher prevalence of heart attacks, strokes, and risk factors for heart disease compared to their mentally healthy counterparts.
But, Why Might Depression Raise Heart Disease Risk?
Several potential mechanisms might contribute to this increased vulnerability. This connection seems to be influenced by biological and behavioral factors
1. Inflammation
Chronic, low-level inflammation is linked to various health issues, including depression. Studies have shown that chronic depression is now considered a significant cardiovascular risk factor for patients who’ve already had a heart attack. So,the inflammation associated with depression might contribute to worsening heart health.
2. Stress Hormones
The MESA study explored the connection between stress hormones and heart disease. They found that participants with higher levels of stress hormones, particularly cortisol, in their urine were more likely to develop high blood pressure within the next few years.
Furthermore, it also showed a worrying 90% increased risk of cardiovascular events with each doubling of cortisol levels over an extended period, which means that chronic stress, reflected by elevated cortisol levels in depression, could contribute to heart problems.
3. Lifestyle Changes
One additional research has shown a positive correlation between depression and unhealthy lifestyles, particularly in developing countries, including habits like smoking (both daily and non-daily) and lower physical activity levels.
It also suggests that depressed individuals with these unhealthy habits are more likely to experience worsening depression over time. Essentially, depression can make it harder to maintain healthy habits, further increasing the risk of heart disease.
4. Reduced Heart Rate Variability (HRV)
Moreover, depression might be linked to altered heart function through reduced HRV. HRV refers to the natural variation in the time between heartbeats.
A reduced HRV is associated with a decreased heart’s ability to adapt to stress, potentially making it more vulnerable to problems. In simpler terms, depression might affect the heart’s ability to handle stress effectively, increasing the risk of complications.
5. Self-Care Neglect
Lastly, depression can also affect a person’s motivation and energy levels, making it harder to prioritize self-care activities like healthy eating, regular exercise, and doctor visits.
These neglected behaviors can worsen existing health problems and contribute to the development of new ones, including heart disease.
Are There Gender Differences in the Depression-Heart Disease Link?
Experts say that there may be some gender differences in the link between depression and heart disease. For example, a large-scale study published in a reputable medical journal found a significant association between depression and subsequent cardiovascular disease (CVD) events in both men and women. But, it was also found that the association was stronger among women. Therefore, women with depression experienced a greater increase in CVD risk compared to men with depression.
On top of that, another study focusing on a cardiac population in Palestine observed that women were more likely to experience severe depression than men. Additionally, it also identified factors like higher post-traumatic stress disorder (PTSD) symptoms and lower resilience as potentially contributing to this gender disparity.
How Treating Depression Can Improve Heart Health?
Now, based on the studies mentioned above, it is clear that there might be a strong connection between depression and heart health. Fortunately, some experts say that treating depression can significantly improve cardiovascular outcomes.
A study published in the Journal of the American Heart Association followed over 1,500 patients with heart disease and co-existing anxiety or depression. Those who received treatment for their mental health conditions (therapy, medication, or both) were 75% less likely to be rehospitalized and 74% less likely to visit the emergency room compared to those who didn’t receive treatment. The same study suggests that treating depression and anxiety in heart patients can lead to a 66% reduction in death from any cause.
Effective Treatment for Depression
Depression can negatively impact heart health through various pathways. Luckily, a lot of in-depth researches show that Transcranial Magnetic Stimulation or TMS therapy is a safe and effective treatment for depression, achieving remission rates comparable to medication.
TMS uses targeted magnetic pulses to stimulate nerve cells in the brain regions associated with mood regulation. These pulses are thought to correct dysfunctional brain patterns and improve communication between nerve cells, reducing depression symptoms.
Benefits of TMS Therapy
- Safe and Non-invasive: TMS does not require surgery or anesthesia.
- Effective: TMS is effective for patients who have not responded well to medication or therapy.
- Long-lasting Results: Many patients experience sustained improvement in their mood after TMS treatment.
So, if you’ve struggled with depression and haven’t found relief with other treatments, TMS might be the answer.
At TMS Institute of Arizona, their team of experienced doctors specializes in providing TMS therapy. They will work with you to determine the best treatment for your needs and guide you through every step. Call them at 480-448-2916 or fill out the contact form.
References:
American Association of Suicidology. (2009). Some Facts About Suicide and Depression. https://www.cga.ct.gov/asaferconnecticut/tmy/0129/Some%20Facts%20About%20Suicide%20and%20Depression%20-%20Article.pdf
Cabello, M., Miret, M., Francisco Felix Caballero, Chatterji, S., Naidoo, N., Kowal, P., D’Este, C., & Jose Luis Ayuso-Mateos. (2017). The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries. Globalization and Health, 13(1). https://doi.org/10.1186/s12992-017-0237-5
Carmin, C. N., Ownby, R. L., Fontanella, C., Steelesmith, D., & Binkley, P. F. (2024). Impact of Mental Health Treatment on Outcomes in Patients With Heart Failure and Ischemic Heart Disease. Journal of the American Heart Association. Cardiovascular and Cerebrovascular Disease, 13(7). https://doi.org/10.1161/jaha.123.031117
Deepti Jangpangi, Mondal, S., Rajiv Bandhu, Kataria, D., & Gandhi, A. (2016). Alteration of Heart Rate Variability in Patients of Depression. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/jcdr/2016/22882.9063
Depression doubles long-term risk of death after heart disease diagnosis, new study findsam. (2017, March 13). EurekAlert! https://www.eurekalert.org/news-releases/787404
Goldstein, B. I., Carnethon, M. R., Matthews, K. A., McIntyre, R. S., Miller, G. E., Geetha Raghuveer, Stoney, C. M., Wasiak, H., & McCrindle, B. W. (2015). Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease. Circulation, 132(10), 965–986. https://doi.org/10.1161/cir.0000000000000229
Hare, D. L., Toukhsati, S. R., Johansson, P., & Jaarsma, T. (2013). Depression and cardiovascular disease: a clinical review. European Heart Journal, 35(21), 1365–1372. https://doi.org/10.1093/eurheartj/eht462
Hala Allabadi, Probst-Hensch, N., Abdulsalam Alkaiyat, Saleem Haj-Yahia, Schindler, C., Kwiatkowski, M., & Zemp, E. (2019). Mediators of gender effects on depression among cardiovascular disease patients in Palestine. BMC Psychiatry, 19(1). https://doi.org/10.1186/s12888-019-2267-4
Kwapong, Y. A., Boakye, E., Khan, S. S., Honigberg, M. C., Martin, S. S., Oyeka, C. P., Hays, A. G., Natarajan, P., Mamas, M. A., Blumenthal, R. S., Blaha, M. J., & Sharma, G. (2023). Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States. Journal of the American Heart Association. Cardiovascular and Cerebrovascular Disease, 12(3). https://doi.org/10.1161/jaha.122.028332
Massimo Fioranelli, Bottaccioli, A. G., Bottaccioli, F., Bianchi, M., & Rovesti, M. (2018). Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based. Frontiers in Immunology, 9. https://doi.org/10.3389/fimmu.2018.02031
Sex Differences in the Association Between Depression and Incident Cardiovascular Disease: (2023). JACC: Asia. https://www.jacc.org/doi/10.1016/j.jacasi.2023.11.015
Study links high levels of stress hormones to increased blood pressure, cardiovascular events. (2021, September 13). NHLBI, NIH. https://www.nhlbi.nih.gov/news/2021/study-links-high-levels-stress-hormones-increased-blood-pressure-cardiovascular-events
WHO. (2023, March 31). Depressive disorder (depression). Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/depression
