I’ve written before about PTSD’s effect on the heart and cardiovascular system, but is there also a link between major depression and heart disease? There is substantial evidence to suggest that not only are those who suffer from depressive symptoms more likely to develop problems with their heart but are more likely to die from cardiovascular problems than those without a diagnosis of depression.
Depression and Lifestyle Changes
First, some of the well-known symptoms of depression are inactivity, loss of interest, low self-esteem, melancholia, difficulties with decision-making, feelings of worthlessness. Major Depressive Disorder makes it nearly impossible to get ANYTHING done, and physical activity, while it can help with depression, is much more difficult when you lack the energy or willpower to get it done. Those with depression are much more likely to have a sedentary lifestyle, and are much more likely to become overweight. In addition, those with depression (and nearly every mental health illness or mental disorder) are more likely to smoke tobacco, drink alcohol, and suffer from drug abuse | substance abuse. All of these lifestyle factors GREATLY increase the risk of developing cardiovascular problems as well as diabetes, which causes cardiovascular problems on its own and can lead to comorbidity of these issues.
Depressive episodes also cause a great deal of stress. Additionally, social and occupational problems are related to depression, and these factors often end up causing problems with life events leading to poor social relationships and employment. In turn, these problems often lead to unemployment and divorce, which lead to even MORE psychiatric disorders such as mood disorders, anxiety disorders, depressed moods, stress, and more. Both social isolation and stress increase your chances of dying by a sudden cardiac event.
Diabetes and Secondary Depression
In those who suffer from a form of depression, the risk factor of developing diabetes increases by about 20%, even after adjusting for other factors like exercise and diet when compared to the general population. To make matters worse, those with diabetes actually have an increased risk of developing depression and similar symptom patterns of depression. The two disabilities seem inextricably linked, with depression making existing diabetes worse, and diabetes worsening depression as well.
Antidepressants and Cardiovascular Dysfunction
Several antidepressants used for psychiatric treatment can cause problems with your heart. Many older tricyclic antidepressants used to treat this psychiatric illness have been shown to cause fatal arrhythmias, or irregular heartbeats. While newer SSRI antidepressants like fluoxetine, citalopram and escitalopram do seem to cause less symptoms, studies show SSRIS also cause arrhythmias, which can increase the likelihood of a cardiac event.
Cardiovascular Disabilities and Secondary Depression
As I’ve written above, stress, social isolation, and diabetes secondary to primary depression can lead to cardiovascular problems. However, depression alone is the biggest culprit. Depression alone predicts the development of coronary heart disease in initially healthy people. In fact, those with clinical depression, even after accounting for other factors are nearly THREE times more likely to develop coronary heart disease. Researchers also have discovered that the relationship is “dose-dependent,” in other words, that the worse your depression, the more likely you are to develop heart problems.
As if all this wasn’t bad enough, when those who suffer from depression DO have a heart attack, they are more than three times more likely to die within 18 months than those without depression.
Depression is a serious medical condition. It isn’t just “feeling down,” or feeling worried. Depression destroys family relationships, careers, and ultimately can take away your health and even your life. Your obesity, diabetes, and heart condition MAY be secondary to your service-connected depression, and you may be entitled to compensation and healthcare because of this.
