Physical and mental health are two sides of the same coin, although we often fail to acknowledge it. It’s understandable—physical ailments are quite obvious and even palpable, while mental health issues are usually undercover and subtle. Because mental health conditions like depression affect your mood, behavior, and outlook on life, they are treated on their own with no consideration of physical health repercussions—and therein lies the problem. Depressive disorders extensively affect your physical well-being. More specifically, people who suffer from depression are more likely to develop heart disease at an earlier age.
Multiple studies have shown depression is correlated with an elevated risk of coronary disease, which can ultimately lead to a heart attack. The simplest explanation of the link between depression and heart health deterioration has to do with unhealthy lifestyle.
Burdened with feelings of sadness, emptiness, and hopelessness, depressed individuals are inclined to adopt a self-sabotaging behavior, often engaging in substance abuse and failing to take proper care of themselves. Many patients coping with moodiness and despair start smoking or, in the case of existing smokers, substantially increase the number of cigarettes smoked a day. Low energy and chronic fatigue—common in depression—are not very conducive to regular physical activity. Even people who played sports regularly may abandon their practice, having lost an interest in the hobbies they once loved.
Unhealthy eating is also quite widespread among the depressed, manifested through either loss of appetite or overeating. Depressed individuals are often not in the mood to cook or plan their meals, resulting in a haphazard meal schedule and unhealthy food choices. (Heart problems aren’t a family tradition that you’re destined to continue.)
The lifestyle changes that take place alongside depression translate into well-known cardiovascular risk factors—smoking, sedentary lifestyle, and poor diet. You can also add to the list the side effects of some antidepressants: weight gain as well as higher levels of cholesterol and blood sugar, which are all harmful to cardiovascular health.
But does the cumulative effect of these factors fully account for the fact that major depressive patients show signs of heart disease six years sooner than non-depressed individuals?
Remember the sides of the same coin analogy? Although depression affects our mood, in reality, the impact is much more profound. Mood disorders are linked to a variety of biological changes that promote deterioration of the blood vessels.
In a nutshell, the culprit is inflammation.
When a patient is going through an episode of depression, the blood level of C-reactive protein (a telltale sign of inflammation) rises, and once the episode is over, the levels go back to normal. There’s no harm if it happens once in a while—we all go through some sort of stress from time to time. But in the case of major depression, the inflammatory response lasts a long time, during which the proteins released can damage the lining of the arteries, resulting in plaque buildup and narrowing of the arteries, the precursors of heart disease.
For someone who is 50 years old or older and has spent half of the past decade depressed, the heart disease risk rises significantly, given all the harmful effects of such prolonged inflammation.
The take-home message? Physical and mental well-being are much more closely intertwined than you think. Our body is a system: a problem in one part triggers a problem in another part, even if these parts seem to be unrelated. If you’re suffering from mood disorders or have a past history of depression, heart health should be a priority. Discuss the risks with your doctor and adopt a heart-friendly lifestyle to keep your heart beating strong for years to come.