Is there a link between Depression and Cardiovascular Disease?

In 1628, William Harvey claimed: “For every affection of the mind that is attended with either pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart” (Frasure-Smith). With his statement, Harvey suggested a link between the mind and the heart. Depression is a widely known condition that affects more than just the brain. Both depression and cardiovascular disease affect numerous individuals worldwide. In fact, the American Heart Association claims that roughly 1 in 10 Americans over the age of 18 suffer depression. Furthermore, the statistics can rise to about 33% for heart attack patients (AHA). Therefore, the link between the two diseases may be more influential than previously thought. But can feeling down affect our physiological health to the extent of cardiovascular disease? Or on the contrary, can cardiovascular disease lead us to have problems psychologically? The answer is yes to both.

Depression can lead to changes that can affect your health. It’s important to take care of one’s mental health just as carefully as taking care of one’s blood pressure or cholesterol. With depression, physiological impacts include increased levels of stress hormones, cortisol, and glucose. In depressed heart attack patients, decreased motivation to follow healthy daily routines can result in poor lifestyle habits such as avoiding exercise, bad diet, and smoking. Individuals with depression can also experience changes in their nervous system and hormonal balance, thus leading to disturbances in their hearts rhythm (Zieglestein). Furthermore, people with depression may have uncommonly sticky platelets which can increase the risk of atherosclerosis (Zieglestein).

On the other hand, a heart attack can impact more than a person’s heart. It can affect their psychological state, mood, attitude, and personal life. Their sense of certainty about future events or confidence in their abilities could be affected. Individuals may be left feeling guilty for any habits that may have caused them to be at risk for a heart attack. They may also feel embarrassment over their current physical capabilities. Most heart attack survivors are capable of returning back to their daily lives. However, patients with depression have a lower chance of recovery than people without depression (AHA).

It is difficult to prove that heart disease directly leads to the development of depression. For instances, an individual may not have been priorly diagnosed with depression before learning about their heart condition. However, as Dr. Roy Ziegelstein claims, “What we can say with certainty is that depression and heart disease often occur together, about one in five who have a heart attack are found to have depression soon after the heart attack. And it’s at least as prevalent in people who suffer heart failure” (Ziegelstein).
References

American Heart Association (2014). How does depression affect the heart? Retrieved by http://www.heart.org/HEARTORG/HealthyLiving/StressManagement/HowDoesStressAffectYou/How-does-depression-affect-the-heart_UCM_460263_Article.jsp#.Wt1GLYjwY2w

Ziegelstein, Roy. Heart & Vascular Institute. Johns Hopkins Medicine. Retrieved by https://www.hopkinsmedicine.org/heart_vascular_institute/clinical_services/centers_excellence/womens_cardiovascular_health_center/patient_information/health_topics/depression_heart_disease.html

Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. JAMA. 1993; 270:1819–1825.