Depression and Heart Disease
Depression and heart disease often go hand-in-hand. When this happens, the presence of the additional illness, depression, is frequently unrecognized, leading to serious and unnecessary consequences for patients and families.
Though depressed feelings can be a common reaction to heart disease, clinical depression is not the expected reaction. For this reason, when present, specific treatment should be considered for clinical depression even in the presence of heart disease
Appropriate diagnosis and treatment of depression may bring substantial benefits to the patient through improved medical status, enhanced quality of life, a reduction in the degree of pain and disability, and improved treatment compliance and cooperation.
How a cascading effect takes a toll
Biology and behavior both help explain why depression makes adults more vulnerable to heart disease, says Franois Lesperance of the University of Montreal.
Depressed adults lack the energy for exercise and may follow unhealthful diets if they feel hopeless. Depression also can lead adults with heart trouble to fare worse than other patients, he says. Because they're less hopeful, they're less likely to take medicine and they tend to stop if there are side effects. Depressed adults also have blood that's more likely to clot and more inflammation in their arteries, which can trigger heart attacks, Lesperance says. And the hearts of depressed people beat at a less variable rate. Natural variability helps to protect the heart, Lesperance adds.
More Facts
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Research has documented a high correlation between depression and increased risk of dying or impairment in patients with coronary heart disease:
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In coronary heart disease patients with a history of myocardial infarction (heart attack), the prevalence of various forms of depression is estimated from 40 to 65 percent.
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18-20 percent of coronary heart patients without a history of heart attack may experience depression.
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Major depression puts heart attack victims at greater risk and appears to add to the patients' disability from heart disease. Depression can contribute to a worsening of symptoms as well as poor adherence to cardiac treatment regimens.
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People who survive heart attacks but suffer from major depression have a 3-4 times greater risk of dying within six months than those who do not suffer from depression.
(Source: NIMH)
Signs of Depression
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Persistent, sad or "empty" mood
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Loss of interest or pleasure in ordinary activities, including sex
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Decreased energy, fatigue, being "slowed down"
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Sleep disturbances (insomnia, early-morning waking or oversleeping)
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Eating disturbances (loss of appetite and weight, or weight gain)
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Irritability
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Difficult concentrating, remembering, making decisions
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Feelings of guilt, worthlessness, helplessness
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Thoughts of death or suicide; suicide attempts
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Excessive crying
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Chronic aches and pains that don't respond to treatment
If a person has five or more of these symptoms for more than two weeks, it is important that these symptoms be brought to the attention of the individual's health care provider.
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