Childhood Depression & Heart Disease

“Their future is bleak,” says Donald Lloyd-Jones, M.D., of today’s youth. Lloyd-Jones, chair and associate professor of preventive medicine at Northwestern University Feinberg School of Medicine and physician at Northwestern Memorial Hospital, is concerned about a startling trend regarding the overall health of children and teenagers. In an investigation of adolescent health profiles, gathered through the 2003-2008 National Health and Nutrition Examination Surveys, Lloyd-Jones and his team found that children and teenagers from age 12 to 19 are more likely to die from heart disease at younger ages than adults do today.

The Study

The study’s participants also provided occasional blood samples and results from physicals, which measured their blood pressures, weights, and heights. Among the 5,547 survey participants, none had met the conditions for optimal heart health. According to the American Heart Association, a healthy cardiovascular system relies on seven distinct aspects:

• Healthy diet and nutrition
• Optimal blood sugar levels
• Healthy weight/Body Mass Index (BMI)
• Being physically active
• Healthy cholesterol levels
• Not smoking
• Ideal blood pressure

The Results

The results from blood samples and survey responses indicated that none of the participants’ diets met the criteria for a healthy diet. About 80% had poor diets, consisting of high levels of sodium and sugar. Additionally, the children and teenagers in this group led mostly sedentary lives. Only 38% of girls and 52% of boys maintained an optimal level of physical activity. Combined, the poor nutrition and inactivity resulted in discouraging statistics for the other factors of heart health.

One of the major risk factors that the surveys, blood tests, and physical examinations ignored, however, was the presence of depressive disorders among the participants. Although physical health is a predictor of heart disease, strong evidence exists that links depression to an exacerbation of other risk factors. Many studies indicate that teenagers who suffered from depression as children are more likely to smoke, struggle with obesity, and lead sedentary lives. The discouraging aspect of this information is that these factors remain to exist despite a remission of depression. In other words, depressive symptoms in childhood impact a person more severely, regardless of getting better. 


Depressed Children At Higher Risk for Heart Attack

What’s more disheartening is that children with depression are also at an increased risk for developing cardiac disease, and not just as adults, but as teenagers. Researchers have remained in the dark regarding the timing of depression and its relationship to heart disease. In collaboration, researchers from the University of South Florida, Washington University, St. Louis, and the University of Pittsburgh indicate that not only does childhood depression increase the risk of subsequent heart disease, but that it may hasten its onset.

Robert M. Carney, Ph.D., professor of psychiatry at Washington University and one of the study’s authors, describes his concern, "Part of the reason this is so worrisome is that a number of recent studies have shown that when adolescents have these cardiac risk factors, they're much more likely to develop heart disease as adults and even to have a shorter lifespan.” For example, people who smoked as adolescents are twice as likely to die by age 55 than people who did not smoke. Obesity and other risk factors result in similar consequences.


Parents of Depressed Children . . .

Interestingly, the researchers also found data to suggest that the parents of adolescents, who experienced childhood depression, had higher rates of heart disease. To understand the role of genetics, their 2011 survey followed up with participants of a 2004 study. In the latter study, the participants were 16 and provided responses regarding their weight, smoking habits, and activity levels. The samples consisted of three groups: over 200 children with a history of depression, about 200 of their siblings, and then 150 non-related children of a similar age group and gender without a history of depression.

The results indicated that regardless of genes or current status of depressive symptoms, early onset depression was the one major risk factor for behaviors that lead to heart disease. In fact, obesity, smoking, and sedentary lifestyles all increased for the group of teenagers who were depressed as children. However, only 15% of the teenagers continued to have depression in the latter study.


Depression Comes First

"Depression seems to come first," says Carney. "It's playing an important, if not a causal, role.” He goes on to discuss the important role of genetics involved with both depression and heart disease. However, when compared, the children with depression demonstrated behaviors that put them more at risk for cardiac issues than their siblings. Carney and his colleagues suggest that more research be conducted, but for now, their conclusions indicate that prevention and treatment of childhood depression should be a top priority for physicians, mental health professionals, and their parents.

Many warning signs of depression in children differ from those of adults. Caregivers should seek help if a child exhibits any of the following, which interfere with their lives:

• Frequent crying or whining
• Constant boredom
• Social isolation
• Poor self-esteem
• Exaggerated sensitivity
• Chronic complaints of illness

These symptoms are only a few of the many indications of childhood depression. Caregivers should be wary of extreme changes in mood or activity, and of course, discussion about suicide, or wanting to hurt themselves or others.

- Melissa Lavery, M.S.

References

Park, A. (2013, April 1). Unhealthy Teens Could Lead to Rise in Heart-Disease Rates | TIME.com. Retrieved January 30, 2015, from http://healthland.time.com/2013/04/01/unhealthy-teens-could-lead-to-rise-in-heart-disease-rates/

Paul, M. (2011, November 11). News. Retrieved January 30, 2015, from http://www.northwestern.edu/newscenter/stories/2011/11/teens-heart-disease.html

The Depressed Child. (2013, July 1). Retrieved January 30, 2015, from http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/The_Depressed_Child_04.aspx

University of South Florida (USF Health). (2014, January 30). Childhood depression may increase risk of heart disease by teen years. ScienceDaily. Retrieved January 30, 2015 from www.sciencedaily.com/releases/2014/01/140130164454.htm

Washington University in St. Louis. (2013, March 15). Depression in kids linked to cardiac risks in teens. ScienceDaily. Retrieved January 30, 2015 from www.sciencedaily.com/releases/2013/03/130315202640.htm