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Depression hurts. Just as people with depression feel emotionally broken and deflated, many people report physical pain in conjunction with this mental disorder. It is not uncommon to feel joint or muscle pain, headaches, or stomach discomfort, but chest pain is most prevalent among depressive symptoms. While researchers and clinicians are uncertain of the causes, they do agree that depression inhibits neural communication, and often, this breakdown can cause the body to react in different ways. Stress, sadness, and despair can cause tremendous heartache. But can people suffer from a literal broken heart? Absolutely.
Broken Heart After Lost Love = Cardiomyopathy
Broken heart syndrome, or stress-induced cardiomyopathy, is real and can affect many people who have lost love, either through death or breakup. While this condition can affect healthy people and is not a sign of a depressive disorder, chronic stress and sadness that lead to depression have been linked to heart disease. And while heart disease is not caused by a sudden loss, its co-existence with clinical depression can be fatal.
A 12-person panel consisting of psychiatric scholars has recently made a recommendation to the American Heart Association to add depression as a major risk factor for heart disease. More significantly, the panel’s findings indicate that coupled with heart disease, depression increases a person’s chances of heart attack and death. The group most at risk for a cardiac event, possibly leading to surgery or death, is women under 55, with moderate to severe depression. In fact, this demographic is twice as likely to experience the consequences of heart disease.
Depression = Risk of Heart Disease
Depression is considered a comorbid disease; it occurs simultaneously with many other illnesses. Cause and effect remains unclear, but symptoms of depression, such as fatigue or apathy, may decrease a person’s overall health. These same symptoms may also keep people from recognizing the warning signs of serious health issues. People may also become depressed from the stressors and fear related to serious illnesses. Regardless, having depression can lead to a host of physical issues, including diabetes, obesity, poor nutrition, a sedentary lifestyle, and substance abuse. Many of these same conditions typically lead to heart disease.
Risk factors for heart disease:
Moreover, bodily responses to depression, such as over productions of cortisol (stress hormone) or pro-inflammatory cytokines (immune system response), may cause inflammation of the heart, further diminishing its strength and structure.
Anxiety = Doubled Risk of Death
Most people who have heart disease and depression also suffer from anxiety. The presence of anxiety alone doubles a person’s risk of dying. Combined with depression and a person’s chances of death triple. What causes such a significant increase of risk? Lana Watkins, Ph.D., associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center in Durham, N.C., explains that depression and anxiety have different risk factors, and when coupled, significantly jeopardize health. Depression, by itself, is a behavioral disorder; disregard for health will lead to other consequences. Anxiety causes the release of adrenaline, which increases blood pressure. Constant worry, along with a sedentary lifestyle, can lead to disaster.
What Is The Treatment?
"Anxiety reducing medications combined with stress management could improve outcome[s] for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention,” says Watkins. Unfortunately, depression is not so easily treated. Current therapies work differently for people with depression, and only half of those that receive treatment for depression experience remission.
Robert M. Carney, Ph.D., professor of psychiatry at Washington University School of Medicine in St. Louis, was one of the researchers involved in the aforementioned recommending panel. He is concerned by the lack of evidence regarding the treatments of depression and heart disease. To date, no research exists that demonstrates a correlation between the treatment of depression as a protective factor against heart disease, heart attack, or death. "We believe better depression treatments may improve survival," states Carney. “More research will be needed, though, before we can say treating depression can improve heart health or survival in patients with heart disease."
Where do we go from here?
Leaving depression untreated can lead to a poor quality of life. Effective treatments for depression include cognitive behavioral therapy (CBT) or talk therapy; selective serotonin reuptake inhibitors (SSRIs), such as Zoloft or Prozac; and serotonin and norepinephrine reuptake inhibitors (SNRIs), like Effexor and Cymbalta. By treating depression, people may be able to adopt healthy habits, such as nutrition, exercise, and cessation of tobacco use. These choices may decrease the risk of heart disease and death, and may also improve depressive symptoms.
- Melissa Lavery, M.S.
American Heart Association. (2014, June 18). Depression linked to higher heart disease death risk in younger women. ScienceDaily. Retrieved January 27, 2015 from www.sciencedaily.com/releases/2014/06/140618165107.htm
American Heart Association. (2013, March 19). Anxiety, depression identify heart disease patients at increased risk of dying. ScienceDaily. Retrieved January 27, 2015 from www.sciencedaily.com/releases/2013/03/130319202148.htm
Depression and Heart Disease. (n.d.). Retrieved January 27, 2015, from http://www.nimh.nih.gov/health/publications/depression-and-heart-disease/index.shtml
Depression: Recognizing the Physical Symptoms. (2013, November 10). Retrieved January 27, 2015, from http://www.webmd.com/depression/physical-symptoms
Kotz, D. (2007, December 12). 4 Health Problems That Depression Can Cause. Retrieved January 27, 2015, from http://health.usnews.com/health-news/articles/2007/12/12/happier--and-healthier
Is Broken Heart Syndrome Real? (2013, April 15). Retrieved January 27, 2015, from http://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/Is-Broken-Heart-Syndrome-Real_UCM_448547_Article.jsp
Understand Your Risk of Heart Attack. (2015, January 12). Retrieved January 27, 2015, from http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp
Washington University in St. Louis. (2014, February 24). Panel recommends listing depression as a risk for heart disease. ScienceDaily. Retrieved January 27, 2015 from www.sciencedaily.com/releases/2014/02/140224171141.htm