You Gotta Have Heart…..and Mind Too!

Many of us are schooled in the risk factors of heart disease.

We know that smoking, inactivity, being overweight, and high blood pressure all contribute to cardiac disease.  Depression, however, is not usually listed as one of the risk factors of heart disease although it has been on the list of risk factors for over a decade, but few doctors take that into account when dealing with their patients.

“Depression is a risk factor that needs to be taken as seriously as any other – it’s up there with smoking,” says Professor Gavin Lambert, National Health and Medical Research Fellow at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia.  “Not only is it a risk factor for developing heart disease, but it may also exacerbate existing heart disease. If you already have heart disease and go on to develop depression you’re four times more likely to die within six months.”

We talk about depression as being a mental illness and often neglect to realize that it is a physical illness as well.  Depression can cause damage to the heart by increasing the production of stress hormones.  Too much of this hormone can damage blood vessels over time.  It can constrict the blood vessels, making them narrower than they should be, can raise blood pressure and increase plaque build up as well as increase inflammation which can in turn cause clots to form.  This doesn’t even mention the effects that naturally flow from depression – low moods that can lead to or increased smoking or to drinking too much or to eating poorly or to forgetting exercise or medication.

We know that often people who suffer serious illness like cancer or a heart attack are prone to experience depression but we seldom consider that depression can arrive because of such illness.  “It’s possible that there’s also a physiological affect on the brain – your brain needs oxygen and nutrients like any other part of the body so if circulation is affected by disease it could have an impact on the brain,” Lambert says. “There’s also a strong link between inflammation and heart disease and inflammation and depression. It could be that inflammatory chemicals that contribute to heart disease could also cause changes in the brain, but we don’t know.”

Today people having suffered a heart attack are seen by physiotherapists and nutritionists but they are not usually seen by a psychologist or a social worker who would deal with the mental health of the patient.  Perhaps we need to see that physical and mental issues cannot be isolated and that we have to treat the whole person, not segments of them.  Just raising the awareness of the possibility of depression as a factor in heart disease is a beginning.  Sadly it is a factor in far too many physical diseases.

-Bernadette