All the more reason to prioritize your mental health.
The conversation about heart disease risk usually focuses on what you eat and how physically active you are. You might be surprised, then, to learn that your mental health can also impact your risk of heart disease.
The relationship between depression and cardiovascular disease goes both ways: Having depression can increase your risk of developing heart disease later on, and having a traumatic health event (like a heart attack) increases the risk of depression. In fact, at least a quarter of people with heart disease also experience depression.
There are two key reasons for this link: lifestyle and inflammation.
The Lifestyle Theory
As anyone who has had it can tell you, depression can make you feel lethargic and hopeless, and seriously rob you of energy and motivation. One of the first things that might slip up is your ability to take care of yourself.
People with depression often go through the days in survival mode, just trying to fulfill their roles (such as parent, spouse, student, or employer). As a result, they may rely on takeout for dinner, and they’re more likely to turn to high-carb, high-fat, high-sodium comfort foods or convenience foods.
Having depression also increases the risk of smoking, using drugs, or abusing alcohol. About a third of people with depression have the signs of alcohol abuse disorder, according to the American Addiction Centers.
And of course, if depression leaves you feeling lethargic, you’re more likely to skip exercise—or have trouble getting out of bed at all. Research suggests exercise can help relieve symptoms of depression, but unfortunately, the energy to exercise is often totally absent.
Finally, having depression may make someone less likely to stick to their doctor appointments. This may be due to the lack of energy, or the sense of hopelessness. Even calling to book an appointment can feel like an insurmountable task.
The problem with all these lifestyle habits is that they go against the recommendations for a healthy heart. As a result, if someone is really struggling with their depression and struggling to find healthy ways to cope, they may adopt unhealthy habits that put them at risk for heart disease.
The Inflammation Theory
Both depression and heart disease involve chronic inflammation and elevated cortisol levels. Cortisol is a stress hormone. In small amounts, it can actually help regulate inflammation, but in high amounts for prolonged periods, cortisol can trigger and worsen inflammation.
People with depression tend to have higher cortisol levels than those without depression, according to a 2013 study by researchers at Roosevelt University in Chicago, IL. This can lead to systemic and chronic inflammation in the body.
That inflammation can then damage the artery walls, eventually leading to atherosclerosis. This is when the walls of the arteries narrow and harden, increasing the risk of blockage, high blood pressure, heart attack, and stroke.
Preventing Heart Disease with Depression (and Vice Versa)
Depression and heart disease may be risk factors, but it’s important to remember that one does not *cause* the other. Correlation is not causation.
Treating depression may help you stick to heart-healthy habits (and those habits can also help improve your depression symptoms). Treatment for depression may include therapy, medication, or lifestyle changes.
And conversely, treating your heart disease can reduce your risk of depression. That’s partially because you will feel less health-related stress and enjoy a better quality of life.
Moral of the story? If you want to protect your heart, don’t neglect your mind, and if you want to protect your mind, don’t neglect your heart.
Depression and heart disease: a two-way street. Cambridge, MA: Harvard Health Publishing, 2016. (Accessed on May 16, 2019 at https://www.health.harvard.edu/heart-health/depression-and-heart-disease-a-two-way-street.)
Dienes KA, Hazel NA, Hammen CL. Cortisol secretion in depressed and at-risk adults. Psychoneuroendocrinology. 2013 Jun;38(6):927-40.
Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014 Dec;94(12):1816-25.
Heart disease and depression: a two-way relationship. Bethesda, MD: National Heart, Lung, and Blood Institute, 2017. (Accessed on May 16, 2019 at https://www.nhlbi.nih.gov/news/2017/heart-disease-and-depression-two-way-relationship.)
Inflammation and heart disease. Dallas, TX: American Heart Association. (Accessed on May 16, 2019 at https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/inflammation-and-heart-disease.)
Millenial women: understanding the links between heart disease and depression. Baltimore, MD: Johns Hopkins Medicine. (Accessed on May 16, 2019 at https://www.hopkinsmedicine.org/health/wellness-and-prevention/millennial-women-understanding-the-links-between-heart-disease-and-depression.)
Treating alcoholism and co-occurring disorders. American Addiction Centers, 2011. (Accessed on May 16, 2019 at https://www.alcohol.org/co-occurring-disorder/.)