Depression and Heart Disease
How Does Depression Affect the Heart and Risk Factors for Heart Disease?
Depression may directly or indirectly affect the heart in many ways. Researchers believe the following may occur as a result of depression:
- Changes in the heart's electrical system
- Increases in blood pressure
- Changes in blood clotting
- Increases in insulin and cholesterol levels.
High blood pressure, high cholesterol, and diabetes are known risk factors for heart disease. Problems with clotting or the heart's electrical system can increase the risk of a heart attack or stroke.
Depression may also increase the levels of stress hormones, including cortisol and adrenaline. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.
Why Is Depression Underdiagnosed in People With Heart Disease?
Despite the enormous advances in research in the past 20 years, depression often goes undiagnosed and untreated. For a couple of reasons, this is even more common in people with heart disease. For example, when people with heart disease show signs of depression, their families and friends -- and even their healthcare providers -- may mistake them for inevitable accompaniments to heart disease.
Symptoms of depression also may overlap with those of heart disease and other physical illnesses. However, skilled health professionals will recognize signs of depression. They will also inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.