By Faith Trussell, RN, BSN
Depression is a serious and debilitating disorder in its own right, having long been associated with increased mortality, but it is interesting to note that it is now officially recognized by an American Heart Association expert panel as a risk factor for heart disease. Hundreds of carefully executed and documented studies have confirmed that the issue of depression is indeed a causative factor of death from cardiovascular disease.
One of the questions still waiting to be answered is the mechanism of the association between psychological distress and mortality. There are two possibilities. One is that people with depression frequently have harmful health behaviors, such as smoking, obesity and less physical activity. The other possible reason is purely biological: people with depression have higher cortisol levels, inflammatory factors and dysfunction of the sympathetic nervous system – all of which are potential precipitators of coronary heart disease.
Furthermore, research shows no “reverse causation”. In other words, people with cardiovascular disease are not found to be more likely to have depression, but people with depression ARE more likely to have heart problems. Researchers note that this lends credence to their finding depression to be an acknowledged risk factor.
In light of these findings, there is hope that physicians will routinely screen patients for depression, as they do for other risk factors of cardiovascular disease such as obesity, hypertension and smoking. It is also hoped that, as the public gains education regarding this association, they will willingly seek treatment for depression, as many patients unfortunately do not follow through with referrals for mental health treatment because of stigma and lack of insurance coverage. Knowing that depression can lead to physical disease is good reason to deal with it as effectively as possible. If you suffer from depression, talk to your doctor about it. It may save your life.
Note: This column is provided by Senior Life Solutions, a program at Cedar County Memorial Hospital dedicated to addressing the emotional health of senior adults. Call 417-876-3656 for more information.