Treat Depression Before it Harms Your Heart

It has long been observed that individuals with cardiovascular problems have an elevated risk for major depression that can interfere with their treatment and recovery. Now, in a scientific statement published online Feb. 24, 2014 in the journal Circulation, the American Heart Association (AHA) has acknowledged that the association works both ways—by formally declaring that depression is not only a result of cardiovascular problems, but also a cause, and that treating depression may help improve long-term survival.

“The AHA statement is a major step in acknowledging that depression must be recognized and treated in the effort to combat heart disease,” says MGH psychiatrist Christopher M. Celano, MD, whose research focuses on depression and cardiac care.

“On the one hand, heart disease may cause people to feel fatigued, unmotivated, or anxious, which can lead to increasing social isolation and depressive symptoms. On the other, depression can lead to similar feelings of fatigue, physical inactivity, and poor medication compliance, which can increase the risk for and progression of cardiac disease. This two-way association can be especially difficult for those individuals with both depression and cardiac illnesses, as each of these problems can make the other worse.”

The AHA panel, which evaluated evidence from 53 major studies, recommended that depression be added to smoking, obesity, diabetes, and hypertension on the list of official heart disease risk factors.

WHAT YOU CAN DO

Consider seeking a professional assessment if you experience two or more of these symptoms of depression for two weeks or longer:

  • Persistent feelings of sadness, anxiety, or emptiness
  • Feelings of hopelessness
  • Loss of interest in activities you previously enjoyed, including sex
  • Decreased energy, fatigue
  • Changes in appetite or sleep habits
  • Restlessness, irritability
  • Difficulty concentrating, remembering or making decisions
  • Persistent physical symptoms, such as aches and pains, or stomach problems
  • Thoughts of death or suicide

Treating depression improves heart health.

Biological and behavioral

Both heart disease and depression involve similar underlying mechanisms, Dr. Celano points out.

“The biological mechanisms that are characteristic of both conditions include factors such as elevated levels of inflammation, increased platelet aggregation (clotting) in the blood, increased levels of stress hormones, insulin changes, higher blood pressure and cholesterol levels, sleep problems, negative changes in the lining of arteries, and impairment of the autonomic nervous system,” says Dr. Celano.

“The behavioral factors are linked to activities such as smoking, drinking, substance abuse, physical inactivity, and consuming a poor diet. Social isolation and fewer stress-reducing activities are also characteristic of both conditions, as is poor management of medications and medical problems.

Lowering the dual risk

Depression is not a part of normal aging. That’s why getting prompt professional assessment for long-term feelings of hopelessness and sadness is essential. (See What You Can Do for symptoms of major depression.) Taking steps on your own can help your mood and heart health, too.

“Lifestyle changes, such as exercising, consuming a healthy diet, staying socially involved, and improving your sleep hygiene, are strategies you can use to improve your mood,” Dr. Celano says. “Taking any prescribed medications is important as well,.Reach out to trusted friends for support. Don’t try to ‘snap out of it:’ Ignoring depression is not helpful.”

Mounting evidence

The AHA’s recommendation is supported by several 2014 studies. In one large study of people with signs of heart problems, female participants under 55 years of age who reported experiencing moderate to severe depression were more than twice as likely as those without depression to suffer a heart attack, have heart disease, require artery-opening procedures or die over the three-year study period. Another study involving 63,000 initially healthy adults found that over 11 years, those participants who were mildly depressed had a five percent increased risk of developing heart failure, and those who were moderately or severely depressed had a 40 percent increased risk.

A study involving healthy older adults with clinical depression, published in the January 2014 issue of Psychosomatic Medicine, suggests that early depression treatment in individuals without heart disease may also help cut risk for heart attacks and strokes. Over eight years, participants who received enhanced care for depression provided by a team of healthcare professionals experienced half the risk of heart attack or stroke as a similar group who received standard care. The study suggests that treatment for depression is especially beneficial if initiated before the onset of cardiovascular disease. MMM

The post Treat Depression Before it Harms Your Heart appeared first on University Health News.

Read Original Article: Treat Depression Before it Harms Your Heart »

Powered by WPeMatico