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Depression Is Bad for Your Heart
Excerpt from THE ERICKSON TRIBUNE July 2007

For years, doctors have suspected that emotions can increase the risk of heart disease, the nation’s number one killer. New studies provide evidence that heart disease and depression are linked.

To put it another way, people over 65 who become depressed after a heart attack are more likely to die from cardiac arrest than are non-depressed people. Investigations shed light on the role of depression in heart health and test some approaches to reducing the risks.

Mind body link reveals new treatment options

The heart/depression link is particularly relevant to seniors because both heart disease and depression are common in people over 65. One out of three heart attack survivors over age 65 suffers from major depression.

Also, depression increases by five times the chance of dying from a heart attack within a six month period. It is not entirely clear when depression causes a heart attack and when it is the result, but in either case, the studies point to the need to treat depression to reduce heart disease.

"It was not always fashionable for doctors to dwell on the mind/body connection," says Nieca Goldberg, M.D., medical director of the NYU Women's Heart Program, New York University's School of Medicine, and author of The Women's Healthy Heart Program. "In the past, the medical community amputated the head from the rest of the body and failed to consider how treating depression can reduce heart attack risk and improve quality of life."

Cardiologists have evidence of the value of teaming up with psychiatrists and other mental health specialists to improve heart health through such interventions as counseling, medication, and new port networks.

"Women are two or three times as likely as men to be depressed, meaning they have a greater potential for heart disease that is not always recognized as frequently as that of men," Goldberg says. Women and their physicians should be on the lookout for any signs of depression that may not be obvious.

"It is not dear whether the problem is the depression itself or other factors that result from depression such as poor eating habits, noncompliance, and physiological disturbances of the heart function." says Thomas Morris, D.O., Erickson Health physician at Monarch Landing, an Erickson-built-and-managed community in Illinois.

Choosing medicines that do not harm

"Medicines must be chosen with caution," Morris says. "Some widely used antidepressant medications can actually cause heart irregularities, so I don't use" these in my practice," he adds. "It is important for people to work with their doctors to develop a good treatment plan that will both improve their quality of life and reduce the likelihood of heart disease."

Roy Ziegelstein, M.D., executive vice chairman, Department of Medicine at Johns Hopkins Bayview Medical Center, says, "It is critical to treat depression and related factors even when studies do not conclusively prove they reduce heart disease.”

"You treat what is bothering the patient. If your patient had a rash, you would treat it without asking if there were evidence that the rash prevented heart attack. You should do the same with heart" attack and depression, even though there is no evidence, this will directly reduce the risk of heart disease," he says.

"It is hard to diagnose heart disease and depression in people over age 65. If I am 24, I go to the doctor and find that I have heart disease or depression or both. If I am 81, I am more likely to dismiss the symptoms of heart disease or depression as being due to old age, and I might get the wrong diagnosis, " Ziegelstein says.

Even when older people suspect there may be a problem, they don’t always help get it diagnosed," Ziegelstein says. " Patients should help the doctor, explore what is wrong and why that is the case. They should ask, ‘Doc, could it be this?’ Through observation and cooperative work, the patient is better able to help the doctor identify and treat an underlying conditign like depression."

Causes of depression coming out of the dark