Depression │ How Depression Hurts Your Heart


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As if feeling bad weren’t enough, negative emotions could be harming your heart. Over time, persistent blues, anxiety or anger can increase the risk of heart disease—or make an existing condition worse. “Psychosocial factors are increasingly recognized as important predictors of heart disease,” says Richard Stein, M.D., director of preventive cardiology at the Beth Israel Medical Center in New York and author of “Outliving Heart Disease.” “Depression is right up there with high cholesterol, smoking and high blood pressure as risk factors for heart attack.” Hostility and anxiety, says Dr. Stein, aren’t far behind. The Mood-Heart Link On one level, it’s as simple as taking care of yourself: People who are depressed, angry, anxious or highly stressed are less likely to eat healthfully, exercise regularly, quit smoking or take their medication as directed. But negative thoughts and feelings may also harm the heart more directly. Depression and anxiety disorders can alter heart rhythms, raise blood pressure and increase blood-clotting factors. Meanwhile, the “stress” hormones norepinephrine, epinephrine and cortisol—often released in abundance when people are depressed or angry—may increase such heart disease risk factors as inflammation and insulin resistance, notes Edward Suarez, Ph.D., an associate professor of psychiatry at Duke University’s school of medicine in Durham, NC. Blood pressure is part of another mood-heart link. Studies show that some people react to stress or anger with spikes in blood pressure, which over the years increases their risk of atherosclerosis, the main cause of heart attacks. The turbulent blood flow during these spikes may damage blood vessel walls and make a person more susceptible to plaque buildup, says Richard Jennings, Ph.D., a professor of psychiatry and psychology at the University of Pittsburgh School of Medicine. How to Feel Better If you have persistent negative moods, it’s important to lighten your emotional burdens. “Just living better and feeling better is enough of a reason to treat these issues,” says cardiologist Dr. Stein. But it may also benefit your heart: One study at the Stanford University School of Medicine found that when depressed people who’d had a heart attack were treated with antidepressants, they saw a significant decrease in their risk of dying over the next two and a half years. So if negative feelings begin to color your world dark blue or angry red, talk to your doctor about whether you might benefit from psychotherapy, a stress or anger-management program and/or antidepressants. “Cardiologists and primary care physicians are not trained to recognize these issues,” says Dr. Stein. “To get the best care, you have to make this part of the discussion.” 4 Ways to Lift Your Spirits * Walk. Incorporating 30 to 45 minutes of moderate-to-vigorous exercise into each day isn’t just good for the heart, it helps treat depression—and may even prevent it from recurring. * Dine on fish. Eating Omega 3–rich seafood at least twice a week also confers double benefits, protecting the heart and, some preliminary studies have found, helping lift depression. * Engage. A good support system and social life help buffer you from the physiological effects of negative emotions. * Laugh. Rx: funny movies? Yes! Laughing regularly is associated with the healthier function of blood vessels, according to Michael Miller, M.D., director of preventive cardiology at the University of Maryland Medical Center in Baltimore. Sources: American Journal of Preventive Medicine, December 2005; Circulation, October 12, 2004 and February 1, 2005; Journal of the American Medical Association, December 20, 2000; Psychosomatic Medicine, November/December 1999 and November/December 2006; Psychotherapy and Psychosomatics, February 2006. Easing a broken heart and a troubled mind may take time, so don’t get discouraged. Feeling well is worth the effort. Writer: Stacey Colino ©MDminute: Heart, Issue 1, 2007

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