Which condition comes first?
The World Health Organization predicts that by 2020 heart disease will be the number one cause of death and disability worldwide and that depression will be second. But the extent to which these two chronic conditions are caused by each other, or happen to occur in tandem, is an area experts are still exploring. How to treat both conditions simultaneously is another.
"Depression as a risk factor for heart disease leads us to question whether we should be treating the mind and the body together," says Leo Pozuelo, MD, associate director of the Bakken Heart-Brain Institute at the Cleveland Clinic.
Whichever comes first, depression and heart disease make a devastating combination. Depression can also get in the way of recovery once you have heart disease.
Research suggests that repeat cardiovascular events are more closely associated with depression than they are with smoking, diabetes, high blood pressure, or high cholesterol. A recent Duke University study also found that depressed heart-failure patients were 50% more likely to die or to be hospitalized for their heart condition than patients who were not depressed.
In the first six months after a heart attack, a depressed person's chances of dying are four times higher than a nondepressed person's, even if they have the same heart damage. "Depression itself makes people sicker in ways that we don't really have a clear understanding of," says Kenneth Robbins, MD, professor of psychiatry at the University of Wisconsin–Madison.
Whether you've battled depression for years or only developed symptoms after your heart disease, taking your depression seriously may be the best thing you do for odds of surviving heart disease.