Studies show that patients who are depressed or who have increased levels of the hormone and neurotransmitter norepinephrine in the blood have twice the incidence of chronic heart failure.
Not only are people with depression more likely to experience heart failure, research shows that people with heart failure are more likely to experience depression.
Worse, people with heart disease who are depressed have an increased risk of death after a heart attack compared to those who are not depressed. Depressed heart attack survivors are twice as likely to die or have more heart problems in the two years following a heart attack.
The underlying link is stress hormones. Depression and/or anxiety often results in chronically elevated levels of stress hormones, such as cortisol and adrenaline. Heart attack itself will increase stress hormones. When high levels of stress hormones signal a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair of arteries and heart muscle that are crucial to surviving heart disease.
Depression and anxiety disorders may may affect heart rhythms, increase blood pressure, and alter blood clotting. They can lead to elevated insulin and cholesterol levels. These risk factors, with obesity and pre-diabetes or hypoglycemia, are known as Metabolic Syndrome. Depression is also one of the symptoms of Metabolic Syndrome. These symptoms often serve as both a predictor of heart disease and part of the body's response to heart disease, a part that worsens the heart's condition.
A recent study though the National Institute of Mental Health measured norepinephrine, epinephrine (adrenalin) and cortisol levels in the depressed patients before and after Electroconvulsive Therapy, in which an electrical current is administered to the brain. Electroconvulsive Therapy is commonly known as shock therapy. Electroconvulsive Therapy (ECT) was shown to reduce the levels of these hormones to those observed in healthy subjects.
This study, the researchers say, supports the premise that depression is an illness that affects the whole body and adds to the urgency for diagnosing and treating major depression in patients with heart failure complicated by depression.
SOURCES: National Institute of Mental Health, Proceedings of the National Academy of Science.
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