अवसाद से हृदय रोगों का खतरा Relationship between Depression and Heart diseases

Author : Dr. P. D.GUPTA

Former Director Grade Scientist, Centre for Cellular and Molecular Biology, Hyderabad, India

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For years, it has been a well-known fact about the relationship between depression and heart disease. At least a quarter of cardiac patients suffer from depression, and adults with depression often develop heart disease. it is such a relationship that everyone wants to know “why.” So far a definitive explanation of this curious relationship has yet to emerge.  

It is a puzzle: Is depression a causal risk factor for heart disease? Is it a warning sign because depressed people engage in behaviours that increase the risks for heart diseases? Is depression just a secondary event, prompted by the trauma of major medical problems, such as heart surgery? Experts say the urgent need for answers is clear: According to the World Health Organization, 350 million people suffer from depression worldwide, and 17.3 million die of heart disease each year, making it the number one global cause of death.

The promising news is that new insights are emerging because of the large data analysis, scientific innovation, and heightened public awareness. “Thirty years of epidemiological data indicate that depression does predict the development of heart disease,”.  

Signs of depression

Depression can come on slowly. The symptoms are different for everyone. They can be mild, moderate or severe. Some of the more common signs are:

· Changes in appetite, like overeating or having little interest in food,

· Changes in sleep, such as trouble sleeping or sleeping too much,

·        lack of energy,

·        feeling sad, hopeless, or worthless,

·        crying for no reason, and

·        loss of interest or pleasure in activities you normally enjoy.

Relation between Depression and Heart diseases

“Those who have elevated depressive symptoms are at increased risk for heart disease, and this association seems to be largely independent of the traditional risk markers for heart disease,” Indeed, the association between depression and heart disease is similar to the association of factors such as high cholesterol, hypertension, diabetes, smoking, and obesity and heart disease. 

To establish a true cause-effect link between depression and heart disease, we need evidence from randomized controlled trials showing that treating depression reduces the risk of future heart disease. In other words, what needs to be studied is whether treating depression prevents heart disease in the way treating high cholesterol and blood pressure does.

Early treatment for depression, before the development of symptomatic cardiovascular disease, could decrease the risk of heart attacks and strokes by almost half. In the meantime, the existing evidence prompted the American Heart Association (AHA) to issue a  warning that teens with depression and bipolar disorder stand at increased risk for developing cardiovascular disease earlier in life.

Pregnancy and depression

Another study showed that women who were depressed during pregnancy had a 32–83% increased risk of developing some form of cardiovascular disease in the two years after giving birth compared with those who were not depressed.

You may think you should stop taking medication for depression when you are pregnant. Remember that, if left untreated, depression can have serious effects on both you and your baby. If you are taking antidepressants and are thinking about getting pregnant (or are already pregnant), talk to your doctor first, before stopping any medication

How does depression affect pregnant women?

New moms with depression may have trouble caring for their babies. They might not want to spend time with their baby, which can lead to a baby who cries a lot.

If you have depression while you’re pregnant, you may have trouble caring for yourself.

·        Depression during pregnancy can also lead to:

·        miscarriage,

·        delivering before the due date (preterm),

·        giving birth to a small baby (low birth weight).

If depression during pregnancy isn’t treated, it can lead to postpartum depression. Postpartum depression is a serious condition that can last for months after giving birth. It can affect your health and how well you bond with your baby.

Can depression be cured?

With treatment, most people recover from depression. Treatment can include one or more of the following:

Social support: Community services or parenting education.

Family therapy: With your partner and/or children. This can help when children are older.

Individual therapy: Talking one-on-one with a family doctor, psychologist, psychiatrist, social worker, or other professional.

Medication: Drugs used most often to treat depression are SSRIs (selective serotonin reuptake inhibitors). (The author has his own study and views)