Episodes of sadness are completely normal, and usually time-limited. But in cases where feelings of depression and/or sadness persist for at least two weeks or more, that stress can begin to take a toll on your body, especially your heart, say University of Michigan Health experts.
Symptoms of clinical depression can include sleeping issues, a poor diet (overeating, undereating), limited energy to motivate, inability to concentrate, memory loss and feelings of anxiety or irritability. Episode lengths can vary and range in severity, says psychologist Leah Richmond-Rakerd, Ph.D., from brief single episodes to recurrent ones. For briefer spells, think of it like a broken ankle: initially traumatic and stressful, but as you get better, your mood improves as well. But for others, a depressive mood can persist, and that’s when help is needed.
“If this goes on for a period of time, we want you or your loved ones or your friends to tell you about that and to seek medical attention, because it's not only going to affect you in terms of your depression, but it's going to affect your heart health,” said Michelle Riba, M.D., a psychiatrist at Michigan Medicine. “ And that's what we're talking about today.”
Depression, sadness linked to heart health issues
Beyond the brain, depression has been shown to be an independent risk factor for many heart conditions. “It’s not just indirect, that you’re not exercising, sleeping or taking care of yourself. There are some direct physiological effects related to mental health conditions, such as depression, on the heart,” Riba said.
Cortisol — a stress-related hormone in your blood — contributes to your risk of heart attack and abnormal heart rhythms, explains Nicole Bhave, M.D., a cardiologist at the U-M Health Frankel Cardiovascular Center.
Mental health issues can also arise before or after a heart-related diagnosis or event. There’s a whole spectrum of emotional responses occurring, explains Bhave. “[For the] first few weeks and couple of months, it’s on providers to screen people for anxiety and depression during that time,” she explained.
Treatment options do exist, though, for depression, says Richmond-Rakerd.
“Several behavioral treatments or therapies have been found in large scale studies to be effective in reducing depression symptoms. Two main treatments include cognitive behavioral therapy, [also known as] CBT, and behavioral activation. CBT is a treatment that focuses on helping individuals learn how to identify and change thought patterns that are problematic, including those that are common in depression, and that have a negative effect on individuals’ behaviors and emotions. Behavioral activation stems from evidence that there's a close relationship between our activity and our mood, spending time with friends, doing meaningful things that we enjoy, trying out new activities and challenges,” explained Richmond-Rakerd.
Riba also explains there’s a growing body of evidence that supports the effectiveness of physical activity for improving mood and reducing symptoms of depression.
“Cardiac rehab is a structured exercise program that we typically recommend for all patients after a heart attack or any heart procedure, and often in patients with congestive heart failure as well. After a heart attack, for instance, it's usually 36 sessions, three times a week [for] a three-month period,” Bhave said. “I think one of the greatest benefits of participating in rehab is the social aspect of meeting people who also have heart disease, [such as] being able to talk and get reassurance of being able to exercise in a very safe environment as a means of sort of setting habits that hopefully people will continue,” she explained.
To learn more about depression and burnout symptoms and treatments (including non-medication options), the role of stress in heart health and types of heart conditions related to stress, watch the full livestream video above with Bhave, Riba and Richmond-Rakerd.