It’s been reported extensively that there is in fact a two-way relationship between heart disease and depression, two of the most disabling diseases worldwide. Firstly, depression can increase your risk for heart disease. According to Jessica Byrne, a registered dietitian at the Heart and Stroke Foundation South Africa, depression can lead to damage in your blood vessels by increasing stress hormones, inflammation, blood glucose, blood pressure and heart rate. “It can also lead to unhealthy behaviours – smoking, substance abuse, overeating, inactivity and social isolation – that increase your risk of heart disease,” she explains.
Additionally, depression is much more common in people with heart disease than the general population, explains Byrne. "And people who have suffered a heart attack and are also suffering from depression often fare significantly worse and suffer more complications than those without signs of depression."
Increased risk of mortality
A recent UK study found that individuals with heart disease who had moderate to severe depression were at five times the risk of all-cause mortality (death from any cause within 30 days after hospital admission date) than those without.
The study leader Professor John Cleland, a cardiology professor at Imperial College London and the University of Hull in the UK, reported that the study’s results suggest depression is strongly associated with death during the year following discharge from hospital after an admission for heart failure, and that the team expect this link to persist beyond one year.
"We know that depression is common in heart failure and affects 20 to 40% of patients," he stated. "Depression is often related to loss of motivation, loss of interest in everyday activities, lower quality of life, loss of confidence, sleep disturbances and change in appetite with corresponding weight change. This could explain the association we found between depression and mortality."
Byrne agrees with the findings. "Depression often leads to poorer adherence to medication and a treatment programme, and often the person is less motivated or feels like they don’t have the energy to make positive lifestyle changes and participate in cardiac rehabilitation,” she says. "It is important to discuss any depressive feelings with your doctor, who can assist or refer you on to another healthcare provider who can offer more support."
Symptoms of depression
According to Cassey Chambers of the South African Depression and Anxiety Group (SADAG), symptoms of depression can include any of the following:
- Persistent sad or 'empty' mood
- Loss of interest in activities that were once enjoyed
- Feelings of hopelessness and pessimism
- Feelings of guilt, worthlessness and self-reproach
- Drastic changes in sleeping habits
- Changes in appetite – loss of appetite (usually men) or overeating (usually women)
- Decreased energy, fatigue and feeling run down.
- Increased use of alcohol and drugs
- Restlessness, irritability or hostility
- Difficulties with concentration or memory
- Persistent headaches, chronic pain or digestive disorders that don't respond to treatment
- Deterioration of social relationships
When to seek help
"When someone has suffered a heart condition, the immediate concern is their physical health, but often their mental health is overlooked," remarks Byrne. "It can be a frightening experience and the survivor might feel 'down' after being diagnosed with their condition."
Some of the symptoms of depression – such as fatigue or feeling run down – may also be symptoms of heart disease. However, Chambers points out that if symptoms of depression are persistent over a period of two to four weeks and impair your functioning and relationships, then it is important to seek help.
Treatment
"The best form of treatment for depression is a combination of medication from a psychiatrist or a GP, therapy from a psychologist, joining a support group, and learning as much as you can about ways to cope with depression," says Chambers.
Although these are by no means a replacement for proper medical care, the following tips from SADAG can help you cope with depression:
- Get out of bed and get dressed every day.
- Make sure that you are getting adequate sleep each night. Eat a balanced diet and avoid drinking alcohol, or using drugs that have not been prescribed to you.
- Try to participate in social or religious activities.
- If you are physically able, get regular exercise.
- Write your feelings down in a journal.
- Surround yourself with positive people and influences.
- Talk to someone about how you are feeling.
- If tasks seem insurmountable, break them down into smaller tasks.
How Clicks Clinics can help you
Clicks Clinics will help you prevent or manage heart disease with their wide range of screening tests. These include:
- Blood Pressure (BP) Test
- Cholesterol Testing and Consultation
- Lipogram Blood Test (to determine different types of cholesterol)
- Clicks Full Basic Screening (BP, Body Mass Index or BMI, meal guide and exercise plan)
- Clicks Screening Measurements only (BP and BMI)
- Clicks Comprehensive Screening (BP, BMI, Glucose and Cholesterol screening, plus meal and exercise plan)
To make an appointment at a Clicks Clinic, call 0860 254 257 or visit Clicks Clinics online.
For more info
Heart and Stroke Foundation: For more information visit www.heartfoundation.co.za or call 0860 1 HEART (43278) to speak to a health consultant.
South African Depression and Anxiety Group: For free telephonic counselling and referrals seven days a week, call 0800 21 22 23 or SMS 31393. For more information, visit www.sadag.org.
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