The Sad Connection Between Depression and Heart Disease

Man lying on his bed staring at his phone.

Posted February 19, 2021

“A two-way street.”

That’s how experts describe the connection between depression and heart disease. But for the 350 million people who suffer from depression and the 17.3 million who die each year of heart disease worldwide, drawing a line between the heart and the head is not a straightforward exercise.

What we do know is that people with a depression disorder or symptoms have a 64 percent higher risk of developing coronary artery disease. Evidence suggests that people with depression experience physiological changes that can predispose them to heart disease. Sticky platelets (the cells causing blood to clot), for instance; some studies have shown that treating depression makes a person’s platelets less sticky again. 

Conversely, those with poor heart health may be at higher risk for depression. A review of nearly a quarter century of research in the U.S. found major depression in nearly 20 percent of heart attack survivors, compared to 7.1 percent of the general U.S. adult population. 

The same review found that a significant number of heart attack patients had continuing depression after discharge from the hospital, leading the authors to conclude that “depression is common and persistent” among those patients.

Coping During COVID 

Depression and heart health are inextricably linked, but personal habits are also clearly a culprit. “Like a snowball rolling downhill,” is how University of Vermont Health Network Cardiologist Ed Terrien, MD, describes the factors contributing to heart disease – poor eating habits, lack of exercise, excessive alcohol consumption and tobacco use. And it’s worth noting that these are the same habits we may develop in response to being depressed. Feeling down? Have a cocktail. Feeling tired? Skip your workout. Need a pick-me-up? Reach for that piece of pie. 

“Life is short,” we tell ourselves, as we indulge – particularly during tough times like the pandemic. 

Just as concerning, says Dr. Terrien, health prevention has simultaneously taken a hit. People have been afraid to go to the hospital or to their doctor for fear of catching COVID-19. They’ve ignored symptoms. They’ve skipped important health screenings. Sometimes, when they’ve finally sought help – often in the emergency department – there have been serious consequences to their delay in care. 

The good news is that we have some control over all of this. As the pandemic wears on, it’s important to take note of how you’re feeling, both mentally and physically. Heart healthy habits like good nutrition and sleep, exercise and stress-reducing activities like mindfulness improve heart health. 

It’s also important to check yourself routinely for signs of depression. There are several types of depression that may have different symptoms and patterns. High-functioning depression, for instance, also known as dysthymic disorder, may be less obvious because it occurs when a person has only 2 to 4 symptoms of depression for a period of at least two years. 

If you’re feeling any of the symptoms listed below, get in touch with your doctor. 

  • Feeling sad
  • Loss of interest in activities that you've always enjoyed
  • Withdrawn from others
  • Reduced energy
  • Feeling hopeless about the future 
  • Thoughts of suicide

Interactive Tool: Am I Depressed?

The pandemic has been a long, challenging crisis. It will end, and until it does, it’s important to be as healthy as possible – both in mind and body. 

Learn More Ways to Stay Healthy and Cope with COVID-19