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Depression is the common term for several different mental health disorders, known collectively as depressive disorders or mood disorders. People affected by these conditions, and especially people affected by major depression, have an increased risk for a variety of serious health problems, including heart attacks and heart disease. According to the results of a new study published in 2013 by Duke University Medical Center, depression also reduces the effectiveness of heart-healthy exercise and moderate alcohol consumption. The underlying mechanism for this reduced effectiveness is a depression-related increase in the body’s levels of inflammation.

Depression Basics

When mental health experts and the general public use the term depression, they’re usually referring to major depression, also known as major depressive disorder. Figures compiled by the National Institute of Mental Health indicate that roughly 7 percent of American adults have symptoms of this disorder during any given year; roughly 2 percent of U.S. adults have severe major depression symptoms.

The term depression can also refer to dysthymia (dysthymic disorder) and minor depression, two conditions that—although technically less severe than major depression—still make clearly damaging changes in the lives of affected individuals. In addition, it can refer to conditions such as postpartum depression, psychotic depression and seasonal affective disorder. The various forms of depression are called mood disorders because they feature significant distortions of a person’s baseline state of mind or mood. The term mood disorder also applies to bipolar disorder, a condition that classically combines periods of depression with periods of an altered mental state called mania.

Inflammation Basics

Inflammation is an immune system response that occurs in the body’s blood vessels, as well as in the tissues surrounding those vessels. Its underlying positive function is to speed up the removal or elimination of various things that harm the body, including infectious microorganisms, chemical irritants and cells damaged by an injury. In this context, the body benefits from inflammation and heals faster than it otherwise would. However, the presence of inflammation can lead to more inflammation, and thereby start to trigger harmful changes in the blood vessels and tissues. Some people develop chronic forms of inflammation that damage their hearts and other parts of their bodies continuously over extended periods of time. Doctors can track inflammation levels by tracking blood levels of a substance called C-reactive protein (CRP). When inflammation increases, CRP levels rise; when inflammation decreases, CRP levels fall.

Previously Determined Cardiac Risks

Prior to the most recent findings, the medical establishment already knew that major depression has a serious negative impact on cardiac health. According to a study review performed by the University of Maryland Medical Center, specific changes in cardiac function linked to the presence of depression include an altered heart rate, a reduction in the amount of blood flowing to the heart muscle, and increased risks for blood clots in the arteries feeding the heart. In combination, these changes can set the stage for heart disease or a heart attack. People affected by major depression may also experience unusually severe heart attacks or unusually poor responses to medications designed to combat the effects of heart disease. Milder forms of depression have a smaller, but still significant, negative impact on normal cardiac function.

Newly Identified Effects

Most people can lower their risks for heart problems by participating in regular aerobic exercise. In addition, considerable scientific evidence indicates that light to moderate alcohol consumption (up to two drinks per day for men and one per day for women) can also improve cardiac health. In a study published in 2013 in the journal Brain, Behavior and Immunity, a team of researchers from Duke University Medical Center examined the effects of depression on the heart-related benefits of exercise and modest alcohol intake. They did this by identifying people with untreated depression in a group of 222 study participants, reviewing the exercise and alcohol consumption patterns in these affected individuals, and measuring their blood levels of C-reactive protein (which, as we’ve seen, helps indicate a person’s risks for heart-damaging chronic inflammation).

After comparing the study participants affected by untreated depression to study participants without depression, the Duke University researchers concluded that blood vessel inflammation linked to the presence of unaddressed depression effectively negates the heart-healthy benefits of aerobic exercise. They also concluded that depression’s effects on blood vessel inflammation essentially negate the heart-related benefits of modest alcohol consumption in men. Interestingly, the researchers did not link modest alcohol consumption in women to improved heart health, whether or not those women are affected by depression.

Considerations

The Duke University research team believes that their findings indicate a need to add depression screening to the regular list of medical checks used to assess any given individual’s cardiac risks. They also believe that early identification of depression symptoms by primary care doctors can lead to an overall improvement in the nation’s heart-related health, while simultaneously reducing the annual rate of serious or severe depression.

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