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Global Study Finds Association Between Depression and Heart Disease

pensive man
Research is helping to increase our knowledge of the physical effects of mental health issues.

 Oliver Rossi / Stone / Getty Images

Key Takeaways

  • A recent study found a link between depression and a higher risk of heart issues.
  • These findings underscore the strength of the relationship between mental and physical health, which includes other disease risks as well.
  • Experts believe that working on mental wellness can help boost overall health in significant ways.

In a large-scale, multi-country study looking at cardiovascular disease and depressive symptoms, researchers found a strong link between the two. Those with depression were much more likely to have cardiovascular events and early mortality compared to those who had heart issues but no depressive symptoms.

Published in JAMA Psychiatry, the research covered 21 countries and just over 145,000 participants, tracked over a period of 14 years, in both urban and rural communities. The more symptoms of depression participants had, the higher their risk was for multiple types of cardiovascular issues, regardless of geography.

This adds to previous research connecting cardiovascular function and mental health concerns. A study in JAMA Network Open published in February, involving over 500,000 people in China, also found that depression is a risk factor for all-cause and cardiovascular disease mortality in adults, particularly men.

There are many theories about why this connection may exist, from changes in inflammation levels to the possibility that those with depression may not practice as much heart-healthy self-care strategies like healthy eating, keeping stress levels low, exercising, and maintaining social connections—which have all been linked to heart health.

What This Means for You

Research continues to support the idea that mental health is health, and that taking care of your mind is just as important as caring for your body. By working on one, you can help the other to increase your overall health.

The Mind-Body Connection

Although using the terms "mental health" and "physical health" implies these are two distinct, separate aspects to wellness, the recent study highlights how they can be deeply interconnected. In addition to cardiovascular issues, conditions like depression and anxiety are often associated with:

  • Chronic pain, especially lower back pain
  • Headaches
  • Digestive issues like IBS
  • Vision problems
  • Reduced appetite or increased cravings for food
  • Slowed thinking, speaking, or body movements
  • Overall aches and pain

In terms of emotional or mental effects, the American Psychiatric Association defines depression symptoms as including:

  • Low mood, irritability, sadness
  • Decreased interest or pleasure in daily activities
  • Decreased motivation
  • Insomnia or hypersomnia

Estimates suggest major depressive disorder is very common, and affects between 6% and 18% of the world population.

"When it comes to addressing mental health issues, there can unfortunately still be a degree of stigma involved, even if there are physical symptoms," says Cheryl Carmin, PhD, psychologist at The Ohio State University Wexner Medical Center.

Cheryl Carmin, PhD

"Knowing that you may be affected both physically and mentally is helpful for trying to understand what's going on, and seeking appropriate treatment."

— Cheryl Carmin, PhD

Building Your Health

Often, health changes seem to go in one direction: You address physical symptoms or make lifestyle tweaks, and your mental health improves. For instance, you might start exercising regularly to get more energy and maintain your weight, and then find your mood improves as well.

But it's also possible for those benefits to go in the other direction as well. By focusing on your mental wellbeing, you may see physical advantages as a side effect. For example, recent research in JAMA Psychiatry found that several types of therapy, including cognitive behavioral therapy, resulted in significantly enhanced immune system function that stayed robust for at least six months after treatment.

"Mental and emotional issues can affect physiological reactions, and that goes both ways," says Ian Sadler, PhD, psychologist at Columbia University Irving Medical Center. "For example, we often see people with compromised immune function and chronic health problems facing mental health challenges. Addressing physical health will have an impact on mental well-being, and vice versa."

A Word From Verywell

If you find yourself struggling with emotional and mental health challenges and experiencing signs of depression—which may manifest as physical symptoms like fatigue, chronic pain, headaches, and stomach pain—talk with your primary care physician or another healthcare provider for appropriate referrals. You may be able to do telehealth sessions with a therapist or counselor, even as a new patient.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. 

For more mental health resources, see our National Helpline Database.

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Article Sources
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  1. Rajan S, McKee M, Rangarajan S, et al. Association of symptoms of depression with cardiovascular disease and mortality in low-, middle-, and high-income countriesJAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.1351

  2. Meng R, Yu C, Liu N, et al. Association of depression with all-cause and cardiovascular disease mortality among adults in ChinaJAMA Netw Open. 2020;3(2):e1921043. doi:10.1001/jamanetworkopen.2019.21043

  3. CDC. Mental health conditions: Depression and anxiety. Updated March 23, 2020.

  4. Andrade L, Caraveo-Anduaga JJ, Berglund P, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys [published correction appears in Int J Methods Psychiatr Res. 2003;12(3):165]. Int J Methods Psychiatr Res. 2003;12(1):3-21. doi:10.1002/mpr.138

  5. Shields GS, Spahr CM, Slavich GM. Psychosocial interventions and immune system function: A systematic review and meta-analysis of randomized clinical trialsJAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.0431