Global Study Finds Association Between Depression and Heart Disease

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.

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.

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.