Manage Depression: Protect Your Heart

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The Connection Between Depression and Heart Disease

Experts believe there are several reasons depression affects the heart.

Nervous system imbalance: The body's autonomic nervous system (ANS) helps the body respond to changes in environment. The ANS has two parts: the sympathetic response (famous for the adrenaline-pumping fight-or-flight response to stress) and the restorative nervous system (which slows heart rate and breathing).

"It's clear that the balance between the fight-or-flight response and the restorative system is significantly altered in depressed patients," Stein says. They have a heightened fight-or-flight response, which puts stress on their systems, making them more prone to cardiovascular events. "Depression also seems to alter the balance of some of the hormones, which favors heart disease," he says.

Blood more likely to clot: The platelets of depressed patients seem to be more reactive, or "stickier," says Christopher O'Connor, M.D., professor of medicine in cardiology at Duke University Medical Center. This matters because when we bleed, our bodies send platelets—small particles in the bloodstream—to the site to help the blood clot. The "stickier" the platelets, the more they clot, including in blood vessels leading to the heart, which can increase the risk of heart attack, O'Connor says.

Less likely to listen to doctor: A less-biological explanation is that depressed patients are less likely to follow a doctor’s orders about medication and lifestyle changes before, and after, a heart attack.