Depression and the Heart |
For decades, we’ve divided health into neat categories: mental health on one side, physical health on the other. The brain over here. The heart over there. Different specialists. Different appointments. Different silos.
But biology doesn’t respect those boundaries—and neither does depression.
A growing body of research now makes something unmistakably clear: Depression is not only a disorder of mood and motivation; it is also a condition that affects the heart, blood vessels, and our long-term cardiovascular risk. In other words, mental health is cardiovascular health.
This isn’t a metaphor. It’s physiology.
Large observational studies and meta-analyses consistently show that people with depression are more likely to develop cardiovascular disease—including coronary artery disease, heart attack, stroke, and heart failure. The increased risk is not trivial, and it persists even after adjusting for traditional cardiovascular risk factors such as smoking, hypertension, diabetes, and obesity.
Importantly, this association isn’t limited to major depressive disorder. Even subclinical depressive symptoms such as low mood, fatigue, and anhedonia (reduced interest in activities that were once enjoyable) have been linked to higher cardiovascular risk. For clinicians, that’s a crucial point: Patients don’t need to meet full diagnostic criteria for depression to experience real physiological consequences.
The relationship also works in the opposite direction: After a heart attack or stroke, rates of depression rise sharply—and patients with depression after a cardiac event have worse outcomes, including higher mortality and higher rates of recurrent events.
This bidirectional relationship tells us something essential: Depression and heart disease are not separate problems that merely coexist. They are biologically intertwined.
So how does a psychological condition increase cardiovascular risk? One of the most compelling answers comes from recent large-scale research examining the........