Depression clearly has a harmful effect on physical health, although the biological reasons for the link between body and mind are unclear. Whatever the reasons, over the past 20 years, it has become evident that depression after a heart attack is much more than an "understandable emotional reaction" to a stressful, life-changing event -- it is profoundly dangerous, raising a person's chances of having a second, fatal heart attack.
More recently, researchers have studied the flip side of the equation -- the question of whether someone with depression is at increased risk for developing coronary heart disease (CHD) down the line. Indeed, prospective studies show that people who had no CHD but were depressed when the studies began were more likely to develop or die of heart disease. Depression also aggravates chronic illnesses such as diabetes, arthritis, back problems, and asthma, leading to more work absences, disability, and doctor visits.
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Now results from a large Norwegian study suggests that depression increases the risk of death from most other major diseases, including stroke, respiratory illnesses, cancer, multiple sclerosis, and Parkinson's disease. It is also associated with accidental deaths.
Researchers gathered baseline information on physical and mental health for 61,349 Norwegian men and women, average age 48, and then noted the number of deaths and their causes during an average follow-up of nearly 4.5 years. Participants who had significant depression (2,866) had a higher risk of dying of most major causes of death, even after adjusting for age, medical conditions, and physical complaints at the study's outset.
In contrast, a diagnosis of anxiety did not increase the risk of death. However, coexisting anxiety-depression appeared to raise the risk of accidental death and suicide. The researchers theorize that depression may increase the risk of death by directly affecting the cardiovascular and nervous systems. In addition, depression may lead to poor health habits, such as smoking, alcohol abuse, and a sedentary lifestyle, and may affect people's ability to follow treatment regimens. Results reported in the journal Psychosomatic Medicine (volume 69, page 323).
