Depression May Be More Dangerous Than We Thought
Researchers already recognized the link between depression and heart disease. However, until recently, the mechanisms explaining it remained a mystery.
A new study reveals that stress-induced inflammation may explain why mental and cardiovascular health are so intimately related.
A Puzzling Association
A significant body of research has established a connection between the two conditions.
For example, reviews of existing studies have shown that people with cardiovascular disease are more likely to have depression, and people with depression have a higher risk of developing cardiovascular disease.
Also, those with depression and heart disease are more likely to die from the latter than those who only have heart disease.
People with depression are more likely to have heart disease, and vice versa.
This relationship is also proportional, meaning that the more severe the depression, the more likely it is that a person will develop heart disease or die from it.
What explains this link? Researchers from the University of Cambridge in the United Kingdom set out to investigate.
Golam Khandaker, a Wellcome Trust Intermediate Clinical Fellow at the University of Cambridge, led the new research with his colleague Stephen Burgess.
The researchers published their findings in the journal Molecular Psychiatry.
Studying Depression and Heart Disease Risk
The team examined data on almost 370,000 people aged 40–69. The data were readily available in the UK Biobank database.
They first wanted to see whether having a family history of coronary heart disease also increased the risk of major depression, and they found that it did.
In fact, people who had lost at least one parent to heart disease had a 20 percent higher risk of depression.
No Genetic Link
Next, the scientists wondered whether genes determined this link. They calculated the genetic risk score for coronary heart disease but found no connection between the genetic predisposition to develop heart disease and the risk of depression.
This suggested to the scientists that depression and heart disease do not share a common genetic predisposition.
Instead, they wondered whether there were any environmental factors that may raise the risk of developing both conditions.
Scientists use this technique “to assess the causality of an observed association between a […] risk factor and a clinically relevant outcome.”
Their analysis revealed three biomarkers for the risk of heart disease that were also depression risk factors: triglycerides and the inflammation-related proteins IL-6 and CRP.
The scientists explain that our bodies produce the inflammation proteins IL-6 and CRP in response to physiological factors such as infections and lifestyle factors such as smoking, drinking, and physical inactivity, as well as in response to psychological stress.
High inflammation markers are often present in treatment-resistant depression, and high levels of IL-6 and CRP in particular often characterize acute depressive episodes.
Also, previous studies the researchers cited have shown that people with high levels of IL-6 and CRP are more likely to develop depression.
The Shared Factor: Inflammation
“It is possible,” Khandaker points out, “that heart disease and depression share common underlying biological mechanisms, which manifest as two different conditions in two different organs — the cardiovascular system and the brain.”
“Our work suggests that inflammation could be a shared mechanism for these conditions.”
However, the researchers caution that more work is now necessary. They also note that the role of triglycerides in depression risk has yet to be understood.
“Although we don’t know what the shared mechanisms between these diseases are, we now have clues to work with that point toward the involvement of the immune system,” says Burgess.
“Identifying genetic variants that regulate modifiable risk factors,” he goes on, “helps to find what is actually driving disease risk.”
Treatments for Depression
Depression is a mental disorder which affects about 350 million people worldwide.
Its symptoms include, but are not limited to; feelings of helplessness and hopelessness, loss of interest in daily activities, appetite or weight changes, insomnia or oversleeping, anger or irritability, loss of energy, self-
Current popular treatments for depression include antidepressant medications and talk therapy such as counseling or psychotherapy.
Unfortunately, these treatments have many drawbacks.
AD medication is associated with a high risk of side effects and a low success rate, while therapy sessions are notoriously expensive, and often unaffordable or unobtainable for most people.
AD medications have a high side effect risk and low success rate.
Medication for depression comes in the form of antidepressants.
There are typically 4 classes of AD medication, SSRIs (selective serotonin reuptake inhibitors), atypical antidepressants, tricyclics antidepressants and MAOIs (monoamine oxidase inhibitors).
The SSRIs (selective serotonin reuptake inhibitors) are the most commonly prescribed class of antidepressants. They act on a chemical in the brain called serotonin.
The SSRIs include drugs such as Prozac, Zoloft, and Paxil. SSRIs are preferred over older classes of antidepressants because their adverse effects are less severe, however, like all antidepressants, SSRIs can cause an increase in suicidal thoughts and behaviors.
While SSRIs are often prescribed for major depressive disorder (MDD), scientists still do not understand why the treatment does not work in nearly thirty percent of patients with MDD.
They also carry a risk for increased hostility, agitation, and anxiety. In adults 65 and older, SSRIs increase the risk for falls, fractures, and bone loss. SSRIs can also cause severe withdrawal symptoms if you stop taking them abruptly.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer class of medications that may be effective in treating depression.
Examples of SNRI’s
- Desvenlafaxine (Pristiq, Khedezla)
- Duloxetine (Cymbalta) ― also approved to treat anxiety and certain types of chronic pain
- Levomilnacipran (Fetzima)
- Venlafaxine (Effexor XR) ― also approved to treat anxiety and panic disorder
Potential Side effects include:
- Dry mouth
- Excessive sweating
- Changes in sexual function, such as reduced sexual desire, difficulty reaching orgasm or the inability to maintain an erection (erectile dysfunction)
- Loss of appetite
Atypical antidepressants are a variety of newer atypical antidepressants which target other neurotransmitters either alone or in addition to serotonin.
For example, Wellbutrin blocks the reabsorption of the neurotransmitters dopamine and norepinephrine, while trazodone affects both norepinephrine and serotonin.
Again, as with all antidepressant medication, there are many possible side effects.
Tricyclics are among the oldest antidepressants. They work by inhibiting the brain’s reuptake or serotonin and norepinephrine. They also partially inhibit the reabsorption of dopamine.
Because tricyclics have such a broad mechanism of action, they tend to cause more side effects than the other classes of antidepressants. For this reason, the SSRIs and the atypical antidepressants are usually prescribed first.
Again, side effects are usual and severe withdrawal symptoms are often the case if you stop taking them abruptly.
MAOIs (monoamine oxidase inhibitors) are the oldest class of antidepressants.
MAOIs have severe interactions with certain foods, drinks, and medications.
In addition, combining MAO inhibitors with foods or drinks containing tyramine can result in dangerously high blood pressure, which can lead to a stroke or heart attack.
Because of this danger, MAOIs are not typically chosen as a first-
Antidepressants Don’t Help Everyone
As is usually the case with medication, antidepressants cannot cure depression.
At best, they will lessen the symptoms of depression. However, success rates are notoriously low, not much better than a placebo in some cases, while the risk of side effects is extremely high.
This is the reason many people in the medical industry refer to antidepressants as “sugar pills with side effects”.
A Better, Safer Option To Treat Depression
Although very few doctors or medical professionals will know or tell you about it (there is too much money involved in conventional treatment methods), you can actually cure yourself of depression using only CBT (Cognitive Behavioral Therapy) techniques combined with some dietary and lifestyle changes.
Indeed in the past, a number of doctors and scientists had reported such successes in medical journals, but this research is now kept hidden by the pharmaceutical industry.
Recommended Depression Treatment System
I recommend James Gordon’s Destroy Depression System, a comprehensive self-help program.
This system includes a step-
His website explains exactly why and how this system works.
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