Can an unstable mental state trigger heart disease?
If I were to ask you to think about a person you know who has depression or anxiety, there are strong odds that you would be able to come up with at least one or two individuals who have been affected by this disorder. According to Mental Health America, an estimated 1 in 5 American adults suffer from a mental health condition ("The State. . ."). This serves as an alarming statistic, considering the stigma surrounding mental health.
Mental stability is not something one should take for granted, especially when there have been significant amounts of research surrounding the linkage between distressed mental state and other somatic aspects of our health. In particular, there have been numerous studies portraying the strong connection between depression, anxiety, and mental stress and cardiovascular disease. In addition, some studies have gone so far to provide strong evidence that deteriorating mental state can even cause cardiovascular disease, and eventually death due to it.
There has also been research done on the heightened risk of anxiety and sensitivity due to cardiovascular disease, showing that the two are commorbidities of one another. At Loyola University Chicago, Dr. Katie Scrogin from the Stritch School of Medicine presented her research on the relationship between myocardial infarction and increased sensitivity and anxious behavior in rats. Dr. Scrogin's model of a myocardial infarction in rats was mimicked by a coronary arter ligation (CAL) and their responses to novel or adverse stimuli were observed. The adverse stimuli that the CAL rats were subject to was discriminatory auditory fear conditioning. The results showed that although CAL had "negligible effects on open-field behavior," there is a strong connection between the CAL rats and their inability to distinguish between aversive and familiar events. This inability to discern between stressful and neutral environments in turn, "promotes excessive sympathetic activation of the cardiovascular system" (Glasgow). Dr. Scrogin also explained that there was a distinction between male and female rats, where male CAL rats express more conditioned fear and are less able to discriminate between safety and danger, signifying increased anxiety or depression (Scrogin). Despite the results of her study, Dr. Scrogin contested that younger women, and women in general, have a higher risk of death after myocardial infarction. This suggests that the physioloigcal deficits due to depression are more substantial in females than in males.
In a review article published in the journal, Frontiers in Psychiatry, Arup K. Dhar and David A. Barton outline the individual conditions of major depressive disorder and coronary heart disease, and uncover a biological link between the mechanisms of both conditions. In their review, they evaluate the lifestyle factors, psychological stress, and autoimmune mechanisms that contribute to the "multifactorial" connection between major depressive disorder and coronary heart disease. They contest that a critical symptom of major depression, prolonged mental stress, has been "shown to induce prolonged endothelial dysfunction" which is prevelant in the onset of cardiovascular disease or deterioriation (Dhar).
By clearly outlining the links between major depressive disorder and coronary heart disease, the article, along with Dr. Scrogin's study, contribute to the effort to raise awareness about the connection and the necessity for depressive disorders to be de-stigmatized and taken from a physiological approach as well as psychological.
Why is this important?
The alarming startistics about mental health in the United States coupled with the many cardiovascular deficits that Americans face and the comorbidity that exists between them is significant evidence to raise awareness and try to treat one, the other, or both at the same time. Not only does depression cause cardiovascular problems, but cardiovascular problems can cause depression and other mental health issues. Because of their proportional relationship, the connection between the two diseases should be made emphasized more greatly in the medical field.
Works Cited:
Dhar, Arup K., and David A. Barton. “Depression and the Link with Cardiovascular Disease.” Frontiers in Psychiatry 7 (2016): 33. PMC. Web. 12 Dec. 2017.
Glasgow, J., Koshman, Y., Samarel, A.M. et al. Psychopharmacology (2016) 233: 2581. https://doi.org/10.1007/s00213-016-4305-y
Scrogin, Katie. Neuroscience Seminar. Loyola University Chicago. 2017
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