Will Treating Depression Treat Heart Disease?

That's the title on page 8, WSJ, thanks Shirley S. Wang.

I wondered when this would become news. It is true, or so it seems in my practice and clinical sense, that having a cardiac event puts a person at risk for depression. And being depressed puts us at risk for a cardiac event, given the genetics, probably, or self-abuse, like smoking and drinking, and let's not forget, stress.

It makes sense to treat it, obviously, because what could be more life-threatening than suffering times two from life-threatening illnesses? They both kill, depression and heart disease, or they can, without treatment.

Exercise, keep your cholesterol low, watch your blood pressure, take your heart medication if it's indicated, and talk to people about your fears, if you have heart disease. It has to be very scary, having this condition. And depressing when your activities are restricted, when you can't add a little salt.

And we know people who would die rather than give up that sirloin.

Anyway. WSJ tells us that patients who develop depression after heart attacks fare worse in the long term than those who don’t. A recent article in the Archives of General Psychiatry found that patients who develop severe depression post hospitalization for a cardiac event remain depressed for at least 6 months. They have double the risk of dying over the next seven years.

Thus cardiologists and behavioral scientists are wondering if treatment will improve prognoses, and if early screening is necessary. We already know that 6.7% of the general population gets depressed in any given year (National Institute of Mental Health).

Research is inconclusive regarding the effectiveness of treatment and screening, but I think most family physicians, probably internists, too, are sensitive to depression, ask about it as a matter of course. They know people kill themselves, and no one wants this on their conscience. Family physicians have always used us, the mental health professionals of the medical network, to treat this, depression. Tweak a bit with the meds and the psychotherapy, and voila, a better quality of life.

It's about time the cardiologists caught on. We've always been here.

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