As a condition, depression doesn’t always fly solo. In fact, depression is actually a risk factor for many health problems. Part of the reason is that depression can rob you of the desire to take care of yourself and take steps to prevent illnesses like high blood pressure (also called hypertension) and diabetes.
Depression can also cause physical changes within your body that disrupt its normal functions, like higher levels of inflammation and stress hormones and changes in heart rate, circulation, and metabolism. These changes can set the stage for other conditions.
The connection between depression and related conditions also goes in the other direction. Many diseases that affect your quality of life, like arthritis or multiple sclerosis (MS), can lead to depression. For some people, stress and anxiety are the triggers. For others, it can even be their medication.
High Blood Pressure
Depression affects between 20%-30% of people with high blood pressure. On its own, high blood pressure is a risk factor for heart disease and stroke. Add in depression and it can harm your quality of life and raise the risk of death.
Low-grade inflammation may be the common link, and a large population-based study found that some high blood pressure medications might decrease the risk of depression.
They include:
- Angiotensin agents (enalapril and ramipril)
- Calcium antagonists (amlodipine and verapamil)
- Beta-blockers (atenolol, bisoprolol, carvedilol, and propranolol)
If you have high blood pressure and are at risk for depression, talk to your doctor about the right medication for you.
Heart Disease
There’s a strong link between different types of heart disease and depression, especially when depression happens early in life. Depression can be as serious a risk factor as high cholesterol and high blood pressure. But it can also double the risk for obesity and diabetes, two more threats to heart health.
Some depression drugs are part of the problem. Antipsychotics can cause weight gain and an increase in blood fats, which are both heart disease triggers. Paroxetine, an SSRI, can hamper the work done by the cells that line your arteries and set the stage for heart diseases. Tricyclic antidepressants can affect heart rhythm, which increases heart disease risk.
And the link goes in both directions: Depression that starts after a heart disease diagnosis is the most dangerous risk factor for dying within 10 years of heart disease.
Stroke
Strokes happen when blood flow to the brain is cut off. The relationship between stroke and depression is complex. Depression increases stroke risk by 34%, even if you don’t have typical risk factors like high blood pressure.
Some people get depression after having a stroke. This can happen because a stroke can make physical changes to the brain. Depression can make another stroke more likely, so it’s important to seek treatment.
Chronic Pain
Pain and depression are closely related. One can cause the other, and each can make the other feel worse. The depression-pain link can happen whether the source of your pain is an injury or an illness that causes pain, like cancer or arthritis, or even if the pain has no obvious cause.
One reason may be that the stress and lack of sleep from chronic pain are set-ups for depression. The number of people affected is high. Up to 85% of those with chronic pain have severe depression, and up to 65% of those with depression have chronic pain. (Pain is one of depression’s first symptoms).
Eating Disorders
An eating disorder like anorexia or bulimia often goes hand-in-hand with depression. You might have had depression before the eating disorder, or it may start around the same time or sometime after the eating disorder. The trigger can be the mental distress of binge eating, vomiting, or slashing calories.
About one-third of people with either anorexia or binge eating disorder and up to half of those with bulimia have depression. And those numbers are even higher if the eating disorder is severe enough to need hospital care. The conditions are so closely linked that some depression symptoms can get better with treatment for the eating disorder.
Substance Use Disorder
When substance use disorders and depression happen together, it’s called “dual diagnosis” or “co-occurring disorders.” People with a substance use disorder account for nearly 20% of all those with a mental illness. From the other direction, depression makes you 40% more likely to have a substance use disorder.
Signs of depression and substance use disorder often look the same, so it can be hard to tell the conditions apart to get the right diagnosis and treatment. Whether the substance abuse disorder leads to depression or vice versa, or they share a cause, they can feed off each other.
This is especially true if you use the substance to self-medicate. Eventually you can develop serious physical illnesses, too, especially from alcohol abuse. Many people who are addicted to nicotine become depressed when they try to stop smoking.
Other Mental Illnesses
If you have depression (or any mental disorder), you’re at a high risk for another one at some point in your life. It can happen as soon as the first year after your first diagnosis, but the risk can stay high for 15 years or more. An anxiety disorder is very likely, with the risk being as high as 40% over 5 years, especially if your depression started before you were 20.
Depression is also a risk factor for developing Alzheimer’s and dementia symptoms. If you have Alzheimer’s and depression, depression treatment can help with cognitive function and quality of life.
Diabetes
If you have depression, your risk for type 2 diabetes goes up by 60%. One reason is that some depression medications affect blood glucose control and cause weight gain. Another is that depression can keep you from healthy lifestyle habits. A poor diet and little exercise are risk factors for diabetes.
If you have type 1 or type 2 diabetes, you have an increased risk for depression from the stress of diabetes self-care. That can make it even harder to manage your diabetes. Also, diabetes complications can make depression symptoms worse.
Asthma
People with childhood asthma have twice the risk for depression later on. The explanation for the relationship is complicated. The two conditions seem related to similar changes in the body’s nervous system. They’re also both linked to inflammation levels.
There’s also an emotional component: Many people with asthma grapple with stress and that may prompt depression (and anxiety). No matter which condition came first, depression can make your asthma worse if it keeps you from following your care plan.
What’s more, your emotions can trigger asthma attacks. And if you feel that you’re doing a poor job at controlling your asthma, your depression can feel even worse.
Multiple Sclerosis and Other Autoimmune Diseases
Depression is a common symptom of MS and other inflammatory diseases, from rheumatoid arthritis (RA) to inflammatory bowel disease. When MS alters certain areas of the brain, these changes can affect your emotions and your behavior. The stress of MS, as well as some MS medications, can trigger or worsen depression.
Depression can set in at any time in the disease’s progression. But it doesn’t seem tied to how severe the MS is. It can happen to anyone at any stage. Besides bringing along its own symptoms, depression can worsen MS pain, fatigue, and cognitive problems.
Arthritis
Inflammation is also the likely physical link between depression and all types of arthritis,
including osteoarthritis, psoriatic arthritis, lupus, ankylosing spondylitis, gout, and RA. But depression can also result from the stress of the physical condition. It affects about a third of people with arthritis, often those with the highest pain level.
Because depression heightens your sensation of pain, it can make your arthritis symptoms feel worse. When both arthritis and depression keep you from functioning well and following your care plans, your risk for other health conditions rises.
COPD
COPD, or chronic obstructive pulmonary disease, inflames your airways and makes breathing difficult. Dealing with this serious illness can lead to depression. Many people who are depressed smoke, and smoking is a major risk factor for COPD. The inflammation caused by depression can also lead to COPD flare ups.
If you have a hard time sticking with your COPD treatment plan and being as active as you should be, depression can make these challenges even more difficult. Exercise is a great boost for both conditions.
Osteoporosis
Osteoporosis is a bone-thinning disease that makes you more likely to break bones. Antipsychotic medications that treat depression can raise your risk for it. Some can cause high blood levels of the protein prolactin. Too much prolactin can lead to bone loss, a major risk factor for osteoporosis.
After menopause, women are at a higher risk for both bone loss and depression. Doctors aren’t exactly sure why. Because of the spike in osteoporosis among women later in life, it’s important to head off both health threats with the help of your doctor.