Depression linked to heart disease

The human heart is arguably the most critical organ we have, the center piece that pumps blood to every part of our body and keeps us in moving shape. There are all sorts of issues that can come with that, though. 

Dr. Chippy Ajithan understands matters of the heart. The Sarasota Memorial Hospital staff physician, who works at the Sarasota Memorial Medical Arts Building, has been a specialist in cardiology for two decades. 

The cardiovascular field is defined by immediate observable metrics, the way a heart is damaged by external factors and how it can degrade. That’s how Ajithan started in her field, but as time has gone on, she has a new opinion: that the entire human being needs to be treated as an entity to bring about better health.

She said we should consider how mental illness and damage can translate into the physical realm and affect our hearts and bodies. 

There’s preliminary evidence to support her beliefs. A November 2020 American Heart Association study found that people with depression were significantly more likely to have worse cardiovascular health. The AHA survey, which included more than 4,000 people, screened for depression and cross-referenced it with weight, diet, smoking habits, physical activity and other factors. The research indicated people with severe depression were three times more likely to have heart disease than those without depression, and people with mild to moderate cases were 1.4 times more likely. 

“So much of our psychological health has been linked to disease,” Ajithan said. “The concept of how depression, chronic stress [and] anxiety having sort of this pessimistic and dissatisfied view on life, anger — all of that relates to disease. And how having the opposite by being being optimistic, having resilience and finding gratitude … makes a positive impact.”

The traditional culprits of heart disease are well known, which isn’t to say people follow healthy habits. A history of smoking, diabetes, poor eating habits, high blood pressure, high cholesterol and a sedentary lifestyle can all lead to heart damage.

Ajithan has seen patients come in for years with heart disease and damage, and she can tell pretty quickly if one of the aforementioned facts is playing a part. Having more of these risk factors exponentially increases the possibility of disease, and Ajithan said she has been seeing an increasing number people coming in with these many factors.

She said people’s struggles with heart disease and risk factors are clearly not getting better and, if anything, are getting worse. She attributes that to a growing population dealing with high levels of stress, which can lead to turning to quick, easier foods that are higher in calories and relatively less healthy.

“Modern life has spiraled into this current existence of not having time, being overworked and being overwhelmed,” Ajithan said. “And we let our health go.”

She’s starting to combat that by encouraging a mindfulness and all-encompassing health plan that considers mental hardships. On her end, that requires sitting down with patients and learning more about them, something that could be overlooked with a different approach.

She remembers one patient who had a family history of premature heart disease but made sure to eat healthy and even run in marathons. All the same, Ajithan said, the patient had relationship that went badly, which led to addiction and a spiral that ended in a heart attack. Physical symptoms were no doubt part of the reason for the heart troubles, but Ajithan said the hard personal conditions were a factor as well.

“We know [physical symptoms] to be tried and true,” she said. “When something is very black and white, and when you have five minutes per patient, you focus on that, and you move on. … But it's so varied with things [that lead to physical issues] that you would never imagine. These are individuals that look like they are completely put together. Until you ask, you don't know.”

What’s required from patients, in her eyes, is a willingness to confront those mental issues they might not want to. Repression can be an easy out, but it can also lead to bottled emotions that can damage your entire body. Eating healthier and finding diets that can combat certain cardiovascular issues are also critical. For those looking to go another way, meditation can bring a sense of peace that can combat depression and anxiety.

As for exercise, which can help with both physical and mental strain, Ajithan wants people to think about high intensity interval training, which involves a quicker but more demanding level of exercise.

She said depression and anxiety can cause physiological symptoms that trigger our sense of flight or flight, and that kind of heightened alertness can suppress your body and immune system from healing when fighting illness. Instead, trying to stay in a positive mindset can be much better for your body.

“Wellness is true psychological and physical well-being where there is a true sense of resilience, optimism, purpose, happiness and joy to your life,” she said. “No matter what happens to you, you have the ability to deal with it in a very healthy manner.”