Talking to a Therapist Can Save Your Heart

It might be time to stop treating physical and mental health as two separate entities and consider them to go hand in hand. Depression is not ‘all in your head’ and can have a detrimental effect on your health. One of the ways to manage depression is through psychological therapy, which translates to talk therapy. However, psychological therapy is not all just talk. A recent study shows that it is associated with a lower risk of heart disease and stroke. The study was published in the European Heart Journal.

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Talking can be Good for Your Heart

"Our study suggests that improving mental health could also help physical health, especially in those aged under 60," said study author Céline El Baou, a Ph.D. student at University College London, UK. "People whose depression symptoms improved after therapy had a 10% to 15% lower risk of cardiovascular disease than those who did not improve. Comparable effects were found in similar studies investigating low-fat diets."

Globally, cardiovascular disease is the leading cause of death, taking about 18 million lives annually.

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Can Managing Depression Prevent Heart Disease?

People with major depressive disorders have a 72% higher risk of developing heart disease when compared to their healthy peers.

The current study is the first to evaluate whether reducing depressive symptoms with psychological therapy is linked to a lower likelihood of future cardiovascular disease.

The participants of the study were 636,955 adults over 45 years old with depression who had completed a course of psychological therapy and did not have cardiovascular disease or dementia.

66% of the participants were women with the average age being 55 years. Information on psychological treatment, the incidence of cardiovascular disease, and death were obtained from national electronic health record databases in England and linked at the individual level.

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How Depression Level is Calculated

The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression levels before and after therapy. The PHQ-9 assigns a score of 0 (not at all) to 3 (nearly every day) to nine items, including little interest or pleasure in doing things; feeling down, depressed, or hopeless; trouble falling or staying asleep, or sleeping too much; feeling tired or having little energy; poor appetite or overeating; feeling you are a failure or have let yourself or your family down;Depression was defined as a score of 10 or more.

Improvement in depression was defined as a reduction of 6 points or more in the PHQ-9 score and no worsening of anxiety (defined as an increase of 4 points or more on the Generalized Anxiety Disorder scale) between the start and end of treatment. Anxiety was included in the definition so that the outcome of therapy was not considered good if depression improved but anxiety worsened.

Patients were followed for new onset all-cause cardiovascular disease, coronary heart disease, stroke, and all-cause mortality. Follow-up started 365 days after the last therapy session and those with a cardiovascular event during this period were excluded to reduce the likelihood that previously undiagnosed disease was the cause of depression.

During a median follow-up of 3.1 years, depression symptoms improved in 373,623 (59%) participants and did not improve in 263,332 (41%). There were 49,803 cardiovascular events and 14,125 participants died.

Manage Depression, Save your Heart

Improvement in depression was associated with 12%, 11%, 12%, and 19% lower risks of any cardiovascular disease, coronary heart disease, stroke, and all-cause mortality, respectively, versus no improvement. The analyses were adjusted for characteristics that could influence the relationships such as age, ethnicity, gender, socioeconomic deprivation, and other health conditions.

The associations were stronger in people aged 45 to 60 years old. For them, depression improvement was linked with a 15% fall in the risk of cardiovascular disease compared to no improvement; the equivalent figure for those 60 years and over was 6%. In addition, 45 to 60-year-olds with improved depression had a 22% decreased likelihood of death during follow-up compared to those not improving, while those 60 and over had a 15% reduction.

Getting Help Can Help You Live Longer

El Baou said, "The findings are consistent with previous research suggesting that interventions to modify risk factors for cardiovascular disease are more effective at a younger age. This highlights the value of receiving help early to gain the most benefit."

Limitations of the Study

The researchers take into account that the results do not definitively prove that reductions in cardiovascular disease were caused by relief of depression. In addition, data were missing on lifestyle behaviors such as smoking and inactivity which could raise susceptibility to cardiovascular disease and limit the effect of psychological treatment.

El Baou said, "Our findings emphasize the importance of making psychological treatments more widely available and accessible to enhance mental and physical health. This is especially relevant for certain groups who face barriers to accessing psychological therapies and are at greater risk of cardiovascular disease. Collaborative care systems where specialists from both disciplines work together could be one way to make treatment more accessible and obtain better outcomes overall."

If you didn’t have enough reason to seek therapy before, this study should give you a good reason to pursue therapy. Remember, depression is a mental illness, and like how you go to the doctor for your stomach ache, you should see a professional for your mental health. There is no shame in taking care of your health, both physical and mental.

Reference:

1. Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England - (https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehad188/7097470)

Source-Medindia