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According to recent surveys, about 75 percent of Americans are worried, depressed or angry about the economy. All of us, it seems, know someone who has lost their job recently, and many of us worry that we might be next. Sleep is hard to come by for many of us during these turbulent and uncertain times, and as I have discussed in recent articles on this website, chronic sleep deprivation, itself, has previously been linked to higher mortality rates in some clinical studies.

A number of illnesses have previously been linked to periods of prolonged stress, and particularly those situations that leave people feeling “helpless and hopeless” with respect to the events that are causing them to feel stressed. Prolonged periods of severe stress tend to disrupt the normal function of critical systems in our bodies, including the brain, the GI tract, the immune system, the reproductive system, and the cardiovascular system. Two important and timely news studies, just published in the Journal of the American College of Cardiology, further add to our understanding of the potentially adverse impact of chronic stress on our health.

In the first study, from Harvard University, more than 63,000 women participating in the enormous prospective Nurses’ Health Study were evaluated. All of these women underwent extensive psychological and physical evaluations in 1992, 1996, and again in 2000. None of these women had any clinical history of coronary artery disease or stroke at the time that they underwent their initial evaluation in 1992. The incidence of sudden cardiac death, heart attack, or death due to heart attack was then assessed in this huge cohort of adult women during the 8-year monitoring period. Additionally, the incidence of clinical depression (as measured by standardized mental health questionnaires and the use of antidepressant medications) was evaluated and analyzed in these patient volunteers.

The presence of clinical depression was found to significantly correlate with the risk of cardiac events in this study, even after controlling for other preexisting coronary artery disease risk factors in these 63,469 women. The presence of clinical depression was associated with a 49 percent increase in the risk of fatal heart attack (myocardial infarction) due to coronary artery disease. Sudden cardiac death was also much more common among the depressed women in this gigantic clinical study, and especially among the women who were taking antidepressant medications. In fact, the women who were taking antidepressant medications experienced more than twice the risk of sudden cardiac death (2.33-fold increased risk) when compared to the women without any history of depression or antidepressant use!

Therefore, clinical indicators of depression, including depression confirmed by standardized mental health screening questionnaires or the use of antidepressant medications, were associated with a strikingly increased risk of coronary artery disease, heart attack, fatal heart attack, and sudden cardiac death. If you believe that you are depressed (or if family or friends believe that you may be depressed), please see your physician or a mental health expert, as chronic depression can, indeed, be a matter of life or death. Read the rest of this entry »

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