The link between mental and physical health

My father once went to the hospital after suffering a heart attack (he’s still alive kickin’ and hollerin’, don’t you worry). He had high cholesterol (perhaps due to the tons of sausages and liverwurst he ate... Not that I'm judging). Doctors did an angiography in order to examine the blood vessels. Since blood vessels don’t show up on X-rays, a dye is injected that flows through the blood vessels and shows up white on a X-ray. A doctor can see if there are blockages or problems along the way. Risk factors for having a heart condition that may result from blockages in the arteries that supply it with blood are eating fatty foods with lots of cholesterol, being overweight, having diabetes, smoking, being male and being over 45. It is especially rare for young women to require an angiography and it’s because of this fact that a certain study draws our attention today.

According to the study, young women suffering from depression who are also undergoing an angiography are at a higher risk to suffer from a poor cardiovascular outcome. Their outcomes, either death or a major cardiovascular problem, resembled the typical outcomes for men 65 years of age and older.

As the famous saying goes (perhaps only famous in this special social circle of doctors I seem to hang out in lately), correlation does not mean causation. Simply because these women had depression, it does not mean that depression caused later severe cardiovascular problems. Importantly, young women undergoing angiography already have something troublesome going on underneath. It is extremely rare for young women to need this procedure. Therefore, they already may have been heading towards severe cardiovascular problems and the depression may have been the final gust of wind that tipped them over the edge.

We know depression increases mortality of all causes at any stage in an individual's life. We are not sure this study adds, detracts or clarifies anything with regard to that more or less established fact. We do not think, as some people have concluded, that this study means young women's health is more likely to be adversely affected by depression than anybody else's.

So, what are the take home messages:

Correlation does not mean causation

Depression is a serious condition that we need to actively treat. There is no 'pull yourself together' here.

Mental and physical health are far more linked than people commonly believe. In fact, if you ask Russ and Andres our resident doctors, they are the same thing: health. Seeing them separately only contributes to stigmatising people who suffer from mental health problems. Nobody thinks you can 'pull yourself together' from a heart attack so nobody should think you should 'pull yourself together' from an episode of depression.