If you’re suffering from depression, it’s highly unlikely you’d see a cardiologist about it—but maybe you should. Some 30% to 50% of clinically depressed individuals are also likely to develop cardiovascular disease, according to psychiatrist Angelos Halaris. And 60% of heart disease patients suffer from clinical depression.
That’s why Halaris is proposing a new multidisciplinary medical subspecialty—psychocardiology—to help bridge the treatment gap for patients with (or at risk for) both heart disease and depression. A psychocardiology subspecialty could lead to earlier detection of heart disease risk in psychiatric patients and psychiatric problems in heart disease patients, he said. And it would help ensure safe and correct use of medications in patients needing both antidepressants and heart medication.
“It is only through the cohesive interaction of such multidisciplinary teams that we can succeed in unraveling the complex relationships among mental stress, inflammation, immune responses and depression, cardiovascular disease and stroke,” said Halaris, who serves as medical director of Adult Psychiatry at Loyola University Chicago School of Medicine.
Stress is the common denominator in this psychocardiology equation. Stress triggers an inflammatory response in the human body, by signaling the immune system to produce a class of inflammatory proteins called cytokines.
One such protein, called interleukin-6, protects against the negative consequences of stress in the body—to a degree. But what starts out as a protective mechanism can turns nasty over time. We know not that chronic inflammation triggers all sorts of problems, including hardening of the arteries and heart disease.
Where does depression come in? Well, stress triggers depression; and depression can cause a lot of stress. It’s a vicious cycle where all roads lead to increased interleukin-6 production. And increased interleukin-6 production leads to increased risk of heart disease.