Scientists are finding that even after depression eases, the risk of stroke can remain high.

“We thought that once people’s depressive symptoms got better their stroke risk would go back down to the same as somebody who’d never been depressed,” says epidemiologist Maria Glymour, who lead the study when she was was at Harvard’s T.H. Chan School of Public Health. But that’s not what her team found.

Even 2 years after their chronic depression lifted, Glymour says, a person’s risk for stroke was 66% higher than it was for someone who not experienced depression.

Scientists don’t know yet the mechanisms involved, she says – why depression would predispose someone to stroke. It could have something to do with the body’s physical reaction to the psychological malady, Glymour says.

“Changes in immune function,” she says, “[or] inflammatory response, nervous system functioning – all of these might influence blood pressure [or] cortisol levels and thereby increase your risk of stroke.”

It’s also possible, she says, that depression changes a person’s behavior in ways that increase the risk of stroke. People may be more likely to smoke cigarettes or drink excessive amounts of alcohol when depressed, or find it harder to get exercise.

Glymour says the study’s findings imply that the negative health effects of depression are more likely cumulative over time – people whose diagnosis of depression was very recent were not more likely to have a stroke than people who never had symptoms.

That’s one more reason why it’s so very important to treat depression as soon as possible, she says. Dr. Renee Binder with the American Psychiatric Association agrees.

“There is no health without mental health,” Binder says, adding that people should be routinely screened for depression and anxiety when they see their primary care provider.

The answers to just a few questions – such as whether patients feel sad many days of the week or get pleasure from everyday activities – can be clear warning signs that more extensive screening is needed, maybe including a referral to a mental health specialist.

The good news, Binder says, is that depression can be “extremely treatable” once its addressed. A short course of psychotherapy or a short course of meditation, she says can quickly turn things around in many cases.
May 17, 2015

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