DEPRESSION MAY EFFECT YOUR HEALTH AND RESPONSE TO MEDICAL CARE

Written by: Patrick Randolph, Ph.D.   Date updated: 4/18/2019

What is depression?

Symptoms may be temporary in response to stressful life events like grief or trauma, but could need treatment if at least 5 of the following depressive symptoms (Need DSMIV reference here) occur for longer than two weeks:

  • Depressed mood on most day, including feelings of sadness or emptiness
  • Loss of pleasure in previously enjoyed activities
  • Too little or too much sleep
  • Unintended weight loss or gain or changes to appetite
  • Physical agitation or feelings of sluggishness
  • Low energy or fatigue
  • Feeling worthless or guilty
  • Trouble concentrating or making decisions
  • Ongoing thoughts of death or suicide

Depression causes a person to have low mood and may leave them feeling persistently sad or hopeless.

Physical symptoms of depression

Depression can affect physical health in the following ways:

Weight gain or loss

Extremely overweight individuals were much more vulnerable to depression,(104, Depression and post-operative complications: an overview, Ghoneim, 2016) being nearly 5 times more likely to have experienced severe depression in the past year than individuals of average weight. While being overweight can effect diabetes and heart disease, being underweight can be harmful to the heart, affect fertility and cause fatigue.

Chronic pain

There are unexplained aches and pains as depression is related to lower pain tolerance Depression and postoperative complications: an overview. Depression and pain worsen one another.

Heart Disease

Many suffering with depression lack the energy and motivation to do things that improve the condition. A poor diet and inactive lifestyle may contribute to heart disease.

Inflammation

Chronic stress and depression are tied to inflammation and immune system functioning. Depression may be due to chronic inflammation, although more research is needed to determine which causes which. Other medical conditions associated with inflammation include irritable bowel syndrome (IBS), Type II
diabetes and arthritis.

Sexual health

In addition to the relationship difficulties that may arise from depression, there may also be decreased sex drive, difficulty becoming aroused, fewer or less pleasurable orgasms.

Aggravation of chronic health conditions

Chronic health conditions tend to create depression and depression tends to worsen overall health. A person with depression may also lack the energy or zest to be involved in the treatment plan, which tends to worsen the ailment.

Sleep disturbance

Depression may cause insomnia, early morning awakening, nightmares and feeling exhausted upon awakening. Long-term sleep deprivation is associated with high blood pressure, diabetes, weight-related issues, and some types of cancers.

Problems with stomach and digestion

Diarrhea, vomiting, nausea or constipation andchronic problems like irritable bowel syndrome are often reported by people with depression. Depression may result in long-term suppression of activity in the hypothalamus, pituitary gland and adrenal glands, which affects several areas of our health.

Depression’s effect on disability, suicide and finances

Depression is the leading cause of disability globally (Improving health outcomes for patients with depression) (3) with productive years lost to disability (4) 3 times greater than from diabetes, 8 times greater than from heart disease and 40 times greater than from cancer. Depression is the major driver of suicide (10) with more deaths than from homicides and motor vehicle accidents. Depression is very expensive, with 50% to 100% higher health care costs and indirect costs related to lost productivity (8).

Does depression cause health problems or do health problems cause depression?

Both health problems and depression worsen one another to create a “vicious” cycle. This means it’s important to address both physical and psychological issues in the management of our overall health, even though our culture generally focuses on medical concerns much more frequently and aggressively than psychological ones.

Does depression affect surgical outcomes?

Depression tends to suppress immune functioning, resulting in more post-operative complications, infections and an increase in general post-operative death. This results in longer hospital stays, recovery times and financial burdens.

Depression is associated with higher pain following surgery and in the months or years to follow.

Depression increases the risk of post-operative delirium, which may cause for a long and incomplete recovery after surgery.

Depression is associated with lower quality of life following surgery and has a strong association with suicide.

Surgical procedures tends to be less effective in those who are moderately depressed or worse, notably in weight loss surgery, spine surgery and coronary artery bypass surgery. (Depression and post-operative complications: an overview, Ghoneim, 2016)

Outlook

Depression can be treated successfully, especially if it is addressed early and aggressively using a number of combined therapies.