• Health

Depressed? Angry? Your Heart May Suffer As a Result

5 minute read
John Cloud

We all know that emotions originate in the brain. But we usually talk about our emotions coming from our hearts. If someone you know doesn’t give up easily, you might say, “He’s got a lot of heart.” Not every culture would agree — for instance, when Italians want to say someone has heart, they say instead, “Ha fegato”: “He has liver.”

But what about bad emotions? When you feel so sad or so angry that your heart “aches,” could it actually be true? Two new studies add support to the theory that, yes, what goes on in your mind can, literally, break your heart. (Read “Giving the Finger: This Hurts Me More Than You.”)

In the first study, just published in the Journal of the American College of Cardiology (J.A.C.C.,) a team of eight researchers looking at more than 63,000 women who were participants in the ongoing Nurses’ Health Study, found that those who reported basic symptoms of depression (like feeling down and incapable of happiness) had a higher-than-normal risk of coronary heart disease. And women who were clinically depressed were more than twice as likely as other women to suffer sudden cardiac death. None of the participants had heart problems at the study’s outset, but nearly 8% had symptoms of depression.

The researchers theorize that depression might have some direct physiological impact on the heart — like causing it to work harder in the face of stress. The study also found that the more depressed women were, the more likely they were to smoke cigarettes or have high blood pressure and diabetes — not exactly heart-healthy conditions. Or it may be that the antidepressants prescribed to treat those with mood problems were associated with heart ailments; in the study, sudden cardiac death was linked more strongly with antidepressant use than with women’s symptoms of depression.

The antidepressant theory is just that — a theory. It could be that the antidepressant takers in the study were simply the most depressed. But if the theory is substantiated by further research, it would add to a growing body of evidence suggesting that antidepressants carry a high risk (particularly for teenagers) when weighed against the drugs’ still uncertain benefits. Scientists have already shown that antidepressants are a bad idea for those about to undergo coronary artery bypass surgery.

No one is sure exactly how depression hurts the heart, and one plausible explanation is that the train runs in the opposite direction — a damaged heart and its consequent stress on the body might activate, somehow, genes or other physiological changes that contribute to depression.

But another new paper, also published in the J.A.C.C., lends credence to the idea that it is our moods that work on our hearts and not the other way around. In this paper, researchers from University College London reviewed the findings of 39 previously published articles and found that men who are angry and hostile are significantly more likely to have a cardiac event than those who aren’t. That may sound unsurprising — we all know that anger can stress your heart. But it’s important to note the difference between aggression and just being aggressive. Previous studies (here’s one) have found that so-called type A’s — those who are driven, competitive and obsessed with deadlines — are not more likely to experience heart disease. In other words, your type A co-workers who are annoyingly ambitious and dutiful are no more likely to have a heart attack than you are. Rather, it’s the seething, angry types with underlying hostility who are the ticking time bombs. Anger, it turns out, is physiologically toxic.

The authors of the second paper offer the standard theories about how an angry emotion translates to a physical heart attack: angry people have a harder time sleeping; they take prescribed drugs less often; they eat worse, exercise less, smoke more and are fatter. These things add up: compared with the good-humored, those who were angry and hostile — but had no signs of heart problems at the outset — ended up with a 19% higher risk of developing coronary heart disease, according to the University College London paper.

The two studies reify gender stereotypes: women get their hearts broken through sadness; men “break” their hearts (via heart attack) through anger. But both studies suggest that men and women have a common interest in understanding that some causes of cardiac disease — poor diet or lack of exercise or bad sleep habits — may have a precipitating cause themselves. Whether male or female, letting yourself get overwhelmed by emotion can damage not only your mind but also that crucial organ, the heart.

Read TIME’s 1992 article about depression and drug therapy.

Read “Depression Drugs for Kids: How Safe?”

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