Vijai P. Sharma, Ph.D
People with cancer, heart disease, diabetes, epilepsy or osteoporosis appear to run a higher risk of disability or death, if they are clinically depressed.
As a psychologist who evaluates individuals for mental-medical disability, I can attest to the disabling effect of depression, unfortunately.
Does depression (or stress) cause medical disorders or the medical disorders cause depression? It might not be an unsolvable "chicken or the egg" puzzle, but it would take a long time to unravel the exact relationship between depression and disease.
Some of the biological underpinnings of the depression-disease relationships have recently come to light. For instance, take depression and heart disease. Depression might play a part in formation of blood clots via serotonin. Depression and serotonin deficiency go hand in hand. When there is less serotonin in the blood, chances of blood clotting increase. An artery-blocking blood clot can have serious consequences for the heart and the brain.
Researchers have also observed that the heartbeat of a clinically depressed individual is unusually steady, which is not supposed to be good for the heart.
In America, 10% of diabetic men and 20% of women are clinically depressed. Depressed diabetics are much more likely to develop heart disease, blindness, or nerve damage. Depression makes the body less responsive to insulin via cortisol. Cortisol tends to be elevated in the depressed (or stressed) individuals. Elevated cortisol doesn't allow the body to properly utilize the insulin.
Cortisol is also implicated in the depression-osteoporosis relationship. Elevated cortisol may make some depressed individuals more prone to osteoporosis. Such risk tends to increase as a woman nears the menopause. Cortisol doesn't allow the bones to properly absorb calcium and may in fact accelerate calcium loss with menopause and aging.
Depression must be promptly identified and treated. Early diagnosis and treatment of depression is not just a "good idea," but it some cases, it can save a person from becoming disabled for life or dying prematurely.
Primary care physicians play a crucial role in the diagnosis, treatment and referral of depressed individuals. They have a difficult job to do in absence of a trained assistant who can do psychological screening for all patients who have major and chronic medical disorders.
The Depression and Bipolar Support Alliance points out how hard it is to fathom the depth of depression in an 8-minute visit with your doctor, which is the national average of the doctor-patient "face time."
For such medical disorders as heart disease, cancer or diabetes, primary care doctors usually refer to specialists for further tests and treatment. Specialists, understandably, conduct rigorous and technologically sophisticated examinations for the implicated organs such as the heart, lungs and colon. Ironically, the subtle and the hidden psychological issues and the accompanying life stress do not receive an equally thorough and in-depth examination.
Psychological therapies can effect physical changes. Counseling, with or without medication, can help to modify brain neurotransmitters such as the serotonin, reduce stress hormones such as the cortisol, and enhance the immune function.
Alternative medicine expert, Andrew Weil, says that controlled breathing is the most powerful method he has found to reduce stress and anxiety.
Trained breathing quiets down the nervous system, lowers blood pressure, regulates heartbeat and improves circulation, digestion and the immune function. Breath relaxation buffers the body and mind against the ill effects of the stress, anger, anxiety or depression.
In one study, mental relaxation and focused awareness of breathing for 15 minutes twice a day reduced doctor visits over a 6-month period and saved the health care system tow hundred dollars per patient.
The formula for happiness and health is hard work, exercise, rest and relaxation. To be relaxed and happy is a full time job and a half. But, you get paid for the overtime.
Appreciation of what's around you and gratitude for what you have is an exercise for the mind.
Breath is the bridge to get to the royal road of rest and relaxation.
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Copyright 2003, Mind Publications
Posted February 2003
Dr. Vijai Sharma
Your Life Coach
By Telephone