Depression may affect physical health

People who suffer major depression may also be at risk for serious physical changes in the body and brain, according to Dr. Paul McClelland, a psychiatrist at St. Agnes Hospital in Baltimore.
The most obvious changes result indirectly from complications linked to major depression, he said. Some of the most common complications include:
Anorexia, which can cause irreversible kidney damage or damage to other organs including the brain.
Self harm, which can cause physical damage to the body through self-inflicted wounds.
Noncompliance with a doctor’s medication or treatment plan, which can lead to heart attacks, strokes or other problems.
Self neglect, which may result in avoiding medical treatments for new physical symptoms. Patients might also miss mammograms or colonoscopies.
Abuse of tobacco, alcohol and drugs, which can cause significant damage to the lungs, liver, brain and other organs.
Profound insomnia.
While there is clear evidence of indirect connections between depression and physical harm to the body or brain, Dr. McClelland said it is less clear whether there are more direct links.
“There have been research studies going back more than 30 years linking depression to the function of the immune system in the body, showing in a variety of ways that when people are very depressed, their immune system often doesn’t work the way it’s supposed to,” he said.
When the immune system is not functioning properly, Dr. McClelland said, individuals are more prone to infections and cancer.
“It appears when people are severely depressed, they sometimes are more prone to blood clotting, probably through the adherence of platelets,” he explained. “This is thought to explain why people who have severe depression after a heart attack or stroke have a worse prognosis than people who are not depressed. They are more likely to have subsequent heart attacks and strokes.”
Dr. McClelland cautioned that research has been focused on highly select populations of patients.
“It’s very difficult to apply this research at this point, and the results are not always consistent,” he said.
When dealing with depression, the most important problem facing health care professionals is missing cases of depression, according to Dr. McClelland.
“Primary care doctors are overwhelmed,” he said. “They have so little time allotted to them to see their patients. There aren’t enough mental health professionals.”
Dr. McClelland encouraged family and friends to look for signs of depression in loved ones and encourage them to seek medical treatment. Some signs of depression include a loss of the ability to enjoy anything, feeling hopeless, changes in sleep patterns, loss of energy, poor appetite and thoughts of suicide or hurting oneself.