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Worried about other health problems
Dear Doctor
I have read that having Depression might make those affected more at risk of certain physical illnesses, such as diabetes and heart disease. I’m worried about my physical health, yet I feel it might be difficult to ask my doctor, as I always visit about depression and he doesn’t seem interested in my physical health worries.
Robert
Dear Robert,
Thank you for your letter, which raises an important issue regarding whether having Depression increases the risk of other illnesses, particularly Heart Disease and Diabetes.
In recent years, we have become more aware of how big a part lifestyle plays in many illnesses. The strong links between smoking and lung cancer and between alcohol intake and liver disease are well established, but now we also know that factors such as diet, obesity, lack of exercise and stress can play a significant part in a wide range of conditions.
Anybody who has suffered from Depression will be aware of how it can affect all aspects of your life: appetite, diet, weight, energy, exercise, sleep, alcohol and cigarette consumption may all change, along with deterioration in mood. And, of course, occupational and relationship problems may well be present and will certainly increase stress.
It is not surprising, then, that people suffering from Depression will generally be more at risk of illnesses, such as Heart Disease and Diabetes, that are significantly influenced by lifestyle. Media interest in this area has been stimulated by recent research in Canada.
One study looked at 800 patients with known Heart Disease, and found that those who also suffered from Major Depression or Anxiety Disorder were twice as likely to have a heart attack over the following two years, compared with those with known Heart Disease who did not suffer from Major Depression or Anxiety Disorder.
Another study looked at more than 30,000 patients and found that younger patients with Type 2 Diabetes (Type 2 Diabetes tends to be associated with obesity, whereas Type 1 Diabetes is caused by failure of the Pancreas to produce sufficient Insulin) were 30% more likely to have suffered from Depression in comparison with patients who did not have Type 2 Diabetes.
You mention that your doctor “doesn’t seem interested in my physical health worries”. The majority of patients with Depression will also suffer, to a greater or lesser extent, from Anxiety. Often there is anxiety about health matters and GPs may well wish to take a reassuring line, rather than rushing to investigate every symptom that is presented. In these circumstances, it can easily seem to the patient that the doctor is not interested. It is also true that the GP has to be very careful not to assume that symptoms are due to anxiety. Even the most anxious and, seemingly, irrationally worried patient can develop serious physical pathology. Indeed, as discussed above, they are at increased risk of doing so.
I would suggest that a good approach to your GP might be to mention that you have read that, as a sufferer of Depression, you may be more at risk of Heart Disease and Diabetes and that, consequently, you would welcome advice on what lifestyle changes you can make to reduce your risk factors. This may shift the consultation away from mental health issues and allow you to mention any symptoms that are concerning you.
Yours sincerely,
Gerry McPartlin