Depression & Heart Disease

Q. This past winter, my former spunky 85-year-old mother-in-law suffered pneumonia, followed by fatigue, depression and anxiety, as well as a sense of impending doom. She stopped going out with her friends and could not sleep or talk. Her doctor did not find any illness but prescribed Valium and Dalmane. She did not take these often since she knew they were addicting medications. Last week she had a heart attack. Has research documented a relationship between depression, anxiety and cardiac disease? Two weeks before the heart attack, a pulmonary exam was taken. It did not reveal any continuing pneumonia, but the hospital doctor thought she was still suffering it.

A. Pneumonia (infection of the lung) can indeed be very serious, especially in the elderly. It is the sixth leading cause of death in the United States. Most cases can be cured with antibiotics. Depression and anxiety disorders are also very common and can cause serious disability. It sounds like your mother-in-law has a significant degree of depression and anxiety, but without more details and exam, I cannot give an exact diagnosis, meaning pneumonia may recur. Just a thought, dementia (such as Alzheimer's) may also cause these symptoms. There are several studies that have shown a relationship between depression and heart disease. Although there are some conflicting studies that do not show a causative relationship, I do believe depression may cause heart disease, and it also may result from heart disease. After a heart attack, about 25% of cardiac patients are depressed. Also, patients with cancer, neurologic disorders such as Parkinson's, and diabetes have a much higher risk of depression. Some animal studies have shown a link of depression, causing a decrease in immune function, which can lead to tumors.Your mother should be considered for antidepressant/anxiety treatment and be evaluated by a psychiatrist if not yet done.