Talk therapy for depression may help lower heart disease risk

Depression is a common mental illness that impacts people all over the world. It can be debilitating and difficult to manage. There is often a complex relationship between depression and other health problems.

For example, people with certain chronic illnesses may be at an increased risk for depression. And vice versa, people with depression can be at a higher risk for other health problems like pain and type 2 diabetes.

Prompt treatment for depression is critical for the well-being of individuals, both mentally and physically.

Psychotherapies are one common component of treatment for depression. A common term for psychotherapy is talk therapy. There are different types of psychotherapy, but they can focus on discussing concerns, identifying harmful thought patterns, and managing behaviors and emotions.

Dr. Sarah-Nicole Bostan, clinical health psychologist and director of behavior change strategy at Signos, who was not involved with the study, explained to Medical News Today how talk therapy is used to treat depression.

“Psychotherapy is often recommended as a first-line approach in the treatment of depression due to its known effectiveness and minimal to no side effects, beyond occasional discomfort in therapy. Cognitive behavior therapy (CBT) including behavioral activation is one of the most effective types of evidence-based treatments for depression in which patients learn more helpful ways of not only seeing themselves but also learn to practice new behaviors and routines to help get them unstuck.”
— Dr. Sarah-Nicole Bostan

“Effectiveness of therapy can be measured throughout the course of treatment through validated assessments, but at minimum should be assessed at the beginning and end of a course of treatment,” she said.

Researchers are still working to understand how psychotherapy may indirectly benefit other areas of health.

Cardiovascular disease (CVD) is a broad category of health problems of the heart and blood vessels. Examples of cardiovascular diseases include heart attack, stroke, and heart failure.

Researchers of this retrospective cohort study wanted to understand the relationship between the effective treatment of depression and the risk for cardiovascular disease.

Researchers included 636,955 participants in their analysis. All participants met specific threshold criteria for depression and had completed a course of psychotherapy. In addition, participants did not have cardiovascular disease before using the Improving Access to Psychological Therapy program.

O​n average, researchers followed up with participants about three years later, looking at the incidence of cardiovascular events and death from any cause.

Researchers found that those who showed improvement in depression after psychotherapy saw the highest amount of benefit. They found that “those whose depression symptoms improved after therapy were 12% less likely to experience a cardiovascular event than those who did not.”

T​hey further found that improved depression after therapy was associated with a decreased risk for coronary artery disease, stroke, and all-cause mortality. The analyzed reduced risk for cardiovascular disease was greater for people under the age of 60 than those over the age of 60.

Study author Celine El Baou, Ph.D. student and Rare Dementia research assistant, explained the key findings of the study to MNT:

“We found that people whose depression symptoms improve after a course of therapy are at a lower risk of cardiovascular disease a few years later, compared to those people who do not improve. There was little previous research on the topic of modifying cardiovascular risk after psychological therapy — and the relationship between depression and cardiovascular risk is complex, so we did not know what to expect before running the analyses.”
— Celine El Baou, study author

T​his study is a step toward understanding how psychotherapy impacts other areas of health. Additional research is needed to deepen understanding in this area.

The study had limitations that are worth noting. First, the measurements of improved depression rely on participant self-reporting, which introduces certain limitations. It’s also challenging to examine all the factors that may have contributed to improved depressive symptoms.

The study also cannot prove that improving depression causes a reduced risk for cardiovascular disease. It’s possible that people made other lifestyle changes that also reduced risk.

Researchers acknowledge the possibility of reverse causality, and the study’s results can’t be generalized to people who are not seeking treatment for depression. The study also had a limited follow-up time, so future studies could include more extended time frames.

Finally, researchers did not have data on several potential confounders, like participants’ social support, alcohol use, or tobacco use. These unavailable factors could have impacted depression treatment outcomes and cardiovascular risk.

Overall, the study indicates psychotherapy’s significant role in other health outcomes.

“​This research confirms what we’ve known for quite some time, which is that even a limited number of sessions varying in length from 30 minutes to one hour over the course of a few short months can not only significantly ameliorate depression symptoms, but can set someone on a healthier trajectory for years to come through giving patients the tools to address their future stressors.”
— Dr. Sarah-Nicole Bostan

Celine El Baou explained to MNT that more research is needed in this area but that the study indicates the importance of psychological therapies.

“This research is a first step towards understanding this association. More research is needed to establish causation or understand behavioral or biological mechanisms in places. But it suggests how important it is to make psychological therapies widely accessible,” she said.