Depression: Associated Conditions - Chronic Health Problems

There is a high rate of overlap between depression and chronic health conditions.  Chronic health conditions are long-term medical problems that are influenced by lifestyle factors (e.g., diet, exercise, stress management, and sleep) and require active engagement from patients for best management. Some examples of chronic health condition symptoms are heart disease, hypertension, type II diabetes, chronic pain, and chronic obstructive pulmonary disease.  Nearly 75% of Americans have one of these chronic conditions and over 25% have multiple chronic conditions (Ward).  There is also a strong relationship between depression and chronic health conditions.  For example, people with a chronic health condition have depression at rates between 11% and 51% (depending on the condition) compared to only 16% of the general population (CDC)
Why Do Depression and Chronic Health Conditions Occur Together?
There are several theories about why depression and chronic health conditions go hand in hand.  Some argue that depression causes people to engage in unhealthy behaviors that increase risk for the development of chronic health conditions (e.g., lots of comfort eating to cope with low moods increases risk for heart disease).  Others argue that chronic health conditions cause people to feel depressed (e.g., having a heart attack can be very scary and depressing).  Still others argue for a shared risk factor that causes both depression and chronic health conditions. For example, a common theory of this type (“Inflammation Hypothesis Dysregulation”) suggests that some people have problems with chronic inflammation that can cause weakness, concentration difficulties, fatigue, and general discomfort which can all be risk factors for both chronic health conditions and depression (Miller).

1. Ward BW. Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Preventing chronic disease. 2013;10.
3. Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression.  Andrew H. Miller, Vladimir Maletic, and Charles L. Raison