• Home
• Workbook
• About AS@W
• People
• Partnerships
• Resources
• Frequently Asked Questions (FAQ)
• Other Publications
• Media / Press
• Presentations
• Ordering Print Copies
• Contact
• Links
  

AS@W...Depression and Physical Health Conditions

Why should mood difficulties in individuals with a health condition be addressed?

• Many people with health conditions also experience mood difficulties (such as low mood, depression, worry, anxiety, and anger).

• Higher rates of mood difficulties have been found among individuals with the following health conditions:

• Health conditions make it more likely that individuals will have mood difficulties.

• Mood difficulties can worsen the physical symptoms of health conditions.

• Mood difficulties make it difficult to carry out recommended treatment and self-care for health conditions.

What is the relationship between depression and specific health conditions?

Heart Disease:

• About one-third of individuals with coronary heart disease have depression.

• For individuals who have had a heart attack, post-heart attack depression is an even stronger risk factor for mortality and future cardiovascular events than smoking.

• Depression is associated with a 33% increased mortality risk in heart failure patients.

Asthma:

• Almost one-half of individuals with asthma have depression.

Chronic Obstructive Pulmonary Disease (COPD):

• COPD comorbid with depression is associated with longer hospital stays and higher rates of mortality.

• Up to one-half of the individuals with COPD may have depression or anxiety.

Kidney Disease:

• Individuals with a diagnosis of chronic kidney disease and major depression have worse health outcomes than individuals diagnosed only with chronic kidney disease.

• Individuals with depression are twice as likely to not begin dialysis or to be hospitalized.
• Some research has shown earlier mortality for patients with untreated depression.

Diabetes:

• About 1/3 of adults with diabetes also have depression (compared to about 5% of the general population). Being diagnosed with diabetes more than doubles the likelihood of having depression.

• Patients with diabetes and depression have poor metabolic control, higher complication rates, increased health care use, poorer quality of life, increased disability rates and increased mortality rates.

• A recent 2008 study found that individuals diagnosed with Type 2 diabetes and depression had higher blood glucose levels over a four year period than individuals who were not depressed. In individuals with diabetes, lower blood glucose levels, or greater glycemic control, is associated with fewer health complications, lower mortality rates, and a better quality of life.

• Increased severity of depression is associated with:

• Poor self-care behaviours
• Poor participation in education programs
• Poor diet

Pain:

• Patients with chronic pain have elevated rates of depression.

• Patients with increased depressive symptoms experience higher levels of pain.

What are some things that can help individuals who are dealing with a mood difficulty and a health condition?

• In addition to ensuring you are getting appropriate care for your health condition, it can be helpful to build coping skills, such as those taught in Positive Coping with Health Conditions (see: http://www.comh.ca/pchc):

• Relaxation
• Manage worry
• Activating your life
• Problem solving
• Managing depressive thinking
• Managing anger
• Relationship building

References

Anderson, B.L., Yang, H., Farrar, W., Golden-Kreutz, D.M., Emery, C.F., Thornton, L.M., Young, D.C., & Carson, W.E. (2008). Psychological intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 113, 3450-3458.

Bilsker, D., Samra, J., & Goldner, E. (2008). Positive Coping with Health Conditions. Accessed from http://www.comh.ca/pchc/

Brenes, G. (2003). Anxiety and chronic obstructive pulmonary disease: prevalence, impact, and treatment. Psychosomatic Medicine, 65, 963-970.

Chapman, D., Peyy, G., & Strine, T. (2005). The vital link between chronic disease and depressive disorders. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 2, 1-10.

O’Connor, C., Jiang, W., Kuchibhatla, M., Mehta, R., Clary, G., Cuffe, M., Christopher, E., Alexander, J., Califf, R., & Krishnan, R. (2008). Antidepressant use, depression, and survival in patients with heart failure. Archives of Internal Medicine, 168, 2232-2237.

Park, H., Hong, Y., Lee, H., Ha, E., & Sung, Y. (2004). Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care. Journal of Clinical Epidemiology, 57, 978-984.

Rudisch, B., & Nemeroff, C. (2003). Epidemiology of comorbid coronary artery disease and depression. Biological Psychiatry, 54, 227-240.

Sirois, B. & Burg, M. (2003). Negative emotion and coronary heart disease: a review. Behaviour Modification, 27, 83-102.

Walters, K., Rait, G., Petersen, I., Williams, R., & Nazareth, I. (2008). Panic disorder and risk of new onset coronary heart disease, acute myocardial infarction, and cardiac mortality: cohort study using the general practice research database. European Heart Journal, 29, 2981-2988.

 

About AS@W

How was Antidepressant Skills at Work developed?

The guide was developed by British Columbia Mental Health and Addiction Services (BCMHAS), an agency of the Provincial Health Services Authority. The guide and accompanying materials have been authored by Dr. Dan Bilsker, Dr. Merv Gilbert, and Dr. Joti Samra – registered psychologists and scientist-practitioners with expertise in issues relating to workplace mental health. These psychologists are with the Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University. The guide was written on the basis of a review of the scientific literature; consultation with employers, unions, mental health providers and employee groups; and adaptation of existing self-care depression programs.

How can the manual be accessed?

The manual is available for viewing and free download at www.carmha.ca/antidepressant-skills/work/ or from www.bcmhas.ca/research. Individuals or organizations are free to print and make multiple copies of the guide, with permission from CARMHA. Print copies and audio CDs are available at a low cost from our ordering page at www.comh.ca/ordering/