Mood disorders hike teens’ risk of heart disease

Adolescents who have major depression or bipolar disorder face a greater risk of heart disease and of getting it earlier, according to a scientific statement from the American Heart Association.  Canadian Dr. Benjamin Goldstein from Sunnybrook Health Sciences Centre in Toronto chaired the committee that made the statement.

‘Vigilance is warranted’

“Vigilance is warranted,” says Goldstein. “Weight, blood pressure, checking cholesterol—all of these heart-related factors are important for all teens. But they are particularly important for teens with mood disorders…

“Teenagers with mood disorders should be monitored at lower thresholds, there should be interventions at lower thresholds which means there should be less hesitation to intervene and to treat in terms of improving these cardiovascular risk factors.”

‘Mood disorders… have physical manifestations’

Approximately five per cent of male youth and 12 per cent of female youth, age 12 to 19, have experienced a major depressive episode, says the Canadian Mental Health Association. Goldstein says a conservative estimate is that two to three per cent of adolescents have bipolar disorder, with mood swings from extreme lows to extreme highs.

There is a tendency to see mental and physical problems as separate, says Goldstein, and that should stop. “(We want) to bring to people’s attention that these mood disorders, although they are characterized by symptoms that are brain-based such as sadness and irritability, they also have physical manifestations. So we need to stop looking at psychiatric disorders as residing solely in the head.”

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A call to action

It is not clear why teens with major depression or bipolar disorder are more likely to have several risks for cardiovascular disease, but the statement suggests it may be related to inflammation and other types of cell damage.

Based on a group of scientific studies, the committee hopes to spur action from patients, families and healthcare providers to reduce the risk factors.

“From the perspective of cardiovascular health, there need to be a recognition early and ongoing,” says Goldstein. “And heart health needs to come to the fore in terms of the treatment of these teens and not be relegated until they’re in middle age at which point a lot of these condition will have already accumulated.”