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Summary: Yes, there is a connection between depression and mortality, specifically between depression and premature mortality, which means death before average life expectancy.

Key Points:

How Do You Assess the Relationship Between Depression and Mortality?

In a paper published in 2023 called “Depressive Symptoms and Mortality Among US Adults,” a group of researchers report the results of a study with the following goal:

“To examine the association between depressive symptoms and mortality in a large, diverse, nationally representative sample of US adults, and to examine how lifestyle factors mediate this association.”

Let’s take a look at how they conducted the study.

To address their research goal – and answer the question in the heading above the research team examined data collected between 2005 and 2018 by the National Health and Nutrition Examination Survey (NHANES) cross-linked with data from the National Death Index (NDI). While the data above include individual 18+, this study examined data from individuals age 20+.

Among people with major depressive disorder and depressive symptoms, researchers examined these outcomes:

  • All-cause mortality, or any death
  • Mortality associated with cardiovascular disease
  • Mortality associated with ischemic heart disease

Researchers grouped mortality data with data on depression severity:

  • No/minimal depression or depressive symptoms
  • Mild depression or depressive symptoms
  • Moderate to severe depression or depressive symptoms

In addition, the researchers identified the impact of lifestyle factors on mortality. The team used a metric called Life’s Essential 8 (LE8) developed by the American Heart Association (AHA), which indicates scores on the following 8 metrics can identify the difference between a healthy lifestyle and a lifestyle that needs adjustment:

  1. Body mass index
  2. Nicotine use
  3. Physical activity/exercise
  4. Hypertension
  5. Diabetes
  6. Cholesterol
  7. Eating habits
  8. Sleep habits

Now let’s take a look at the results.

Is Depression Associated With Specific Types of Mortality?

We’ll start with the prevalence of depression in the set 23,694 adults over age 20. Roughly half participants were female, half were male, with an average age of 44.

First, the overall prevalence of depression:

  • Mild depression: 14.9%
  • Moderate to severe depression: 7.2%

Second, the association between the presence of depression and all-cause mortality, expressed as a hazard ratio (HR):

  • Mild depressive symptoms vs none: HR of 1.35
    • 35% increased risk of premature mortality, i.e. death before average life expectancy
  • Moderate to severe depressive symptoms vs none: HR of 1.62
    • 62% increased risk of premature mortality

Third, the HRs for the association between depression and mortality associated with cardiovascular disease:

  • Mild depressive symptoms vs none: 1.49
    • 49% increased risk of mortality associated with cardiovascular disease
  • Moderate to severe depressive symptoms vs none: 1.79
    • 79% increased risk of mortality associated with cardiovascular disease

Fourth, the HRs for the association between depression and mortality associated with ischemic heart disease:

  • Mild depressive symptoms vs none: 0.96
    • Weighted averages show no increased risk
  • Moderate to severe depressive symptoms vs none: 2.21
    • 121% increased risk of mortality associated with ischemic heart disease

Finally, the research team also examined the effect of the LE8 lifestyle factors on the connection between depression and types of mortality, as well as the impact of specific depressive symptoms on the connection between depression and types of mortality. Here’s what they found:

  • Impact of LE8 factors:
    • 11.0% – 16.1% of the associations between depression and mortality may have been influenced by individual lifestyle
  • The following depressive symptoms were associated with both all-cause mortality and mortality associated with cardiovascular diseases, but not with mortality associated with ischemic heart disease:
    • Persistent fatigue
    • Persistent low energy
    • Appetite: eating too little/eating much
    • Loss of interest in favorite activities

We’ll discuss these results below.

Depression and Risk of Mortality: What This Means and How It Can Help

When we support a patient with depression, every part of their life matters to us. That’s why we endorse and integrated, whole-person approach to treatment. Everything matters, and every bit of knowledge can help us help patients achieve their treatment goals.

Our goals are their goals, and one of their goals is to live a long and productive life. When we know and understand the association between depression and specific types of mortality, we can counsel our patients on this fact and inform them that a diagnosis of depression increases their likelihood of mortality from serious heart disease.

Then, our patients can use this information to adjustments to their lifestyle to decrease risk of heart disease – adjustments that also contribute to improved mental health, wellbeing, and overall quality of life.

That’s how research like this helps, and why it matters: in the end it can help us help patients improve their lives and thrive – which is our primary goal.

Finding Help: Resources

If you or someone you know needs professional treatment and support for depression, please contact us here at Crownview Psychiatric Institute: we can help. In addition, you can find support through the following online resources:

About Angus Whyte

Angus Whyte has an extensive background in neuroscience, behavioral health, adolescent development, and mindfulness, including lab work in behavioral neurobiology and a decade of writing articles on mental health and mental health treatment. In addition, Angus brings twenty years of experience as a yoga teacher and experiential educator to his work for Crownview. He’s an expert at synthesizing complex concepts into accessible content that helps patients, providers, and families understand the nuances of mental health treatment, with the ultimate goal of improving outcomes and quality of life for all stakeholders.