Stress, Anxiety and Depression

How Does Stress, Anxiety and Depression Relate to Cardiovascular Disease?

Stress often gets a bad reputation, but it’s important to understand that the stress in your life is not always negative. In fact, it’s essential for survival. Good stress can be  a source of motivation and push you to achieve your potential. Stress is an individual feeling and response: What one person may find stressful may not be considered stressful to someone else.

A stressor is a stimulus (such as an event, person, or situation) with the potential to trigger a reaction by your body.When faced with a stressor, your body reacts by circulating stress hormones (adrenaline and cortisol). These hormones send signals that prepare your body to take action, called a stress response. As a result, your heart rate and blood pressure increase, your breathing becomes faster and shallow, you start to sweat, and your entire body tenses up.

This video shows how the body reacts to stress (National Geographic).

The stress response is overactive in both anxiety and depression, two conditions that are strongly linked. Many people who experience depression also tend to have some kind of anxiety.


Stress is your mind and body’s response to any demand, or stressor. It can result when either good or bad things happen. For example, a job promotion would produce a response by your body the same way it would if you experienced a job loss. Stress becomes a danger when there is too much for your body to manage and when there is long-term exposure (chronic stress), which can lead to anxiety and depression.


Anxiety is more than the occasional or daily stress. It is one of the most distressing emotions people experience. The most common anxiety is “general anxiety,” and it can often lead to an anxiety disorder. It includes periods of nervousness or fears that often happen during difficult moments in life. Anxiety becomes a serious problem when it is persistent and interferes with your daily life, affecting your behaviour, thoughts, feelings and physical sensations.


Almost everyone feels sad or depressed at times, but clinical depression is stronger and lasts longer. When sadness is accompanied by the inability to cope with everyday life, it may indicate depression. When depressive symptoms are severe over an extended period of time, every aspect of a person’s life can be affected, including physical health, relationships, and work.

Impact on Your Cardiovascular Health

How Stress Affects Your Heart

Short-term stress can be good, but when you are under stress for long periods of time, also known as chronic stress, other changes occur:

  • Fat cells that were released into the bloodstream for extra energy become converted into cholesterol.
  • Platelets, the body’s blood clotters, become more “sticky” and start building up inside your arteries.
  • Your blood pressure increases for extended periods of time.
  • Your overall patterns of daily life begin to change in ways that make it more difficult to eat well, exercise regularly, and get enough rest.

All these negative effects increase your risk for cardiovascular disease. Learning to manage stressful situations can help you reduce this risk or avoid making your condition worse if you are already living with cardiovascular disease.

How Anxiety Affects Your Heart

Anxiety increases the risk for palpitations, an irregular heartbeat, and heart that races or spasms. Any of these responses may lead to cardiac complications. Anxiety may also lead to unhealthy behaviours, such as smoking, overeating, poor sleep, and decreased physical activity.

How Depression Affects Your Heart

With depression, you can have elevated levels of stress hormones. These have direct physical effects that put your heart at risk. They increase the risk of blood clotting and cause problems with the inner lining of your blood vessels. This leads to the buildup of plaque and to the development of atherosclerosis, or hardening of the arteries.

Depression also has indirect effects that cause added risks to your heart. It weakens your immune system and, like anxiety, influences some of the decisions you make around exercise, healthy eating, smoking, and taking medications safely.

People with depression have a more difficult time finding the energy and drive to make healthy lifestyle changes.

Learn More: Heart Institute psychologist Heather Tulloch, PhD, discusses how depression and heart disease are connected.

Benefits of Lowering Your Stress

When you reduce your stress, you not only help yourself, you help others around you. Because stress can affect your mood and emotions, your behaviour can change and negatively impact those close to you. Stress can make you irritable and more prone to anger. When stress becomes severe, you risk taking out your frustrations on family members and friends.

Keeping your stress under control can reduce the chances that it will affect your loved ones. At the same time, your risk for anxiety and depression will diminish. Several benefits of lowering your stress include:

  • Better self-esteem
  • Improved sleep patterns
  • More energy
  • Better controlled blood pressure
  • Regular heart rate
  • Normal appetite
  • Better concentration
  • Uplifted mood

Just as the stress you experience influences others, a calm and more positive orientation impacts the people around you. When you reduce your stress, your friends and loved ones are more likely to enjoy your company and help you maintain a sense of well-being.

Women who feel the strain of working in high-pressure jobs have, overall, a 40 per cent higher risk of heart disease. Research has found a stronger link between depression and anxiety disorders and heart disease in women than in men.

How much we earn and how well we live also are closely linked to overall health. Women are more likely to have lower socio-economic status than men, and women with lower socio-economic backgrounds and lower levels of education also have higher rates of heart disease than educated women in higher income brackets.