Wiley Cowan has had two strokes and a quadruple bypass, but he has had another problem for much longer.
"The heart issues surfaced just a few years ago, but I feel that I have suffered from depression for a great many years," he said.
Some question whether depression can contribute to heart disease. Dr. Mary Whooley decided to review all the published research she could find on the possible link. Those results are in the Journal of the American Medical Association.
"The majority of studies have found that depression is associated with an increased risk of heart attacks," Whooley said. "This means that depression is not only affecting one's mental health, it may also affect one's physical health."
In fact, she found one out of three heart failure patients has depression. Whooley thinks that elevated stress hormones may damage the heart.
"There may be behavioral consequences of depression such as not taking medications as prescribed or not eating as well or not exercising that may damage the heart," she said.
Whooley said physicians and patients should consider depression when treating physical illnesses.
"Treating the depression first may help the patients recover from their other illnesses even better," she said.
Cowan also agrees with that assessment.
"It's a good holistic approach," he said.
Symptoms of depression include extreme fatigue and loss of interest in things you used to enjoy. If you think you may suffer from depression, talk to your physician.