Depression Is Deadlier Than Coronary Heart Disease

I thought this was a remarkable statistic:

Those with coronary heart disease alone were 67% more likely to die of all causes, while those who were depressed, but otherwise healthy, were twice as likely to do so as those who had neither condition.

But those who were both depressed and had heart disease were almost five times as likely to die as their mentally and physically healthy peers. [1]

If you are severely depressed, or have any other mental health condition, do not just live with it. Your condition may reflect some defect with diet or nutrition that may lead to long-term harm if not remedied. Or it may be caused by an infection which, if not treated, will progress.

One trouble with infections is that all infectious pathogens have evolved ways to disable the immune system, so any one infection makes you more vulnerable to subsequent infections. This is why people with chronic diseases and the elderly generally have many chronic infections at the same time. Each infection is debilitating; but as the number and severity of infections grows, the body weakens. Eventually, pathogens will induce some acute condition like pneumonia that enables them to spread to new hosts, and their first host will die.

I suspect that depressions of infectious etiology are more deadly than coronary heart disease because they imply a more advanced infection. Generally, to infect the brain pathogens have to first infect the vasculature; the vascular infection enables them to cross the blood-brain barrier. One can have a vascular infection (and coronary heart disease) without a brain infection, but as a rule one will not have a brain infection without vascular infection.

The drugs that doctors use for mental health conditions generally moderate symptoms but do not cure. By all means, see the doctors, but don’t expect a cure from psychoactive drugs. So what should you do?

I believe that the best treatment for depression, as our last post suggests, is a ketogenic variant of a healthy diet, good nutrition, and (if an infection is present) appropriate antibiotics. It is wise to start with diet and nutrition first, since diet alone may cure many conditions and a good diet is entirely safe. A healthy diet can greatly enhance mood. Antibiotics have the potential to backfire, so are the last line of defense; but in severe infections will be necessary for a cure.


[1] Depression and heart disease combo more lethal than either one alone, study suggests. ScienceDaily. September 16, 2010. Nabi H et al. Effects of depressive symptoms and coronary heart disease and their interactive associations on mortality in middle-aged adults: the Whitehall II cohort study. Heart. 2010 Sep 15. [Epub ahead of print]

Leave a comment ?


  1. Paul,

    Interesting. Both, depression and CVD, are connected with hypothyroidism.

  2. Hi Mario,

    I’ve updated the post a bit, to reflect other causes for depression. All kinds of pathologies including hypothyroidism can contribute to these conditions and we don’t know for sure the causal weight to give to each factor.

    At the same time infections can cause hypothyroidism, so the causal web may be complex.

    It will be interesting to see how many cases of depression can be cured by diet alone.

    I’m thinking of a follow-up post soon on chronic fatigue, looking at how the CDC CFS team attributed it to psychological causes, which it probably is in mild cases, but all the severe cases are probably due to virus infections as the Human Gamma Retrovirus research is proving. I think we’ll eventually learn that depression is similar — the really severe cases are all due to infections.

  3. This is an interesting study, but I think your analysis might be slightly off. My reference is the book, “Anatomy of an Epidemic” by Roger Whitaker; here is a good review:

    A quote from that page: “Statistically reliable studies prove conclusively that in the pre-drug era and even today, people who do not take psychiatric drugs for depression or certain kinds of psychosis are far more likely to recover completely than those who take the drugs–by a huge percentage.”

    Depression is not nearly as dangerous as being treated for it. The drugs don’t moderate depression symptoms (for long), they worsen it.

    The drugs probably make infections more likely, and then your theory is sound. But, just living with your depression is MUCH safer than being treated for it (by 99% of doctors). Of course, following your dietary suggestions and treating the infection, if any, is the best advice, I’ll agree.

    BTW, your e-book is the finest compilation of heath information that I’ve read (and I’ve read a lot). It answers questions that have stumped me so simply and clearly on the mark. Just astonishing. THANKS!

  4. Joe – Thanks for the praise of the book! It’s the book we wish we could have had years ago, that would have saved us years of trouble and disease. I think it has the potential to help a lot of people, but time will tell.

    Thank you also for the insight regarding depression. I agree that downregulating receptors is a stupid strategy for a treatment, and one that can backfire spectacularly. The statistics about the damage caused by psychoactive drug treatment are probably true. Nevertheless, I would still be reluctant to advise people not to see a doctor. Sometimes the docs do help; and hopefully in the future they will help more. It is safer to advise against the drugs than against the doctors. The placebo effect of hope given by an expert who’s there to help may be worth a great deal to some people.

    But it is absolutely critical for patients to exercise their own independent judgment, to understand the limitations and drawbacks of drug therapies, to optimize diet and nutrition as quickly as possible, and to be aware of the possibility that their disease may be infectious and easily treated with antibiotics.

    By the way, Jenny’s blog, which Joe linked to, is in our blogroll, it’s the best diabetes blog on the web. Diabetics should check out her book, Blood Sugar 101.

  5. Re Joe’s point again and its bearing on the study cited in the post, it would be interesting if the treated depressed and untreated depressed had different total mortality. It’s conceivable that the drugs for depression might be part of the cause of the high mortality seen in the depressed population.

  6. Whitiker’s book cites scores of studies and statistics, but mortality, per se, is not one. For what it is worth, this 2008 study,, says “Importantly, we found that antidepressant treatment increases the mortality hazard of men by 30%”.

  7. Thanks, Paul.
    Yes, it´s very important to fix diet/supplements first, regarding all kind of mood issues.
    And MD´s are very fast with prescribing antidepressants. With hashimoto´s and asperger´s
    whimsicalities keto diet brought me the greatest improvement with stress, overeating and distraction. But too much fat makes me tired and too much protein gives me high insulin. I missed physical activity but had no power. So I added back some carbs. Mainly lots of starch free veggies otherwise I would end up with GERD.
    Personal mind+lifesaver: high quality and sufficient dosages of fishoil, magnesium, vitamin c, b-complex + p-5-p extra and my last discovery: l-tyrosine which gave me back such a calmness that I stopped teeth grinding and sleep like a baby. High focussed now, open minded and mostly stable. Greetings.

    • Joe – Thanks for the link and stat. In the study of the blog post, CHD increased mortality by 67% and depression by 110%. If all the depressed were being treated and treatment raised mortality by 30%, then untreated depression would raise mortality by 62% and be essentially equivalent to CHD. Maybe these conditions are similar in risk before treatment.

      Byron – Thanks for the story. Tyrosine is another amino acid that bacteria crave; Cpn for instance takes tryptophan, tyrosine, and phenylalanine. Be careful; if things start getting worse, I would cut the tyrosine. During my own chronic infection, I developed TMJ also. Have your dentist make up a night guard, it will at least protect the mandibular joint from damage. I think a small amount of starch, 200 calories per day, would do you good. Do 200 calories of our safe starches really trigger GERD, or is it just grains? Keep up the ketogenic dieting and supplements, nutrition and ketones are great! Don’t forget selenium and iodine, those help immune response as well as the thyroid, and it’s best to try to fix the thyroid issues at root causes.

  8. i recently foundyour blog and wow…i am speechless, it is fantastic! my only question… cani gte your book at the store or do i have to buy it online?

  9. Hi Mallory – It won’t be available in stores, just online at,, etc. We’re self-publishing in order to get the book out faster, and brick-and-mortar retailers generally don’t pick up self-published books. Maybe if it does very well …

  10. This makes a lot of sense, and is something holistic practitioners (including eastern and native american traditions) have known and expressed for centuries. Yet good to see it quantified in studies for us Americans who need explicit proof for such ideas.

    I wonder why anxiety disorders aren’t included here- or are they?

  11. The strengthens of this article is it covers many ways to naturally view this problem. What I wonder is why the whole population isn’t depressed if it is a matter of diet. The high sugar diet that is called the sad diet can put stress on an already stressed system.

    Just a lack of energy and feeling sick from the so called food we eat can cause clinical depression. Our defense system is down and it it is easy to pick up infections.

    Our diet doesn’t support health and vitality, and without that it is easy to get down in the dumps. Drugs are just adding to the problem. We suffer from malnutrition and that brings about mental fatigue.

    Fibromyalgia alone is asociated with depression. Unless you know how powerful food is to emotional health you will be missing a potent way to heal.

  12. Hi Blanche,

    Clearly bad diets alone do not normally cause severe clinical depression. Personally I think it’s likely that severe depression is nearly always infectious in origin, and bad diets make the infections far more likely and far more serious.

    That said, a healthy diet does improve mood. So while a bad diet may not be able to cause clinical depression by itself, I think nearly everyone can make themselves happier and less stressed by eating better.

    Of course fibromyalgia is usually an infectious condition. See our post about Ladybug who cured her fibromyalgia with antibiotics: This could explain the co-morbidity of fibromyalgia and depression.

  13. I am wondering how this way of eating has affected Shou-Ching’s endometriosis, since I also suffer from this affliction.

  14. Hi Cynthia,

    We developed the diet over a 5-year period with lots of research and refinement along the way. Shou-Ching believes that dropping toxic foods, especially soy and wheat, and adopting higher fat intake, e.g. adding eggs and bacon, helped a lot. She had previously tried to follow a low-fat diet and was a real soy/soy milk/tofu fiend. Other changes linked to symptoms — dropping wheat and adding vitamin D got rid of autoimmune/allergies, wheat/cereal elimination got rid of acid reflux, and higher fat consumption gave her more energy.

    Her pain disappeared soon after the first dietary changes. However, an endometrioma/cyst and a uterine fibroid have been more persistent. In her last ultrasound about a year ago, they had shrunk but not disappeared. At that time the diet generally had reached its present state but we didn’t settle on the nutritional supplement program until this year.

    • Hi Paul!

      Like Shou-Ching, I have Hypothyroidism (Hashimoto’s) and Endometriosis and I suspect Celiac.

      I just want to say thanks. I was feeling very ill and prayed for some guidance. Then my sister found your book and we said we’d give it a try.

      Honestly, if it doesn’t work out that I have great health so be it, but I do have one thing, a hugely improved quality of life. I have a young baby and I was feeling very ill and worried for my health. I started to try and eat ‘healthy’ – living on lentils, lw fat, legumes, quinoa, etc. I was started to feel even worse and terrified for my health and felt unable to look after my daughter. Since starting phd, I am starting to feel alive and well again. I am concerned about my ovarian cysts however, and I’m getting regular check ups with my Obs. I can’t tolerate any dairy – it gives me huge cysts on my ears. I ate a yoghurt, thinking what the heck, I got a cyst the size of a golfball hanging off my ear and needed an operation to remove it! So I’ll be sticking to completely dairy-free. Also, I saw on the soul cysters forum, that one woman had great success in healing her polcystic ovaries with regular turmeric. Once I stop breastfeeding, I am planning to add that to my diet. Have you any thoughts on turmeric? You probably have some in this blog, I’ll have a peak!

      I’ll let you know if I find any improvement! If Shou Ching has found anything useful for her uterine fibroids, please let me know!

      Best wishes,


      • Hi Monica,

        I am glad you are feeling better!

        Turmeric is safe and so I would think there’s no reason to wait until you start breastfeeding to start regularly using it as a spice in your cooking. It is better absorbed if mixed with pepper.

        I have no idea why dairy does that to you. Very strange. You might try ghee (clarified butter). It is fat only so it should be safe, and it is quite healthful for PCOS and cysts.

        Best, Paul

        • Hi Paul!

          Thanks so much for your response! 🙂

          I’ll try the ghee!

          Interestingly enough, it was my ENT (I’ve had endless ear operations, ear infections since I was 3 years old and a Cholesteatoma that needed removing and I’m now deaf in one ear) that that told me he had come to the conclusion that “90 percent of the patients that come to me have a dairy allergy” – just cut it out of your diet. I’ve had no ear infections ever since age 12 when I stopped. Since then I ate two yoghurts, spaced a year apart and got the same outer ear golfball cyst. I think he was very alone in his belief that dairy and ear problems are often connected. I don’t get the impression other ENT’s agree.

          Anyway, I just wanted to share my experience with you and I’ll let you know how I get on!

          I feel better than ever and I’m grateful to you and Shou Ching for being brave and putting your ideas out there.


  15. I really appreciate your blog and I am working my way through the posts.

    Your assertion that there is a connection between mental health issues and nutrition/diet are bang on. I have read that a very high proportion of schizophrenics are allergic to wheat.

    My daughter started showing symptoms of rapid-cycling bipolar disorder and anxiety last March. Instead of pursuing a medication route, we took her to a doctor that specializes in functional medicine. She had very low levels of many important nutrients and amino acids, a strange hormonal profile, delayed response allergies to a number of foods and low levels of some of the neurotransmitters. We suspect a leaky gut, and are waiting for test results. This is what brought me to your site, as I am trying to find ways to bring healing there.

    I had been feeding my family what I thought was a healthy diet – lots of fruits and vegetables, whole grains, legumes and meat with virtually no processed food. The problem is that my homemade bread was so good we would just demolish it when it came out of the oven. We are now off grains and legumes completely and I am researching the paleo diet. We have had much improvement with supplementation and removing wheat, eggs and dairy from her diet.

    I am trying to plan our diet so that we minimize intake of lectins, saponins and gliadins in order to allow the gut to heal. My current question has to do with the nightshade family. Do I need to avoid tomatoes and red peppers? I really miss them.

  16. Hi Kira,

    I’m very happy to hear you are following the natural healing route. Diet is extremely important for all mental health conditions, some people just don’t tolerate toxic diets and wheat in particular goes to the brain and is disruptive there.

    Most people do OK with nightshades. What you can do is a nightshade challenge — go without them for a few weeks, then eat a lot of them — salsa, etc. — and see how you feel. If you don’t notice anything odd, then you should be fine.

    The same goes for eggs. With dairy, clarified butter/ghee is safe. Dairy fats are very healthy so I would seriously consider eating clarified butter. As the gut heals you can work eggs, butter, cream, whole milk yogurt, and other fatty dairy products back in.

    Grains however you should stay away from forever. The difference is that dairy toxins can’t damage the gut, they only damage if they enter the body through a leaky gut. But wheat damages the gut itself.

    Good luck! Keep in touch.

    Best, Paul

  17. So, would you suggest the Perfect Health Diet for a lady that suffers from endometriosis?

  18. Hi Michael,

    Yes, I do believe our diet would cure or at least minimize the damage and pain from endometrosis. I think removing food toxins is essential, especially soy and wheat and omega-6 fats, and that vitamin D is important also.

    Best, Paul

    • Do you think small amounts of wheat in the form of daily communion at Church would be OK for someone with endometriosis or possible PID? They eat no other gluten. The Cyrex Array 3 gluten test showed very small sensitivity to gluten- 3 markers ini the equivocal range. All the other markers were negative. No positive markers.
      I can understand wheat may have other toxins other than gluten though.

      • P.S. My pelvic symptoms seemed to have developed after I improved my diet- nearly completely eliminated grains (except rice). Increased my Vit D to better levels. Never ate soy. Haven’t eaten refined omega 6 oils for a few years. Have been eating healthy PHD type fats and no sugar for 3 years.
        No test, doctor or scan has identified what is going on. Only that TSH and CRP is elevated. But this is all new in the last year.
        When I ate sugar and grains my CRP and TSH was much better.
        I am wondering if it’s stress and adrenal insufficiency in the last year that has caused this deterioration in health.
        I don’t know what else to do. I’m still young- early 30s. I don’t really want to have an invasive procedure like a laparoscopy.

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