Scientists link depression types to risks for heart disease and diabetes

A major European study finds that different types of depression affect the body differently — atypical depression raises diabetes risk, while melancholic depression increases heart disease risk, highlighting the need for personalized care.

Depression is often seen as a single disorder, but new research reveals that it comes in different biological “flavors” — each with its own physical consequences. According to scientists at the European College of Neuropsychopharmacology (ECNP), certain types of depression can raise the risk of diabetes or heart disease, underscoring the deep connection between mind and body.

Different Depressions, Different Risks

The study, presented at the ECNP Congress in Amsterdam, followed 5,794 adults from the Netherlands Epidemiology of Obesity (NEO) study over seven years. None had diabetes or cardiovascular disease at the start. Participants completed detailed questionnaires about their depressive symptoms, allowing researchers to identify two main subtypes:

• Melancholic depression, marked by loss of appetite, early morning awakening, and low energy.
• Atypical or energy-related depression, marked by fatigue, increased appetite, and excessive sleep.

During the study, about 8% of participants developed a cardiometabolic condition. But the specific illness that appeared depended on the type of depression they had.

Those with atypical depression were 2.7 times more likely to develop type 2 diabetes than people without depression. On the other hand, people with melancholic depression were 1.5 times more likely to suffer from cardiovascular disease — including heart attacks and strokes — but not diabetes.

The Biology Behind the Differences

Lead researcher Dr. Yuri Milaneschi from Amsterdam UMC explained that these differences seem to reflect distinct biological pathways. “Patients with atypical or energy-related symptoms showed metabolic and inflammatory disruptions tied to diabetes risk. Those with melancholic symptoms did not — their link was mainly cardiovascular,” he said.

This biological distinction, he added, supports the growing concept of precision psychiatry — tailoring treatments based on both mental and physical health profiles. “We already knew not all depressions are the same. Now we see their physical effects aren’t either. Understanding these links helps us treat each person more effectively,” Dr. Milaneschi noted.

Mental and Physical Health: Two Sides of One Coin

Commenting on the findings, Dr. Chiara Fabbri of the University of Bologna (not involved in the study) stressed the importance of addressing physical health in depression care. “Preventing and managing diabetes or heart disease in people with depression must be a healthcare priority,” she said.

With diabetes cases projected to rise by 10% in Europe by 2050, experts emphasize that early detection and personalized care can make a critical difference.

A Call for Personalized Medicine

This research strengthens the argument that depression isn’t just “in the mind.” Its effects ripple throughout the body — and understanding these nuances could transform how we prevent and treat both mental and physical illness.