Depression Has An Unexpected Effect On Your Bones

Mental health conditions like depression can have a profound impact on your life. They affect how you feel, think, and behave. Turns out, depression can also have an unexpected effect on your bone health. There are several studies focusing on the link between depression, bone mass loss, and osteoporosis.

According to Columbia University Depression Evaluation Service director Dr. David Hellerstein and endocrinologist Dr. Marcella Walker, there are a few different ways in which depression could negatively impact bone health (via Columbia Psychiatry). One has to do with the possibility that depression causes a dysregulation in the neurotransmitters that affect bone mass – serotonin and norepinephrine — and this leads to bone loss. 

There's also the idea that bone loss might occur because of an increase in your body's stress response (cortisol) and an increase in inflammation, both of which are characteristic of mental health conditions like depression. A 2007 study published in JAMA Internal Medicine that looked at 133 premenopausal women found a significant link between lower bone density and the women in the study who had major depressive disorder (MDD) when compared with the non-depressed participants. 

According to some research done in 2009 by the Hebrew University of Jerusalem, it is also possible that depression could be increasing the activity of osteoclasts, cells which are associated with bone degradation (via Science Daily). 

Living with depression might cause someone to lose weight because of a loss of appetite. This, combined with reduced physical activity, could be negatively impacting your bones too, per Dr. David Hellerstein and Dr. Marcella Walker (via Columbia Psychiatry). 

Finally, medications prescribed for mental health conditions like depression, particularly the antidepressants selective serotonin reuptake inhibitors (SSRIs), can lead to bone loss too, shared Dr. Traci Speed, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, per Creaky Joints. "Antidepressants such as SSRIs and mood stabilizers have a direct effect on bone health and can increase risk of osteoporosis and fractures," explained Dr. Speed. What does this mean for people with depression? 

Experts recommend speaking with your mental health practitioner if you have any concerns that your mental health condition or medications could be leading to bone loss. They don't recommend stopping your antidepressants and mood stabilizers without direction from your healthcare provider. 

There are also lifestyle changes you can make to improve your bone health, like eating a nutritious diet (inclusive of bone health essentials like calcium and vitamin D), staying physically active (particularly with weight-bearing exercises), maintaining a healthy weight (making sure you're not overweight or underweight), and avoiding substances like smoking, alcohol, and drugs. As explained by Dr. Traci Speed (via Creaky Joints), "Avoiding smoking, alcohol, and substances such as opioids can also protect bone health." Keep an eye out for warning signs of osteoporosis too, like bone loss in the jaw, receding gums, poor grip strength, weak or brittle nails, back pain, and bones that seem to fracture easily. 

If you are worried that depression could be affecting your bones, you can have an osteoporosis screening done. You can also do a DXA or bone density scan to assess your bone health. At the end of the day, it's important to manage your mental health concerns while being aware of the risks to other areas of your health. It is possible to handle both hand-in-hand as long as you work with your healthcare providers about any concerns and embrace healthy lifestyle habits. 

If you or someone you know needs help with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.