Medication side-effects can seem unbearable at times: dry mouth, nausea, dizziness, constipation. Certain prescriptions can also increase our risks for developing chronic conditions like thyroid disease and diabetes.

Three years ago, I decided that the pills’ side-effects weren’t worth the relief they brought, so I slowly weaned off all my medication. I then plummeted into a severe depression that ended up taking a far greater toll on my health than the nuisance of my drugs.

You may be justifiably concerned about how your mood stabilizer and antidepressant are altering your biochemistry, but also consider the grave consequences of untreated depression. A 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses, and conditions of the nervous system. In other words, the side-effects of untreated depression are more threatening than those of our meds.

Here are eight health risks of untreated depression:

1. Cognitive Decline

Left untreated, major depressive disorder (MDD) literally changes your brain. A study published online in The Lancet Psychiatry measured brain inflammation in 25 people with more than a decade of MDD and 30 people without depression. The depressed group had inflammation levels of approximately 30 percent higher in certain brain regions including the prefrontal cortex, responsible for reasoning, concentration, and other executive functions.

Given this data, researchers argue that depression is not unlike other degenerative disorders, like Alzheimer’s, that are progressive if not treated.

2. Diabetes

Depression is associated with a significantly increased risk for diabetes. In a meta-analysis of 23 studies published in the Journal of Clinical Psychiatry, there was a higher incidence of diabetes in the depressed participants (72 percent) versus the non-depressed subjects (47 percent).

Researchers speculate that the underlying cause for the elevated risks lies in the challenge for depressed persons to adopt and maintain healthy lifestyle behaviors such as exercising and eating right, causing higher cortisol levels and inflammation.

3. Chronic Pain

In a study published in Dialogues in Clinical Neuroscience, 69 percent of persons who met the criteria for depression consulted a doctor for aches and pains. Mood disorders can show up in surprising symptoms — like bloating, backaches, or joint pain.

According to a one review in Pain Research and Treatment, there is compelling evidence to link fibromyalgia and depression. They co-occur and share a similar pathophysiology and pharmacological treatments. Approximately 40 percent of persons with fibromyalgia experience depressive symptoms. According to the abstract, “these similarities support the concept that depression and fibromyalgia are differential symptom presentations of a single underlying condition.”

4. Heart Disease

The connection between heart disease and depression is well established. Depression and anxiety affect heart rhythms, increase blood pressure, elevate insulin and cholesterol levels, and raise levels of stress hormones. According to the National Institute of Mental Health, three in 20 Americans with heart disease experience depression compared to the one in 20 average of people without heart disease.

A study published in the journal Circulation found that people with heart failure who are moderately or severely depressed have four times the risk for early death and double the risk for being hospitalized, compared to those who are not depressed. Just as persons with coronary heart disease are at risk for depression, those with depression are at risk for coronary heart disease. In a study published in the Archives of Internal Medicine, for example, the men who reported clinical depression were at significantly greater risk for subsequent coronary heart disease and myocardial infarction even 10 years after the onset of the first depressive episode.

5. Autoimmune Disorders

Depression and autoimmune disorders share the common denominators of inflammation and stress. According to a review in Nature Reviews Immunology, “patients with major depressive disorder exhibit all the cardinal features of an inflammatory response, including increased expression of pro-inflammatory cytokines and their receptors and increased levels of acute-phase reactants.” Inflammation in the body impacts every biological system, including our immune system, increasing our risk for developing autoimmune disorders. Because of this shared inflammation, depression and autoimmune disease are beginning to share the same treatments protocols.

6. Gastrointestinal Problems

People with depression often report stomach or digestion problems, such as diarrhea, vomiting, nausea, or constipation. Some people with depression also have chronic conditions, including IBS. According to research published in 2016, this may be because depression changes the brain’s response to stress by suppressing activity in the hypothalamus, pituitary gland, and adrenal glands. According to the review, there are significant associations between GI symptoms and abnormally low cortisol levels post a low dose dexamethasone suppression test (DST). In plain speech, this means depression affects a range of organs and glands that help us to absorb and digest food. Depressive symptoms interrupt their progress and cause discomfort and potentially significant disorders.

7. Osteoporosis and Lower Bone Density

According to research from Harvard University of Jerusalem, depressed people have a substantially lower bone density than non-depressed people and depression is associated with an elevated activity of cells that breakdown bone (osteoclasts). This association was stronger in women than men, and especially in younger women during the end of their period. According to Harvard Women’s Health Watch, depression is a risk factor for osteoporosis. Researchers found that depression triggers the release of noradrenaline, which interferes with bone-building cells.

8. Migraines

Migraine and depression happen together. According to a study published in the International Review of Psychiatry, patients with migraine are two to four times more likely to develop lifetime major depressive disorder, due to similar underlying pathophysiological and genetic mechanisms. And people who leave their depression untreated increase their risk of going from episodic migraines (fewer than 15 per month) to chronic (more than 15 a month). Having one puts you at a higher risk for the other. Because low serotonin levels have been linked to both conditions and SSRIs and tricylics are used to treat both disorders, some researchers hypothesize that the link between migraine and depression lies with a person’s inability to produce serotonin and other neurotransmitters.