Physical Problems and Mental Illness

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It appears that individuals with mental illness have higher rates of physical problems, at least according to an U.S. Government report released last month (April 2012).  But do physical problems cause an increased risk of mental illness or does mental illness cause an increased risk of physical problems?

In regard to mental illness being tied to a greater increase in physical problems, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) report released, in April 2012, indicates that adults aged 18 and older who had any type of mental illness in the past year had higher rates of high blood pressure, asthma, diabetes, heart disease and stroke.  Some of the findings in the recent U.S. Government report are:

• People with major depression in the past year had higher rates of the following chronic health problems than those without major depression: high blood pressure (24 percent vs. 20 percent); asthma (17 percent vs. 11 percent); diabetes (9 percent vs. 7 percent); heart disease (7 percent vs. 5 percent); and stroke (3 percent vs. 1 percent).
• 22 percent of adults with any type of mental illness in the past year had high blood pressure and nearly 16 percent had asthma. The rates in adults without mental illness were about 18 percent and 11 percent, respectively.
•  People with mental illness had higher rates of emergency-department use and hospitalization, according to the report. Rates of emergency department use were nearly 48 percent for people with a serious mental illness in the past year and 31 percent for those without a serious mental illness.
• Hospitalization rates were more than 20 percent for those with a serious mental illness in the past year and less than 12 percent for those without a serious mental illness.

Although the report indicates increased risk, in my opinion, the percentages are not drastically different.  Also, the report doesn’t investigate the possible causes of the physical symptoms such as medication side-effects, stress, access to care or if patients with mental illness are treated differently than patients without mental illness.  I am sure some or all of these come into play.  In my own past personal experience, my physical symptoms were often overlooked or placed secondary due to my mental illness diagnosis.  I guess, in that case, the percentages of physical ailments in individuals with mental illness may be even higher.

According to one opinion in an article in World Psychiatry (v.6(1); Feb 2007), in many countries psychiatrists have forgotten that they are medical doctors.  The author of the article believes that “sadly only a small proportion of psychiatrists have an interest in dealing in a comprehensive manner with people struck by physical illness…Despite having a medical diploma, only a few among the psychiatrists are sufficiently well trained in medicine to be able to deal with patients who have a mental and a physical disease at the same time.”  This seems like harsh words but often many doctors push you out the door with a prescription before really investigating and discussing your health and well-being.  Whatever the case, it seems it is necessary that more research be conducted to unravel the puzzle of higher rates of physical illness in people with mental disorders.

A 2006 study completed at the University of Manitoba, showed a higher rate of anxiety in participants that suffered from a physical illness but even higher rates showed in those with respiratory and gastrointestinal diseases, arthritis, allergies, thyroid diseases and migraine headaches.  Debate is ongoing about what comes first the illness or the anxiety because living with chronic stress can also cause physical problems.  According to an article in the August 5, 2008, Harvard Health Publications, regardless of what comes first, people living with chronic physical illness that have untreated anxiety may have an increase in symptoms and the physical illness may become harder to treat.

It may seem that it has to be one way or another but research indicates that mental illness can cause an increased risk of physical symptoms and physical symptoms can cause an increased risk of mental illness, specifically depression and anxiety.

There is no denying the mind and body connection.  If the body can suffer from pseudoseizures, as was the case with me, then I know the line between mental and physical illness is a fine one.  I imagine as more and more research is conducted, the finer the line will become between the two.

If any of you have any further insight or research in this area, I would love to hear about it.  Please comment on my blog post below as it helps bring further insight and understanding.

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Sources and Links:

Migraines May Raise a Woman’s Odds of Depression

Mental Illness Tied to Higher Rates of Physical Problems: Report

Physical illness and mental health

Depression and physical illness

Separating anxiety from physical illness

The Link Between Anxiety Disorders and Physical Illness

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