Mental health as a part of holistic health
Since the turn of the millennium, there has been an astronomical rise in the prevalence of both mental illness and chronic physical conditions. In the quest to stem this worrisome tide, it is vital to understand the links between the mind and the body. Perhaps, the answer to reducing the occurrence of co-existing conditions and better support those that already have both lies in these links.
The World Health Organization defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ Importantly, there is a need to realize that the components of health as stated by definition are not independent but interlinked. The theme for this year’s mental health awareness month- For mind and for body- explores the vital link between mental and physical health.
What do the stats say?
• On average, adults living with serious mental illness die 25 years earlier than others, mostly due to treatable ailments- Colton, C.W. & Manderscheid, R.W.
• Depression as a mental health illness, and arthritis, as a chronic condition are leading causes of disability worldwide- CDC
• Depression co-occurs in 17% of cardiovascular cases, 23% of cerebrovascular cases, and with 27% of diabetes patients and more than 40% of individuals with cancer- CDC
• Most studies have found a high rate of anxiety symptoms and panic attacks in patients who have chronic respiratory disease, with women at greater risk than men- Health Harvard
• Women with the highest levels of phobic anxiety were 59% more likely to have a heart attack, and 31% more likely to die from one, than women with the lowest anxiety levels- Health Harvard
• Among both men and women with established heart disease, those suffering from an anxiety disorder were twice as likely to have a heart attack as those with no history of anxiety disorders- Health Harvard
• 20% of caregivers of chronically ill individuals reported experiencing depression as a result of their caregiving responsibilities- Health Partners
• People who survive heart attacks but suffer from major depression have a three to four times higher risk of dying within six months than heart attack survivors who are not depressed- Health Partners
What could be responsible for the observed correlation?
The body and the mind are vital components of well-being, and they are both affected by social factors as well as emotional and physiological processes. These three factors are critical determinants of health. Whenever one or more is affected, the individual is at higher risk of developing a mental illness or chronic physical condition or a co-existing condition if one is already present.
People living with chronic conditions often become fed up with all they have to do to maintain their health. Adhering to medication regimen, keeping up with hospital appointments, and sticking to the dietary regulations could all take a toll on their emotional health. Yet, they somehow have to fulfill these obligations if they do not want their health to deteriorate. If they do not adopt the right coping skills, depression or anxiety disorder could set in. Mental health issues then join the already long line of conditions with which they are facing.
Conversely, the nature and presentation of many mental illnesses could increase the affected individual’s vulnerability to a chronic physical ailment. People suffering from depression, anxiety disorder, or bipolar disorder often lack the motivation to take proper care of themselves or adopt a healthy lifestyle. Some even lose the will to live, not to mention live right. Others give in to the temporary escape provided by cigarettes, alcohol, and other drugs. All these ultimately contribute to worse health outcomes.
While some of the factors mentioned above may explain the possible link between mental illness and chronic ailments, research shows that they do not tell the full story. Even when these behavioral factors were controlled, the association between mental illness and chronic physical conditions still held. This proves that physiological factors are also implicated.
People living with mental illness could develop chronic ailments as a direct consequence of their condition or as a result of their medications. Numerous mental health conditions have a negative effect on the sleep cycle, hormonal balance, as well as the body’s inflammatory mediators. Many drugs used in treating mental ailments have also been found guilty of causing precipitating irregular heart rhythms and weight gain. These symptoms put patients at greater risk of developing a wide range of chronic health conditions.
On the other hand, some chronic ailments can cause physiological changes such as disruption in blood circulation and elevated sugar levels. If left unchecked, these could have a negative impact on brain function. Conditions, such as arthritis that are characterized by chronic pain could also precipitate the development of anxiety or depression. Current evidence shows that the higher the frequency and severity of symptoms for a chronic physical condition, the higher the likelihood of a patient developing mental health issues.
Perhaps the silver lining amidst the dark cloud is that treatment in co-sufferers could be interlinked. Research shows that managing chronic physical conditions can lead to a better mental illness prognosis in the same patient and vice versa. Treating depression either with therapy, medications, or a combination of both could improve physical symptoms and achieving tight control of the symptoms of chronic illnesses could also improve mental health.
While there is a need to uncover more evidence, this knowledge could prove crucial in the effective management of mental illness and chronic physical conditions in millions of patients. It is important for healthcare providers to understand and implement integrated treatment programs that effectively cover both mental and physical health issues.
Rod Laughlin, President & CEO Perimeter Healthcare