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Chronic Physical Illnesses with Mental Health Associations

Some physical illnesses affect the brain and nervous system. Some illnesses affect both the person’s body and their brain directly or indirectly through mood and behaviour. Physical illnesses may result in depression, anxiety or other symptoms of mental health disorders.

Diabetes

Diabetes is a condition that can be affected by stress. Emotional and physical stress often has a great impact upon the health of a person with diabetes. When we are stressed our blood sugar level increases. Think back to the fight-or-flight response, when we are preparing to fight or run our stress hormones, such as adrenaline and cortisol, will kick in and raise our blood sugar to boost our energy levels.  So when we are stressed, this response will increase the blood sugar level.  If you are not diabetic, your body will compensate to make sure the sugar levels do not go out of control, but in a person with diabetes the mechanisms may not work so well, if at all, so they cannot control the level of blood sugar.  If the blood sugar levels are not well controlled through diet or medication, then there are also serious health risks, such as blindness, kidney problems, nerve damage, infections do not heal so well. Prolonged high levels of blood sugar also increase the risk of cardiovascular disease, leading to an increased risk of heart attacks and stroke.

So for a person with diabetes, a stressor such as a relationship break-up or being made redundant can have an impact upon their stress levels which in turn affects their blood sugar levels. The complication of other mental health issues can make the picture worse.

In fact stress is not the only psychological trigger for diabetes. Diabetes is diagnosed at higher levels amongst individuals with mental health problems. In particular depression and schizophrenia are recognised as increasing the risk of developing diabetes because they lower the body's resistance to insulin. Also, people with mental health illnesses are exposed to other risks for developing diabetes. For instance, they are more likely to develop obesity or to have higher cholesterol. This is not just because of poor lifestyle choices but also because some anti-psychotic medications are associated with causing weight gain.

People with diabetes also have a higher incidence of anxiety symptoms and disorders than the general population and about twice as many mental health problems as the general population.

Heart Disease & Stroke

Some of the main risk factors for stroke include atherosclerosis, heart disease, high blood pressure, high cholesterol, diabetes and obesity. Others are lifestyle factors like smoking and high alcohol intake.

The risk of heart disease and stroke is increased with high blood pressure and elevated levels of stress hormones and adrenaline. These factors cause the heart rate to increase. It has been found that people who are taking medication for mental health problems are at greater risk of developing abnormal heart rhythms as a consequence and that these abnormal rhythms exacerbate their risk of developing heart disease.

Furthermore, lifestyle factors associated with mental illness have been linked to increased risk of heart disease amongst this population. For example, those with mental health problems are less likely to seek access to services which provide preventative screening tests for risk factors. They are also more likely to have problems with obesity and poor diet.

People with heart disease are also three times more likely than the general population to develop depression. Depression is also more likely to affect those who survive a stroke than people who have not experienced stroke. Psychological problems which occur with heart disease and stroke also impede recovery from these conditions.

Arthritis

Individuals with arthritis are more likely to develop mental health problems, particularly depressive symptoms and anxiety. This is similar to psychological responses to chronic pain.

There has been a lot of research into the prevalence of arthritis in individuals with schizophrenia which has reported lower than average levels amongst this population. This has been attributed to a more sedentary lifestyle, medication providing an anti-inflammatory effect and perhaps even a genetic influence serving to protect them. However, other studies have revealed a higher incidence amongst those with schizophrenia which may be associated with these people having a higher pain threshold and therefore under-reporting it.

Cancer

So far the link between development of cancer and mental health problems is not especially clear. Some research has found that some types of cancers may be higher in individuals with schizophrenia, particularly bowel and gall bladder cancer. These findings have been attributed to poor diet with higher fat content.

Some types of cancer have also been found to be lower in populations with mental health disorders and specifically, respiratory system cancers like lung cancer. It may be because a high proportion of individuals with schizophrenia and other mental health disorders have spent time in institutions where they are not exposed to environmental risk factors. However, other studies have found higher rates of lung cancer amongst those with mental disorders and attributed this to a higher incidence of smoking.

Respiratory Problems

People with mental health disorders are more likely to smoke. In part this is due to social factors like living on the edge of society, struggling to hold down employment, and transient lifestyles. Smoking has also been historically acceptable in mental health institutions. Smoking increases the risk of developing a range of breathing difficulties like asthma, bronchitis, chronic obstructive pulmonary disease (COPD), and emphysema.

People who have chronic breathing difficulties are also more likely to develop mental health problems, particularly mood disorders and symptoms of anxiety. Asthma has a high co-morbidity with panic attacks most likely due to fears about dying. People with respiratory problems who do develop signs and symptoms of mental health disorders are also less likely to take good care of themselves which can mean that they don't manage their physical symptoms well and their condition can deteriorate.

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