LET’S GET PHYSICAL

A few years ago, I was ill with a bout of depression. I felt incredibly low, was hardly sleeping, and felt a crushing lack of self-worth. I remember being at work when all of a sudden I felt incredibly dizzy and shaky. I was suffering with intense migraines and felt exhausted. My doctor diagnosed me with labyrinthitis, an inner ear infection, and I was signed off sick for three weeks. The only thing that made me feel remotely better was to lie in bed in the dark. I spent days in bed, unable to look at screens, or eat properly. All I could do was sleep. This kept happening to me. Every few months I would develop another ear infection. I live with bipolar disorder and have mania, which fills me with energy. I’m often ‘on the go’ for months on end, then when this feeling goes away, I crash and become depressed. I began to notice a pattern, and that these inner ear infections were somehow linked to my mental ill-health...

HOW DOES MENTAL HEALTH AFFECT US PHYSICALLY?

Have you ever really thought about all the various physical symptoms we get with mental illness? Your stomach twisting in knots when anxious, migraines when stressed, insomnia, a racing heart, catching more colds and the flu… The list goes on and on.

While the impact of physical illnesses on our mental health is more understood, the way our mental health can impact us physically seems less discussed – and yet research suggests they are intrinsically linked.

On a societal scale, understanding this connection is important, as when mental health problems exacerbate physical illness, they can affect outcomes and the cost of treatment. In fact, The King’s Fund and Centre for Mental Health estimates that the effect of poor mental health on physical illnesses costs the NHS at least £8 billion a year.

But the best way to understand the connection is on a personal level. Take Liz, who lives with borderline personality disorder, mixed anxiety and depressive disorder. She believes her mental ill-health led her to develop irritable bowel syndrome (IBS).

“It plays up when I go into crisis,” Liz says. “When my mental health is suffering, I also tend to get an extreme illness – or at least that’s how it feels. I generally feel aches and pains throughout my body.”

Olivia, who has bipolar disorder, noticed an impact of her condition on her physical self as well.

“When I experience depression, I feel it in my bones. I feel unstable when walking. My entire body feels cold and detached. When I experience hypomania, my heart races, my head spins. When I experience anxiety, my stomach literally knots, and it triggers IBS episodes.

“Because of my psychosis, I take anti-psychotics that are known to cause weight gain and heart conditions. I’m constantly tested through ECG, blood tests, scans… It’s a difficult balance to maintain,” Olivia adds. “Mental illness has not just affected me psychologically, but I live with several physical health issues. It’s like your whole body is either completely shutting down or revved up.”

When I experience depression, I feel it in my bones. I feel unstable when walking. My entire body feels cold and detached. When I experience hypomania, my heart races, my head spins

WHAT’S THE EVIDENCE?

While even short-term anxiety can show physical symptoms, such as headaches, increased heart rate, and difficulty breathing, it’s the long-term mental illnesses and their impact on our overall health that are the greatest concern.

A study from the British Medical Journal reports that poor mental health can actually lead to an increased risk of some conditions. In a study examining mortality rates in cancer patients, researchers reported that people with the highest levels of self-rated distress (compared to lowest rates) were 32% more likely to have died. Depression has also been found to be associated with an increased risk of coronary heart disease. Hayden, who lives with anxiety and panic attacks, recalls being taken to hospital with chest pains. “It’s happened to me a fair few times. I now suffer with sleep anxiety, where I’m awake for three days straight at times, because I’m terrified to sleep in case something happens.”

This lack of rest caused by her anxiety, as you can imagine, is affecting her physical health. “The only way I can explain it is the way some people have fear of food, I have a fear of sleep – which can mess up blood pressure and general health. Now I’m finding my hair is falling out, even walking can be difficult.”

Dr Natasha Bijlani, consultant psychiatrist at the Priory Hospital Roehampton, explains that optimal health involves maintaining a reasonable balance of many factors.

“Mental and physical health are inextricably linked. When people become mentally unwell, they are also likely to experience various physical symptoms. Those with poor mental health are less likely to receive the physical health care they’re entitled to, partly because they are less likely to seek treatment for these issues, but also because professionals tend to focus on alleviating their emotional distress, rather than screening for or treating physical symptoms that might also be present.”

SO WHAT CAN WE DO ABOUT IT?

Knowing we often feel run down when our mental health is not in a good place, it’s important to look after our overall health. Having a sleep routine, eating healthily, taking regular exercise, and any prescribed medications will benefit general health.

“Lifestyle factors are known to play a strong role in maintaining all-round health,” Dr Bijlani explains. “Those who become mentally unwell can sometimes either neglect such factors, or their symptoms prevent them from maintaining healthy habits. These can include disturbances in sleep and appetite, which can affect their energy levels and performance, as well as nutritional status. Oversleeping, or inability to get enough sleep, affects bodily functions, including blood pressure, risk of stroke, heart attacks, diabetes, forgetfulness, impaired judgement, and can lead to increased risk of accidents.”

With mental illnesses, it’s important to understand why we become unwell in the first place. Looking out for warning signs, the early symptoms and triggers of mental illnesses, help us to seek help and make lifestyle changes. We can ask for support, or confide in friends and family how we’re feeling. The more we educate ourselves about mental health, the more we can look after our health overall.

Top tips to support your mental and physical health:

• Consistency is key, so try to develop and stick to routines that support your health, such as a set bedtime, eating healthily, and exercising regularly.

• Keep a diary or record of your emotional state, alongside sickness. If you notice a pattern, you can start to think about how to address the issue.

• Take time out to recharge when you spot early symptoms – the sooner you address things the better in the long-run.

• Ask for help when you need it – whether from friends, family, or your workplace.