Not surprisingly, when a person is diagnosed with heart disease, cancer, or other life-limiting or life-threatening physical illness, he or she becomes anxious or depressed. But the opposite can also be true: excessive or misplaced anxiety or depression can cause serious physical illness and even impair the ability to tolerate or recover from illness.
The human body does not recognize the artificial separation that medical professionals make between mental and physical illness. Instead, the mind and body form a two-way street. What happens inside a person can have devastating effects on the whole body and vice versa. Untreated mental illness can dramatically increase the risk of physical illness, and physical disorders can lead to behaviors that make mental illness worse.
Decades ago, Dr. David Spiegel and his colleagues at Stanford University School of Medicine studied how patients with breast cancer coped. They showed that women whose depression was declining lived longer than women whose depression was getting worse. Dr. Spiegel said in an interview that his research and other studies have clearly shown that the brain is closely related to the body, and vice versa. “The body usually reacts to stress as if it were physical stress,” he said.
The effect of depression and anxiety on the body
Of course, despite this evidence, chronic emotional distress is often overlooked by physicians. Usually, doctors prescribe treatment for physical ailments such as heart disease or diabetes and wonder why some patients’ conditions get worse instead of better.
Many people are reluctant to seek treatment for their emotional distress. Some people with anxiety or depression, even if they find that they have a serious mental health problem, maybe afraid of being stigmatized and may not seek treatment. Many also try to treat their emotional distress by engaging in behaviors such as excessive alcohol consumption or substance abuse, which only adds to their previous injuries. Sometimes family and friends inadvertently cause a person to deny his or her psychological distress by reading the person’s behaviors and moods normally and do not help him or she seek treatment.
Prevalence of anxiety and depression
Anxiety disorders affect approximately 20% of American adults. This means that millions are involved in the war or extremist response that prepares the body for action.
When under stress, the brain releases cortisol, which is an internal alarm system. This response has evolved to help animals that face physical threats. In this process, respiration and heart rate increase, and blood is directed from the abdominal organs to the muscles that help to resist or escape.
The above protective measures originate from the neurotransmitters epinephrine and norepinephrine, which stimulate the sympathetic nervous system and keep the body alert. But when they are called repeatedly and regardless of the circumstances, persistent stimulation can lead to a variety of physical ailments such as gastrointestinal symptoms such as indigestion, abdominal cramps, diarrhea or constipation and increase the risk of heart attack or stroke.
Depression, while less common than chronic anxiety, can have devastating effects on physical health.
While the feeling of depression is occasionally normal, more than 6% of adults experience such persistent depression that it adversely affects their personal relationships, work and leisure, and impairs their ability to cope with the challenges of daily life. Persistent depression can also increase a person’s perception of pain and increase the likelihood of developing chronic pain. Dr. Spiegel said:
Depression reduces a person’s ability to analyze and respond sensibly to stress. They eventually enter a vicious cycle and their ability to get out of a negative mental state is weakened.
Depression and anxiety often go hand in hand, making people vulnerable to a variety of physical ailments and preventing them from receiving and continuing treatment.
A study of 1,204 elderly Korean men and women who were first evaluated for depression and anxiety found that these emotional disorders increased their risk of physical illness and disability. Anxiety alone was associated with heart disease and depression alone with asthma, both of which were associated with vision problems, persistent cough, asthma, high blood pressure, heart disease, and gastrointestinal problems.
Treatment of depression and anxiety
Although persistent anxiety and depression can be treated with medication, cognitive behavioral therapy, and speech therapy, they usually get worse without treatment. According to Dr. John Fronfelter, treatment for any condition works best when physicians understand the pressures that patients face that affect their behavior and cause clinical harm.
Dr. Fronfelter is an internal medicine physician and chief medical officer at a startup called Jvion. The organization uses artificial intelligence to identify not only medical factors but also psychological, social, and behavioral factors that can affect the effectiveness of treatment. The goal is to develop more comprehensive approaches to treatment that address both the patient’s body and mind.
The startup warns the doctor when the patient’s depression prevents the effectiveness of other illnesses from treating him or her with the analysis he or she performs. For example, patients treated for diabetes who feel frustrated may not make progress because they take their prescription drugs sparingly and do not follow a proper diet. Dr. Fronfelter wrote in July on the MedPage Today website:
We often talk about depression as a complication of a chronic illness. But what we are not talking about enough is how depression can lead to chronic illness. Patients with depression may not be motivated to exercise regularly or cook healthy foods. Many also have trouble getting enough sleep.
Some changes in medical care during the birth of Covid 19 greatly increased patients’ access to treatment for depression and anxiety. The spread of telemedicine has enabled patients to access treatments that a psychotherapist may offer them from other continents.
Patients may also be able to treat themselves without the direct help of a therapist. For example, Dr. Spiegel and his colleagues created an app called Reveri that teaches people their hypnosis techniques designed to help reduce stress and anxiety, improve sleep, reduce pain and quit smoking.
According to Dr. Spiegel, improving sleep is especially important because it increases a person’s ability to regulate their stress response system and get out of a negative mental state. According to him, data showing the effectiveness of the Reveri app has been collected but has not yet been published.