These 4 conditions are tied to mental health issues, according to research

By Naveed Saleh, MD, MS
Published October 19, 2021

Key Takeaways

  • One-quarter of Americans have been diagnosed with a serious mental illness, such as schizophrenia, bipolar disorder, or major depressive disorder, according to the Centers for Disease Control (CDC).

  • A number of chronic health conditions can play a role in the development of mental illness, including chronic pain, inflammatory bowel disease, cancer, and migraines.

  • Careful history-taking and diagnostic procedures can help healthcare practitioners determine whether certain disease states are contributing to mental illness.

Mental health data in the United States paint a troubling picture. More than 50% of Americans will be diagnosed with a mental illness at some point, with 1 in 5 experiencing mental illness within a year. Currently, 1 in 25 Americans is diagnosed with a serious mental illness, such as schizophrenia, bipolar disorder, or major depressive disorder, according to the CDC.

Various stressors play a role in the development of mental illness, including a history of trauma, drug misuse, biological factors/chemical imbalances of the brain, and loneliness. Chronic health conditions can also play a major role. Let’s take a closer look at the relationship between mental health and various health conditions.

Chronic pain

Chronic pain and depression are common in old age and exhibit a bidirectional relationship, with each serving as a risk factor for the other. Nevertheless, there’s a dearth of comprehensive epidemiologic data assessing the prevalence of chronic pain subtypes and comorbid depression, according to the authors of a review published in Clinical Interventions in Aging.[] 

One mechanism that may play a role in the comorbid presentations of chronic pain and depression is neuroinflammation.

Data on the use of antidepressant agents to treat chronic pain and depression at the same time are scant. Data from older patients are especially scarce. On the other hand, the use of nonpharmacologic agents to treat pain and depression is gaining traction. Possible interventions include acupuncture, hypnotherapy, physical exercise, and relaxation techniques.

“The patient should always be part of the decision-making in terms of management," the authors wrote.

"With numerous pharmacologic agents and nonpharmacologic approaches in their armamentarium, pain physicians can tailor the treatment based on each patient’s needs. "

Clinical Interventions in Aging

Inflammatory bowel disease

In the 1970s, researchers discovered that patients with Crohn disease were significantly more anxious, neurotic, and introverted than other people without psychosomatic disease, as well as test norms. In fact, the psychiatric issues that people with Crohn disease faced were similar to those experienced by psychosomatic patients, according to the authors of a study published in Nature.[]

Ever since this observation, various studies have shown that inflammatory bowel disease (IBD) was linked to psychiatric disorders. In Western populations, the prevalence of anxiety and depression in those with IBD is at least double that of the general population. Up to 34.7% of patients with IBD in the active stage were noted to have comorbid depression vs 19.9% of those with IBD in remission. 

IBD patients use more healthcare resources. Moreover, patients with a history of depression are at higher risk for IBD, with prevention possibly involving the use of specific antidepressant treatments.

Cancer

According to the American Cancer Society, depressed mood often occurs in those diagnosed with cancer, as well as family members. After all, dreams, goals, and future events can feel uncertain to those with cancer.

Depression in cancer patients can be mild and temporary or take the form of major depression. In total, one in four people with cancer experience depression.

Those with a previous history of depression are more likely to experience mental illness after a cancer diagnosis. 

Being sad for an extended period of time or having difficulty with day-to-day duties are red flags. Major depression can interfere with a person’s ability to function or follow through with cancer treatments. Treatment strategies for depression include psychotherapy, psychotropic medications, or a mix. Such treatments can reduce suffering and improve quality of life.

Mental health professionals should care for cancer patients with depression in cases of suicidality or other worries about safety. Anorexia, insomnia, and anhedonia, as well as feelings of restlessness, trouble breathing, and profuse sweating, are other indications that mental health services are necessary.

Migraine

Migraine and psychiatric disorders are largely associated, and the combination taxes health care worldwide. Those with migraine—in particular, chronic migraine and migraine with aura—are at higher risk for major depression, anxiety, and suicidal behavior, according to the authors of a systematic review published in the Journal of Headache and Pain.[]

Comprehensive genome-wide association studies have demonstrated that when compared with other neurological disorders, migraine has a higher genetic correlation with psychiatric disorders, thus implicating a common genetic basis or pathway. Consequently, it is important to treat migraine and comorbid psychiatric illness in a concerted fashion, according to the authors.

“The careful history taking and diagnostic procedures related to migraine should carefully take into account the existence of comorbidities,” wrote the authors. “Migraine management and treatment should be tailored to consider the presence of psychiatric comorbidities, taking into account the potential beneficial or synergistic effects as well as treatment complications.”

What this means for you

A number of diseases and conditions can play a role in the development of mental illness, including chronic pain, headaches, cancer, inflammatory bowel disease, and more. When diagnosing and treating patients with mental health issues, healthcare practitioners should take a careful history and keep in mind comorbidities.

Related: 5 medical conditions that mimic psychiatric disorders
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