Which came first? Your medical issue or your mental challenges?
In the complex world of healthcare, a puzzling question often arises: Which came first, mental illness or physical disease? Echoing the chicken and egg debate, studies continue to reinforce the deep interconnectedness between mental and physical health.
Drawing from my experience as a physician, I have observed numerous cases where physical health issues led to mental strain and vice versa. This connection underscores the necessity for a healthcare model that embraces both aspects rather than treating them separately.
Consider Jose, diagnosed with diabetes. His lifestyle, once full of energy and freedom, became restricted by diets and insulin regimens. Gradually, the burden of his physical condition impacted his mental health, leading to depression. This progression from a physical to a mental health challenge is not rare and raises an important question: Are we adequately supporting the mental health of those with chronic physical conditions?
On the other hand, mental health issues can set the stage for physical health problems. Anxiety, for instance, is more than just panic attacks; it can contribute to heart disease, high blood pressure, and a weakened immune system. Emma's story is a case in point. Her prolonged struggle with anxiety eventually led to cardiovascular disease, highlighting the need to consider mental health in treating physical diseases. Notable research has shown significant comorbidity between anxiety and various general medical conditions, including asthma, COPD, diabetes, heart disease, and hypertension. Additionally, high anxiety levels have been associated with an increased risk of developing heart conditions, strokes, and high blood pressure.
A UK Biobank and Finnish study revealed that severe depression is linked to 29 physical conditions requiring hospital treatment, like sleep disorders, diabetes, and heart disease. Most hospitalizations for those with depression were due to endocrine, musculoskeletal, and vascular diseases, not psychiatric disorders. Additionally, depression is associated with chronic inflammation and immune system dysregulation, elevating the risk of cardiovascular disease, diabetes, and autoimmune disorders. Furthermore, depression's impact on energy levels can lead to fatigue and reduced physical activity, contributing to health issues like muscle weakness, weight gain, and cardiovascular problems.
These findings underscore the critical need for a healthcare model that sees mental and physical health as inseparable.
Our healthcare system currently employs a segmented approach that often fails to acknowledge the interdependence of mental and physical health, resulting in gaps in patient care and extended suffering.
Is the solution then for doctors to shoulder more responsibilities within their brief patient interactions? From my experience, this isn't the answer. We once tried Integrated Behavioral Health Consultants (IBH) to bridge the gap between physical and mental health, but despite initial success, we couldn't develop a financially sustainable model to expand it. So, what's the viable solution? As of now, there isn't a clear one. Many attempts have been made to establish practices centered on holistic care, yet they often fall short in terms of affordability and scalability.
In today's world, dominated by the convenience of services like Amazon Prime and Uber, our healthcare system must be user-driven. Any devised solution should prioritize prevention, ensuring it is accessible, affordable, and engaging for everyone.
The persistent "chicken and egg" issue in healthcare serves as a constant reminder of the importance of treating mental and physical health as integrated aspects of overall well-being, rather than separate entities.
Commentaires