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October 6, 2014
by Lisa La Rose, M.A., L.P.C.

Mental Illness and Life Expectancy: How mental illness can shorten lifespan, and what to do about it

October 6, 2014 04:55 by Lisa La Rose, M.A., L.P.C.  [About the Author]

In America, and around the world, being diagnosed with a mental disorder is not uncommon.  More than one in four American will be given a diagnosis of mental illness in any given year.  Many people live with more than one disorder, for about 6% of people with mental illness the disorder causes disability (The Numbers Count, 2014).  The cost of having mental illness can be very high for people struggling with behavioral disorders.  Mental illness can impact a person’s ability to work, go to school, and have healthy and satisfying relationships.  But did you know that it can also shorten a person’s life?   There is consistent evidence that people with mental illness do have more physical health problems and mortality, compared with people who do not live with these disorders (Latoo, Mistry & Dunne, 2013).  

What does the research say?

In one study, Oxford researchers found that mental illness may actually reduce life expectancy by 10-20 years, more even than heavy smoking (20 or more cigarettes a day). On average, people who are heavy smokers may expect to cut about 8- 10 years off of their life span, while people with mental illness may lose between 9-24 years, depending on the type of disorder (Many Mental Illnesses, 2014).   Another study reports that schizophrenia is associated with higher rates of diabetes mellitus, osteoporosis, obesity, and cardiovascular problems (Latoo, et al, 2013).

Additionally, eating disorders can be associated with a higher mortality rate because of physical problems caused by anorexia/bulimia nervosa. Patients suffering from depression are twice as likely to develop type 2 diabetes mellitus, and the prevalence of stroke and myocardial infarction is 3 to 5 times higher, respectively higher than people without depression.  Mental illness in general is associated with an increased risk of hepatitis, human immunodeficiency virus (HIV), tuberculosis, and poor dental health (Latoo, et al, 2013).

The risk of increased physical health problems and mortality is a tragic fact for people struggling with illnesses like schizophrenia, bipolar disorder, substance abuse, personality disorders, and other types of mental illness. There are a number of factors that contribute to poor health and an increased mortality rate, and having certain types of mental illness can increase the risk of early death (Latoo, et al 2013).  It’s important for people with mental illness, their loved ones, and doctors to be aware of the risks associated with mental illness, and also understand how to take steps to prevent early mortality.

What’s the connection between physical health and mental health?

In recent years, more and more has become known about the relationship between physical health and mental health.   The mind and body are connected in so many ways, and they influence each other every day.  This is true for both people with mental illness and people who do not have a mental illness.  One study found that elderly adults who are more physically fit tend to have bigger hippocampi and better spatial memory than those who are less fit (Grohol, 2009). Another study found that uncontrolled anger can lead to heart problems.

People with problems coping with their anger or aggravation were found to be at ten times heightened risk for future heart arrhythmias than those without such anger problems (Grohol, 2009).  These studies demonstrate that maintaining mental health is good for physical health—and the other way around!  This makes it even more essential for people with mental illness to maintain good physical health.

Why are people with mental illness at risk?

Having a mental illness can increase the chances of developing physical health problems for a variety of reasons.  Sometimes, the treatments used to help people with the symptoms of their illness can actually contribute to the development of health problems.   In other cases, the illness itself creates a barrier to maintaining a healthy lifestyle and accessing healthcare (Latoo, et al, 2013).  Some of the reasons that people with mental illness are at risk include:

  • Side effects of medications, especially some antipsychotic medications, can contribute to something called Metabolic Syndrome.  This is a recognized clustering of cardiovascular and other abnormalities that can include hypertension, diabetes, obesity, high cholesterol, and increased risk for cardiovascular disease (Toalson,  Ahmed, Hardy, & Kabinoff, 2004)

  • Lack of access to medical care, and difficulty understanding and following through with healthcare advice

  • People with mental illness may engage in more high-risk behaviors like drug or alcohol abuse (Latoo, 2013.)

  • The suicide rate is higher for people with mental illness

  • The stigma of mental illness may prevent some people from seeking medical care, and physicians are sometimes uncomfortable treating patients with psychiatric disorders

  • Lack of communication between mental health treatment providers and physical healthcare providers, and lack of emphasis by mental health providers on physical health and regular screening for health problems (Latoo, et al, 2013)

All of these factors can contribute to the development of serious and even life threatening conditions in people with mental illness. There are steps that those living with mental illness, their loved ones, and treatment providers can take to help ensure that they stay healthy and live a long life.

What can be done to combat illness and early mortality in people with mental illness?

Both behavioral healthcare providers and physical healthcare providers must communicate well and receive training to ensure early detection and treatment of problems to reduce the rate of illness and mortality in people with mental illness.  Additionally, Latoo, et al (2013) suggests that treatment professionals should implement some of these guidelines:

  • Increase the awareness of both physical health and mental health professionals about the issue of increased illness and mortality.

  • Decrease discrimination and the stigma about mental illness that may reduce access to healthcare

  • Carefully monitor the health of patients taking antipsychotic and mood-stabilizing medications

  • Mental health professionals can encourage people with mental illness to monitor things like weight, diet and exercise

Having poor physical health can make it harder to recover from mental illness. People with mental illness can do a lot to help themselves to prevent or address healthcare issues that can interfere with quality of life, and possibly shorten their lifespan. Mental Health America (2014) offers these suggestions for people with mental illness:

  • Get necessary care:  Get regular check-ups and follow through on doctor’s recommendations.  See a doctor when feeling unwell, or when having side effects from medication.  Talk with a counselor about healthcare goals, and ways to increase motivation to make healthy lifestyle choices.

  • Be an advocate for yourself:  People with mental illness deserve quality healthcare, and they deserve to have their concerns taken seriously.

  • Manage stress: Stress can really take a toll on the body and mind.  Everyday life can include stress about money, work, and relationships,  and it’s important to have ways to ways to relax. Learn and practice stress management skills and techniques.

  • Maintain a sleep schedule:  Sleep can affect mood and thinking, and not getting enogh sleep can make it harder to recover from mental illness. Try to maintain a sleep schedule, and learn about sleep hygiene (a counselor can help with this).

  • Be careful about diet:  Some medications can cause weight gain, and so can an unhealthy diet.  Weight gain can lead to obesity, which can in turn lead to health problems like high blood pressure, heart disease, and diabetes (Latoo, et al, 2013).

  • Get enough exercise:  Exercise can not only help with maintaining a healthy weight, but can also increase self-esteem and decrease feelings of stress, depression, and anxiety. It’s important to find a type of exercise that is enjoyable.  Include others, if that makes it more fun.

  • Know your limits:  Know when you need to day “no”, and know when you’ve done all you can do.

  • Stay connected to others:  Stay connected with positive and loving, and trustworthy people, and participate in enjoyable activities.  Staying connected can decrease isolation and loneliness, and increase feelings of self-esteem.

  • Avoid smoking, illicit drugs and alcohol:  All of these can have a negative impact on health and well-being, but they are sometimes used as ways to cope with stress.  Talking with a counselor can help when giving up these substances is difficult.

 

Following these guidelines can increase the chance that people with mental illness can avoid some of the health risks, and even early mortality, associated with mental illness.  It takes education and effort to combat the risk factors, but many of the health problems associated with mental illness are preventable and treatable.  In addition to the strategies above, people with mental illness can benefit from both group and individual therapy to stay healthy and live fulfilling lives.

How can counseling help?

Doing what’s necessary to stay healthy can be an overwhelming task for anyone.  For people with mental illness this can be even more daunting. They may face challenges and barriers that people without mental illness do not experience.  Skilled counselors can help people with mental illness take the steps necessary to maintain their health, and overcome barriers.  Counseling can help in many ways, including: 

  • Education about the risks associated with certain medications

  • Education about the importance of healthy lifestyle choices (e.g. diet, exercise, social support)

  • Identifying barriers to access to necessary healthcare

  • Creating and following through on goals for fitness and diet

  • Support for making changes in lifestyle

  • Developing good sleep hygiene

  • Finding healthy support in the community

  • Overcoming barriers such as depression, anxiety, and low self esteem that might interfere with making healthy lifestyle changes

Counseling, in combination with good communication with other healthcare providers can help people with mental illness to head-off potentially life threatening health problems, and recover from mental illness.  Having a mental illness does not have to mean poor health and a shorter life span.  There are many things people with mental illness and their treatment providers can do to avoid the health challenges that are known to impact people with mental illness

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Grohol, J. (2009). The Connection Between Mental & Physical Health. Psych Central. Retrieved on July 11, 2014, from http://psychcentral.com/blog/archives/2009/02/25/the-connection-between-mental-physical-health/

Latoo, J., Mistry, M., & Dunne, F. (2013). Physical morbidity and mortality in people with mental illness. British Journal of Medical Practitioners, 6(3), 621. Retrieved July 6, 2014, from http://www.bjmp.org/content/physical-morbidity-and-mortality-people-mental-illness 

Many mental illnesses reduce life expectancy more than heavy smoking. (2014, May 23). Science Daily. Retrieved July 6, 2014, from http://www.sciencedaily.com/releases/2014/05/140523082934.htm 

The numbers count: Mental disorders in America. (2014). Retrieved July 7, 2014, from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

Staying well when you have a mental illness. (2014). Retrieved July 6, 2014, from http://www.mentalhealthamerica.net/sites/default/files/staying_well1.pdf

Toalson, P., Ahmed, S., Hardy, T., & Kabinoff, G. (2004). Metabolic syndrome in patients with severe mental illness. Primary Care Companion to the Journal of Clinical Psychiatry, 6(4), 152-158. Retrieved July 6, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC514841/

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