How Closely Are Mental and Physical Health Related?

For much of the history of modern medicine, the brain and body were studied and treated separately.

But in recent years, researchers have begun to look more closely at the link between physical health and mental health.

In this video, Chris Palmer, MD, explains just how important this link is, and what can happen when it’s overlooked:

Click here for full transcript

So for years, researchers have separated really for millennia, we have separated the mental health field from the physical health field, assuming that mental health is a brain disorder or due to psychological and social problems, and physical health is due to other things. But in fact, over the last century in particular, we have a vast range of accumulating evidence that speaks strongly to the connections between physical health and mental health. And perhaps this was actually first really emboldened by the biopsychosocial model, which says that for mental illnesses, biological, psychological, and social factors all come together to cause mental disorders. But in fact, what a lot of people miss is that biopsychosocial model actually applies to numerous physical illnesses as well, and mostly metabolic illnesses in nature. So what else does biopsychosocial apply to? Obesity, cardiovascular disease, diabetes, autoimmune conditions and others. And so George Engel was a psychiatrist and an internist, and he’s the one who coined that term. And so we need to think about integrating physical health and mental health.

One of the most common, I think, misperceptions or misconceptions is that poor metabolic health in people with mental illness is either a side effect of the medications that we’re prescribing, or it’s actually due essentially to the person’s mental illness itself, lack of motivation, a lack of willpower, overeating, under-exercising, staying in bed too much, using harmful substances like tobacco and other substances. And in fact, we now have about a century of data suggesting something much more profound. And that is that the same biological pathways that can lead to the development of mental disorders, such as schizophrenia, bipolar disorder, chronic depression, overlap a lot with the biological pathways that can lead to things that we call obesity or type two diabetes or cardiovascular disease. And let me give you some clear, easy to understand examples. Higher levels of inflammatory biomarkers are associated with all of those disorders, both mental disorders and metabolic disorders.

Insulin resistance can be associated with both types of disorders. Mitochondrial dysfunction can be associated with both types of disorders. Immune system dysregulation can be associated with both types of disorders. The gut microbiome and disruptions in the gut microbiome is associated with both types of disorders. And so we need to think more broadly when we think about mental health and metabolic health, we need to connect the science and the dots because the reality is right now what we’re doing is not working optimally for hundreds of millions of people with mental illness. And the clearest testament to this is that people with mental disorders on average are dying early deaths. And what are they dying from? They are largely dying from metabolic disorders, things like cardiovascular disease, diabetes, obesity, and the complications of those disorders.

As Chris indicated, we now have a growing body of evidence showing how closely physical and mental health are connected.

I’ll have more to say about that soon.

But in the meantime, I’d like to hear from you: Where have you seen a connection between a client’s physical and mental health? How did you work with it?

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