How Mental and Physical Health are Intertwined

Article | MQ: Mental Health Research

It has long been known that physical and mental health are closely linked. In fact, chronic physical conditions can accelerate poor mental health, and vice versa.

This area of study is a growing focus for scientists around the world. Some of the fascinating ongoing research includes:

Inflammation

The link between heart disease and depression is well documented. People with heart disease are more likely to suffer from depression, and the opposite is also true.

In 2019 scientists at the University of Cambridge identified a link between these two conditions: inflammation.

While inflammation is a natural response needed to fight off infection, chronic inflammation – which may result from psychological stress as well as lifestyle factors such as smoking, excessive alcohol and physical inactivity – is harmful.

People who have a heart attack are at a significantly higher risk of experiencing depression, and people who report at least one parent having died of heart disease are 20% more likely to develop depression at some point in their life.

However, it wasn’t until Dr Golam Khandaker started to investigate that inflammation mechanisms were identified as the link.

“We analysed the data of over 367,000 people from the UK Biobank cohort and identified two important things,” says Dr Khandaker.

Our body state influences the way we feel and react. Strong emotion such as anxiety is made more intense by the feeling of our heart racing.

“Firstly, the reason people often experience heart disease and depression at the same time arises largely from shared environmental risk factors, rather than shared genetic factors.

“This finding is important from a public health perspective because we can start to give advice that could help people reduce their risk of developing these conditions – for example, exercising and quitting smoking.

“Second, triglycerides, which are a fat present in our blood, and IL-6 and CRP, which are proteins from our blood that indicate inflammation, are both likely to be underlying risk factors for depression.

“This is really vital new knowledge because it suggests to us that inflammation could be a key cause of both depression and heart disease. There are a number of ongoing studies (including our own ongoing clinical trial in Cambridge, the Insight study) testing things like if anti-inflammatory treatment could help some people with depression – and this finding suggests we are on the right track.”

Joints and Movement

Around half a million people in the UK have rheumatoid arthritis, and it is thought that one-third of them also have mental illness.

At the other end of this spectrum of movement, people with hypermobility (an unusually wide range of movement in one or more joints) are more likely to have neurodevelopmental conditions, such as autism and attention deficit hyperactivity disorder (ADHD), as well as anxiety, than people in the general population.

Research aims to uncover more about this fascinating relationship between joints, movement and our mental health.

Dr Sam Norton from King’s College London is being funded by Arthritis Research UK and MQ Mental Health to develop a new app that can help healthcare professionals track physical and mental health symptoms in people with arthritis, so they can identify who is at risk of ongoing problems.

“The goal is to develop a digital application to graphically display important clinical information and other factors related to persistent issues, enabling a wider range of important variables to be considered in the time available for outpatient consultations,” says Dr Norton.

“I have collaborated with the development of an app for patients to track symptoms and store information regarding their care (medication, appointments, etc) with a physician dashboard.

This has been made available to patients at King’s College Hospital, with an evaluation underway to examine app usage and the validity of the mental and physical health symptom tracking to monitor treatment initiation.”

MQ has also funded Dr Jennifer Eccles from the University of Sussex to develop and trial a new targeted treatment for reducing anxiety among people with hypermobility.

“Our body state influences the way we feel and react. Strong emotion, such as anxiety, is made more intense by the feeling of our heart racing,” says Dr Eccles.

“The way in which people differ physically can affect how much their body reacts and how likely they are to experience anxiety symptoms. Some of these differences can be related to flexible ‘hypermobile’ joints.”

Dr Eccles hopes that the novel treatment that she and her team are trialling will be able to ease symptoms of anxiety for people who are hypermobile.

Epilepsy and Mental Health

People who have epilepsy, a condition that affects the brain and tends to cause seizures, often also experience mental health conditions (such as psychosis) and neurodevelopmental conditions (such as autism).

It is thought that genetics are key to understanding why that is the case, and this is the focus of research being done by Dr Symon Kariuki from the KEMRI-Wellcome Trust programme in Kenya.

Dr Kariuki is studying the overlap of genetic factors in epilepsy, autism and psychotic disorders through DNA extraction and quantification, sequencing, and genotyping.

“These three conditions are very common in Africa. Their causes are not fully understood, affected people do not receive appropriate treatment, and the conditions often co-exist, reasons for which are not fully understood,” says Dr Kariuki.

“I aim to determine if genetic factors discovered elsewhere have any contribution to the risk of epilepsy, autism and psychotic disorders in our Kilifi cohorts here in Africa.

“I will also study if genetic factors for one condition – say, epilepsy – are also frequently common in autism or psychotic disorders, and vice versa, which may suggest that these conditions are related.

This work will complement our earlier findings from community surveys which showed that mental health problems are comorbid with acute symptomatic seizures and with epilepsy in Africa.”

Gone too Soon

On average, people with a serious mental health condition pass away 14 years earlier than the general population. Although partly due to suicidality, it is mostly due to tractable physical illnesses. Understanding more about how physical and mental health are linked will improve outcomes for the one in four of us each year who experience mental illness.

All these studies are supported by MQ Mental Health Research. The charity, funded by donations, aims to improve our understanding about mental health so that people can receive a diagnosis more quickly, treatments can be improved, and prevention methods can be developed.

To find out more about these studies, and the many other studies that MQ supports, head to www.mqmentalhealth.org

Up to one in four of us experience mental illness every year, yet our knowledge about the causes and the conditions is nowhere near where it needs to be.

Far less money is invested into mental health research than other physical health conditions. MQ, the leading mental health research charity, refuses to accept this as a status quo. MQ invests in cutting edge scientific research into the causes and treatments of mental health conditions so that we can better understand them, and one day even prevent them.

To find out more about MQ, and to find out how you can get involved and support their work, just visit www.mqmentalhealth.org