Mental Health and Physical Health: Should there be a Distinction?
Welcome to Brainwaves, the official blog of Intempo Psychiatry. If you’re new here, welcome to the page! Feel free to subscribe if the content resonates with you and be sure to tune in for updates. If you’re already subscribed, welcome back!
It’s no secret that we tend to separate mental and physical health. When it comes to conditions like hypertension, diabetes and heart disease, we automatically think of medical illness. However, when it comes to conditions like depression, anxiety, or PTSD, it sometimes seems like different rules apply. Within psychiatry, we generally recognize the distinctions that should be made between mental and physical health. If you look through the Diagnostic and Statistical Manual of Mental Disorders, you’ll see that for most disorders, there’s a specifier for illness due to another medical illness, suggesting that certain mental health conditions aren’t psychiatric in nature, even though they present similarly to their psychiatric counterparts. We typically won’t even diagnose certain illnesses definitively, including depression and anxiety disorders, until a thorough medical workup is completed. There is a lot of value in this approach diagnostically – for instance, if someone presents with depression, treatment considerations are completely different if it’s a pure depression compared to depression caused by other conditions such as hypothyroidism or chronic anemia.
As an extension of this example, it’s important to consider how mental illnesses influence medical illnesses and vice versa. Often, patients with depression have comorbid illnesses such as diabetes, cancer, heart disease, and/or chronic pain. When left untreated, depression may worsen comorbid chronic illnesses due to lack of desire to participate in care and decreased engagement in activities designed to improve overall health. On the other hand, chronic medical illnesses may also worsen symptoms of depression and make them more difficult to treat.
Despite the inherent value in these distinctions, I tend to think of psychiatric illness and medical illness/physical health as one and the same. When talking to clients, I try to make this connection as well, especially considering the significant stigma surrounding mental health treatment. I’ve worked with several individuals who had clear mental health concerns but were hesitant to initiate medications or therapy, making statements like “I don’t want to take medications for that. I can just push through it” or “this is all just temporary. I should be back to my normal self soon.” Interestingly, when reviewing their charts, they are often taking medications for other conditions like hypertension or diabetes. When exploring this further with clients, I often find that the hesitancy to engage in treatment is rooted in stigma – many factors contribute to this stigma, but a glaring one is the belief that mental illness and medical illness are separate entities.
To make clients more comfortable with talking about mental health and pursuing treatment if warranted, I often discuss pure psychiatric illnesses as disorders of the brain. Although the brain differs from other organs such as the heart and kidneys, it still is an organ that can experience dysfunction, just like the heart, kidneys, and other organs. There might not always be a lab value or physical finding associated with mental illnesses, but that doesn’t mean they aren’t inherently medical and shouldn’t be addressed like other medical conditions. I find that discussing mental illness in these terms, as opposed to telling a client with some skepticism or hesitancy to engage in treatment, helps break down some of the stigma. My goal is to help clients realize that mental illness and medical illness, despite the distinctions, can be looked at as one in the same.
Until next time!
Dr. McCall
