Depression and anxiety can affect your physical health

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Physical Symptoms

Both depression and anxiety can cause physical symptoms. For some patients these are the most significant symptoms of their condition and the ones which will cause them to make a doctor’s appointment. It is important consider all possible diagnoses and to recognise and treat any depression and/or anxiety whether it is the cause of the symptoms or as a result of them.

These can include:

  • Tiredness
  • Headache
  • Generalised aches and pains
  • Nausea
  • Shortness of breath
  • Pins and needles.
  • Irregular heartbeats (palpitations)
  • Chest pain
  • Sweating
  • Breathing heavily
  • Dizziness
  • Faintness
  • Indigestion
  • Diarrhoea
  • Headache
  • Nausea
  • Shortness of breath
  • Pins and needles.

Long term conditions/ Chronic Physical Health problems

Depression and anxiety are 2-3 times more common in those with a chronic physical health problem. People with long term conditions including those below, may benefit from psychological therapies, with improved outcomes for their physical condition as well as their mental health.

  • Heart disease
  • Chronic Obstructive Pulmonary Disease
  • Diabetes
  • Pain
  • Chronic Fatigue Syndrome / ME
  • Arthritis
  • Sickle Cell and other genetic disorders
  • Irritable Bowel Syndrome
  • Headache and other neurological conditions
  • Stroke

Treating this depression and/or anxiety is vital as it both improves quality of life and disease control.

For instance it has been estimated that:

  • Almost a quarter (25%) of people with diabetes also experience depression. Someone with diabetes and depression will have poorer health outcomes, experience more severe symptoms and require significantly more input from health services.
  • Of those with Chronic Obstructive Pulmonary Disease (COPD), 51% are likely to have clinically significant symptoms of anxiety or depression. Talking therapies input can improve disease control and quality of life for this group of people.
  • Similarly 61% of people who have had a stroke are estimated to develop depression which reduces their physical functioning and quality of life.
  • 30% of those who have had a heart attack develop depression which significantly affects the outcome of their disease.
  • 21.5% of the population experience chronic (long term) pain of which 30-45% may be clinically depressed and are at significantly increased risk of experiencing anxiety
  • Perhaps 30% of primary care consultations and 50% of secondary care outpatient appointments are with patients experiencing a group of conditions which are not yet well understood (currently termed Medically Unexplained Symptoms [MUS] or Medically Unexplained Physical Symptoms - [MUPS]). Some of these are well defined pictures such as fibromyalgia, non-cardiac (non-heart) chest pain and irritable bowel syndrome. Patients with these conditions are often experiencing significant disability and a lack of understanding from those delivering their healthcare. There are also often no real ‘solutions’ available. Many may experience depression and anxiety as a result. Meeting the needs of the depression and/or anxiety can help the patient to self-manage their condition.

Long-term conditions positive practice guide- IAPT 2008
www.iapt.nhs.uk/silo/files/longterm-conditions-positive-practice-guide.pdf

Medically unexplained symptoms positive practice guide – IAPT 2010

www.iapt.nhs.uk/silo/files/medically-unexplained-symptoms-positive-practice-guide.pdf

 

Identifying and treating any anxiety and depression can improve the daily lives of those with long-term conditions through better disease control, less admissions and procedures. It can also reduce overall health costs enabling care for others.

In some cases people may experience a persistent sub-threshold depression (not severe enough for a diagnosis of depression but nevertheless often distressing) and those with this condition can benefit from low intensity interventions provided by the primary well-being practitioners who are part of the IAPT service.

GP’s and their teams have an important role in identifying those with chronic physical health problems (long term conditions) who have depression and anxiety and supporting them to access appropriate treatment including services such as those provided by the regions IAPT services. It is essential to embed mental health and wellbeing screening into the routine care and review of those with longterm conditions.

NICE guidelines for the care of those chronic physical health conditions and depression

http://eng.mapofmedicine.com/evidence

[Also see links page for patient information]