The Link Between Mental and Physical Health

The Link Between Mental and Physical Health

November 3, 2024

Joy Stepinski, MSN, RN-BC

In modern healthcare, the different aspects of the human body are often viewed as separate and distinct problems. Physical health is categorized into an abundance of specialties, such as cardiology and gastroenterology. Mental health is considered a distinct entity. One government website defines mental health as “our emotional, psychological, and social well-being” that “affects how we feel, think, and act, and helps determine how we handle stress, relate to others, and make choices” [1]. Yet many pieces of health literature describe mental and physical health as intricately related.

In the book When the Body Says No, Gabor Maté affirms that the body is inaccurately viewed as entirely separate from the mind [2]. When seeking healthcare for physical symptoms, patients are not usually questioned about stressors in their lives. The author states, “We want to describe human beings – healthy or otherwise – as though they function in isolation from the environment in which they develop, live, work, play, love and die” (p. 3). He describes this as a hidden bias that health practitioners develop as they study and continue into practice.

In fact, stress can wreak havoc, especially when not processed well. Maté explains that stress is experienced in three stages. The stressful event occurs, whether emotional or physical, that the person may perceive as a threat. Next, the nervous system, especially the brain, must interpret the event. Finally, a response occurs where the reaction involves a behavioral or physiological symptom. The interpretation of the stressor plays a large role. For example, the loss of a job may affect self-esteem and cause a significant financial burden. However, this event may instead be viewed as a large opportunity.

The American Psychological Association states that while the body is designed to handle short-term stress, chronic stress can be harmful [3]. Muscle tenseness may lead to various types of headaches or chronic pain. The constriction of the airway may lead to shortness of breath or hyperventilation and panic attacks. The cardiovascular system may experience increased heart rate, high blood pressure, inflammation in the coronary arteries, and a heart attack. The regulation of glucocorticoids and cortisol of the endocrine system may also be affected, playing a role in chronic fatigue, obesity, depression, and other immune conditions. Stress affects the absorption of nutrients and digestion, causing constipation, diarrhea, irritable bowel syndrome, or other gastrointestinal issues. The effect on the reproductive system may lead to low libido, reproduction issues, or disease states. The whole body can be affected by stressors, leading to physical symptoms.

Research supports these statements. In one study, the effect of vital exhaustion on coronary heart disease (CHD) was investigated. This condition was defined as “a state of excessive fatigue, increased irritability, and demoralization” [4]. The authors concluded that adverse cardiac events were significantly higher in participants exhibiting high vital exhaustion. In a separate study, investigators noted that depressive symptoms were a predictor of adverse cardiac events among patients with established CHD. Hopelessness was a key component.

Coronary artery disease (CAD), a major cause of morbidity and mortality, is thought to be independently related to psychological stress [5]. A key characteristic of CAD is atherosclerotic plaque, fatty deposits in the arteries that impede blood flow to the heart. Psychological stress may impact the heart, due to a variety of causes (i.e., job and family stress, anger, hostility, depression, and anxiety). In a proposed mechanism, authors explained that the brain must process these stressors, which leads to several responses. Catecholamines, neurotransmitters that activate the fight or flight response, are activated. The stress hormone cortisol is released. As a result, an inflammatory response occurs that cause consequences to the heart, including atherosclerosis.

Maté discusses the effect of trauma as a cause of autoimmune disease. According to one study, at least 50% of autoimmune diseases are related to unknown factors [6]. Yet up to 80% of patients describe a high amount of emotional stress before the disease onset. Maté describes overlapping characteristics, including diseases such as multiple sclerosis, scleroderma, rheumatoid arthritis (RA), and systemic lupus erythema (SLE) [2]. As in CAD, psychological stress triggers chronic inflammation. A relationship between the endocrine system, sympathetic nervous system, and immune system are linked [6].

Emotional competence may be a key part of healing [2]. According to Maté “recognizing our lack of it is not cause for self-judgment, only a call for further development and transformation” (p. 263). He describes the seven A’s. Through acceptance, the current situation can be recognized. Awareness of signs of stress provide clues for which to pay attention. Healthy anger must be experienced and the cause considered. By developing autonomy, values and self-limits are determined as an internal center of control. Connecting to the world through attachment and emotional support is vital. We assert ourselves as a self-declaration of our being, independent of the things that define us (i.e., personality, abilities, other people’s perceptions). Through affirmation, we recognize our creativity with an ability to express ourselves. We affirm that we are connected to the universe around us with spiritual needs.

Both deeply knowing oneself and recognizing a connection to a higher power is important to well-being and healing. Health depends upon the delicate balance of the physical body, the mind, and the spiritual connection.

References

1.      Substance Abuse and Mental Health Services Administration. (2023). What is mental health? SAMHSA. https://www.samhsa.gov/mental-health

2.      Maté, G. (2011). When the body says no: The cost of hidden stress. Vintage Canada.

3.      American Psychological Association. (2024). Stress effects on the body. APA. https://www.apa.org/topics/stress/body

4.      Williams, J. E., Mosley Jr, T. H., Kop, W. J., Couper, D. J., Welch, V. L., & Rosamond, W. D. (2010). Vital exhaustion as a risk factor for adverse cardiac events (from the Atherosclerosis Risk In Communities [ARIC] study). The American Journal of Cardiology, 105(12), 1661-1665. https://doi.org/ 10.1016/j.amjcard.2010.01.340

5.      Wirtz, P. H., & von Känel, R. (2017). Psychological stress, inflammation, and coronary heart disease. Current Cardiology Reports, 19, 1-10.

6.       Stojanovich, L., & Marisavljevich, D. (2008). Stress as a trigger of autoimmune disease. Autoimmunity Reviews, 7(3), 209-213.