The Connection Between Physical and Mental Health
Reviewed by Dr. Jonathan Bonnet, MD, MPH
Americans of all ages face an unprecedented mental health crisis. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), one quarter of people in the United States have a mental or substance use disorder. Two out of five adults report symptoms of anxiety or depression and Black and Brown communities are disproportionately undertreated. Suicide is now the tenth-leading cause of death in the country.
Even before the pandemic, rates of depression and anxiety were slowly climbing. But the stress, isolation, and grief of COVID-19 have exacerbated these issues even further. The good news? The pandemic has shed light on the state of mental health in the United States.
In the workplace specifically, there’s a heightened awareness among both employees and employers about the importance of mental health support. But how much is known about the connection between physical and mental health? Are employers doing enough to support whole body health and wellness?
How do mental health issues manifest physically?
Our physical health and our mental health are inextricably linked. One can influence the other, and vice versa.
In fact, there are ways in which mental health issues can manifest physically. For example, someone who’s having a difficult time emotionally may have physical symptoms like a stomach ache or insomnia. Other mental health conditions that can manifest physically include:
- Depression: Depression has been associated with a higher risk of several physical conditions, including type 2 diabetes, heart disease, osteoporosis and lower bone mineral density, and sexual dysfunction (including problems with erection or lubrication). But physical symptoms of depression can also be present, including a reduced appetite, trouble sleeping or oversleeping, digestive problems, aches and pains, and headaches.
- Anxiety: People who experience generalized anxiety, panic attacks, or other forms of anxiety can experience physical symptoms, including chest pain, shortness of breath, headaches, muscle aches, difficulty concentrating, digestive problems, and sleep problems.
- Stress: Long-term and chronic stress can impair our immune system, which can lead to infection, illness, and disease. Individuals who experience chronic high stress can be more susceptible to viral illness (which can cause symptoms including stomach pain, nausea, and diarrhea), gastrointestinal (GI) troubles, headaches, muscle tension, allergies, and asthma.
Overall, stress and depression can also cause physiological changes, including metabolic, endocrinal, and inflammatory shifts. These changes can be significant markers and predictors of disease.
How does physical health impact mental health?
Just as mental health can have an impact on our physical health, the wellbeing of our body can also influence the wellbeing of our mind. Here are some of the most common ways physical health can affect mental health:
- Physical activity: Research suggests that physical activity is the largest contributor to indirect effects on mental health. Specifically, individuals who are not regularly physically active are more likely to develop depression and anxiety disorders. (Importantly, individuals already diagnosed with mental health conditions are less likely to engage in activities that benefit their physical and mental health, including exercise, which can worsen their psychological wellbeing even further.)
- Injury: Experiencing a physical injury can be stressful, but the impact of a physical injury on a person’s social life, physical activity, and sense of self can also have a damaging effect on their mental wellbeing.
- Diet: What you eat can have an impact on your physical health, but the quality of your diet can also have an impact on your mental health. Specifically, increased fruit consumption is associated with increased wellbeing and happiness. Moderate alcohol consumption may have a positive effect on physical and mental health, but excessive alcohol consumption is associated with poor mental health outcomes. Overall, eating a balanced diet rich in whole foods, fiber (including legumes, fruits, and vegetables), healthy fats, and lean proteins can help to support a healthy mind.
What physical diagnoses impact mental health?
Receiving a new physical diagnosis can impact your mental health in a myriad of ways. Learning about how a physical condition will impact your life can be stressful and cause individuals to feel hopeless, angry, or depressed.
Though any physical diagnosis can impact your mental health and wellbeing, there are specific diagnoses that are more commonly associated with mental health conditions:
- Diabetes: Type 2 diabetes is associated with a higher risk of anxiety and depression.
- Chronic respiratory disease: Anxiety and depression are common mental health conditions in people diagnosed with chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD).
- Psoriasis: People diagnosed with psoriasis, a chronic inflammatory skin disorder, have a higher risk of depression, anxiety, somatoform disorder (a mental health condition marked by physical symptoms that are triggered in response to psychological stress) and sleep disorders.
- Infertility: Individuals and couples struggling with fertility can also experience symptoms of depression and anxiety.
- Human immunodeficiency virus (HIV): People living with HIV or AIDS are at a higher risk of mental health disorders, including depression, anxiety, and cognitive disorders.
What do employers think about mental health?
Mental health has become a top priority for many employees, some of whom are considering a return to pre-pandemic work life or multiple job opportunities. But data from two national surveys conducted in late 2020 suggests that employers and employees may not be on the same page when it comes to mental health in the workplace. In fact, the data shows several points of disconnect between employer and employee perspectives on mental health:
- Mental health resources: 65% of employers believe that mental health is supported well or very well in their workplace, but only 51% of employee respondents agreed with the same question.
- Substance use support: Only 20% of employers believed that access to substance use disorder treatment and recovery was important, but 84% of employees surveyed wanted better and easier access to care for substance use disorder.
- Workplace stigma: Just 23% of employers implemented an anti-stigma campaign at work around mental health, but 79% of employees reported that an anti-stigma campaign at work would be valuable.
Employers know that stress and burnout are on the rise among today’s employees. About 80% of employers surveyed by McKinsey’s Center for Societal Benefit through Healthcare reported they had some concern about mental health overall, but only 50% of employers planned to make mental health an organizational priority. And just 27-31% of employers surveyed planned to start or expand mental health resources in 2021. The numbers from Kaiser Family Foundation are even worse: their data from the same year show that only 16% of employers developed new mental and behavioral health resources and just 3% increased coverage for out-of-network mental health or substance abuse services.
In many cases, employers are still not doing enough to make mental wellness a priority in the workplace.
What do employers think about physical health?
Historically, employers are better equipped to offer resources that support employees' physical wellbeing. According to the Kaiser Family Foundation, 95% of employers offered health benefits to at least some of their employees in 2021.
Still, the focus of employer-sponsored healthcare has largely been on "sick care," rather than preventive care. Even when preventive care, including cancer screening and vaccinations, is offered without cost, many employees aren’t aware that they can take advantage of these services for free.
In 2020, preventive care plummeted, with colonoscopies down 86% and mammograms and other important cancer screenings down 94%. Though some of these screenings have increased since, colon cancer screenings remained down 25% in March of 2021.
Preventive care is essential to identifying early risk factors and disease. Lack of awareness and access to preventive care, together with the decrease in screenings performed during the height of the pandemic, could have a significant impact on the health and wellbeing of American employees.
What are the best solutions for addressing both mental and physical health?
There are many obstacles when it comes to accessing physical and mental healthcare. Lack of adequate coverage is one of the most common and significant barriers. But even when coverage exists, many employees fail to seek care for mental and physical health complaints because of social stigma.
There is no one-size-fits-all solution when it comes to mental and physical health resources in the workplace. But there are several solutions employers can implement to improve mental and physical health resources:
- Make mental health a priority: Offering resources, like mindfulness courses or access to psychotherapy, is an excellent way to support mental health in the workplace. But there are additional steps employers can take to make mental health a priority, like assigning a senior leader to be accountable for employee mental health and asking for employee feedback about the available mental health resources.
- Create an inclusive and care-positive culture: Mental health stigma in the workplace can prevent employees from seeking help when they need it most. How is your organization reducing stigma and opening the doors to mental health communication? Tactics your organization may consider include implementing an anti-stigma campaign, ensuring that your organization values mental wellbeing, encouraging leaders to openly discuss their mental health challenges and successes, and training colleagues to know how to identify signs of distress and how to respond.
- Improve access to preventive care: Research demonstrates a strong association between physical and mental health. Providing employees with adequate healthcare coverage can go a long way toward improving their mental health. But preventive care takes it a step further. Preventive care is essential for the early detection of serious health concerns and overall health outcomes. By providing access to preventive care, employers can help their employees to improve their long-term health and keep healthcare costs low over time.
Providing preventive care to employees can make an impactful difference in improving their mental health and their long-term overall health outcomes. To learn more about how Forfend enables organizations to provide practical and effective preventive healthcare for every employee, visit this link.