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Our mental and physical health are interconnected. Poor physical health increases the chances of us developing poor mental health and vice versa. Almost one third of people who suffer from a long-term physical health condition also have a mental health condition, most commonly depression or anxiety.
Taking good care of our mental health and wellbeing when we have physical health problems can help to support our overall wellbeing. If we are physically unwell, it is also important to be aware of the symptoms of depression and poor mental health, to take steps to improve our mood and to reach out for help when needed.
The Link Between Physical Health and Depression
People with long-term physical conditions are at a significantly higher risk of developing a mental health condition. Living with a long-term health condition such as diabetes, cardiovascular disease or chronic pain, can lead to feelings of helplessness, isolation and depression.
- People with fibromyalgia are up to three times more likely to have depression than those who do not
- A Diabetes UK funded study found that depression can play a direct role in increasing the risk of developing type 2 diabetes
- One study of 1,204 patients with chronic pain found that 60.8% of them had depression, with 15.2% experiencing suicidal thoughts
Along with depression, people with long-term conditions and chronic pain commonly experience anxiety.
Even when we feel unwell for a short time, it is possible to develop a low mood and feelings of hopelessness, anger or stress, which can lead to poor mental health.
Physical problems can affect our mental health in various ways, including:
- Stress over appointments or test results
- Feeling frustrated over having limited mobility or being in pain
- Feelings of being isolated or lonely
- Anger or feelings of unfairness about being unwell or impaired
- Poor self-esteem or low confidence (especially about our appearance)
- Worry over stigma and/or discrimination
When we are experiencing sickness or physical issues, we may also have to take time off work which can lead to money worries and additional stress.
Stress and depression can affect our physical health in various ways including:
- Heightening our perception of pain
- Interfering with our sleep patterns (sleeping too much or too little, problems falling asleep or staying asleep)
- Changing our eating patterns or affecting our appetite
- Causing us to use negative coping mechanisms that make us unwell (such as unhealthy foods, excess sugar, smoking, drugs or alcohol)
- Affecting our energy levels making us feel fatigued, sluggish or listless
When we are depressed, we often fail to prioritise our self-care, which can make us feel worse. If you have depression, it is vital to continue to look after your physical health as well which includes keeping up with medical appointments, taking any medication as prescribed and trying to live a healthy lifestyle.
A Holistic Approach to Managing Physical Health and Depression
A holistic approach to managing physical health and depression involves making lifestyle changes and seeking support that addresses all aspects of our wellbeing. This means considering our physical, mental, emotional, social and spiritual needs. Key components that support our wellbeing include regular exercise, good nutrition and adequate sleep.
Exercise
Regular exercise and physical activity can improve both our mental and physical health. Exercising can increase our oxygen levels, boost circulation and help us to maintain a healthy weight. Exercising can also boost endorphins (feel good hormones) which can make us feel better and reduce our stress levels and improve our levels of confidence and self-esteem.
Getting more exercise can be an important lifestyle change that can help to ease the symptoms of depression, especially when used in conjunction with other treatment methods.
Any type of physical activity that gets you moving is helpful. The British Medical Journal (BMJ) noted the following types of exercise to be especially beneficial if you have depression:
- Walking or jogging
- Yoga
- Strength training
Diet
An unhealthy diet can negatively impact our health, for example a poor diet is linked to obesity, diabetes, heart disease, high blood pressure and some cancers.
A poor diet can also cause certain nutritional and vitamin deficiencies, which also affect our energy levels, brain function and mood.
A healthy diet includes one that is rich in fruits and vegetables, lean proteins and whole grains. Healthy fats, such as omega-3 fatty acids, are thought to support brain function.
To support your physical and mental health you should avoid:
- Ultra-processed food
- High fat and high sugar foods
- Missing meals or overeating
- Too much caffeine or alcohol
Low levels of B vitamins (such as B-12, B-6 and folate) have been linked to depression. There is also thought to be a link between iron deficiency (anaemia) and depression. If you are concerned you may have a vitamin deficiency you can take supplements such as multivitamins or iron.
Our brain and gut are in constant communication. People with depression often experience gut-brain dysfunction as well. This includes appetite disturbances, metabolic problems and nausea. Our gut microbiome may be linked to poor mental health, due to imbalances in gut bacteria. To maintain a healthy gut flora, in addition to eating a healthy, balanced diet, you can take probiotics as either a capsule or as a yoghurt drink. Although research is ongoing, it is thought that probiotics may help to boost mood and cognitive function.
Sleep
Sleep plays a crucial role in both our mental and physical health. Depression can cause sleeping problems and not getting enough good quality sleep can make us feel down, moody and irritable. Poor sleep can also lower our immune system and can heighten our perception of pain.
To support both our mental and physical health, it is vital to practise good sleep hygiene to try to regulate and improve our sleeping patterns.
Tips for a good sleep include:
- Try to keep a routine (going to bed and waking up at roughly the same time each day)
- Ensure your sleeping environment is quiet, comfortable and has the right amount of light for you
- Avoid caffeinated drinks or alcohol before bed (these can interfere with our circadian rhythm) – try switching to a relaxing camomile tea instead
- Avoid using electronic devices such as phones or tablets at bedtime – they emit blue light which is thought to affect sleep
- Find ways to relax before bed such as doing some deep breathing techniques or a gentle stretching routine
- Don’t eat heavy meals before bed
Some people like to use herbal remedies or alternative treatments to support their mental and physical health needs. This includes taking supplements, or using aromatherapy, acupuncture or reflexology. Whilst these alternative treatments may help to relieve your symptoms, it is important to address the underlying cause of your illness and to discuss any changes to your treatment plan with your GP.
Addressing Chronic Illness and Depression Together
Chronic or long-term illnesses usually last for three months or more and cause disruption to our daily life and activities. Chronic illnesses usually have no cure, although they can be controlled using different types of treatment and lifestyle changes. People with a chronic illness are more likely to struggle with stress and depression than the general population.
Stress is very bad for our mental and physical health. If you are living with a chronic illness, it is even more important that you are able to reduce your stress levels. Being stressed can raise blood pressure, increase our perception of pain and make us feel overwhelmed.
By incorporating stress management techniques into your daily life, you can begin to feel more positive, empowered and in control. Reducing stress can also ease your muscle tension and lessen aches and pains.
Some simple stress management techniques include:
- Relaxation techniques such as yoga, meditation or deep breathing
- Mindfulness-based stress reduction (MBSR)
- Progressive muscle relaxation (PMR)
- Journaling or channelling your feelings into another creative outlet such as art or music
Many people with chronic illness also suffer from depression. Symptoms of depression are more pervasive and long term than the usual sadness and despair that may accompany a chronic diagnosis. Some of the symptoms of depression include:
- Persistent low mood
- Loss of interest in daily life and activities or personal hygiene
- Low energy
- Feeling hopeless and worthless (may include thoughts of self-harm/suicide)
- Problems sleeping (insomnia) or sleeping too much
- Poor appetite
- Headaches, nausea or digestive issues
If you are experiencing chronic illness and depression together, it is vital that you continue to engage with treatment for your illness as well as seek help for depression.
Mental Health Support as Part of Physical Care
Seeking mental health support can form a key part of your physical care plan. This includes therapy and counselling, as well as taking medication.
Psychotherapy, such as cognitive behavioural therapy (CBT), has been shown to be beneficial in dealing with both depression and physical problems, especially chronic pain. CBT helps us to identify and reframe negative thoughts and to understand how our thoughts, feelings, emotions and behaviours are connected.
Therapy can be done one to one between a patient and therapist, although some people experiencing depression and physical health problems may benefit from accessing group support where they can connect with others facing similar issues.
Some people find taking medication, such as antidepressants, can help them when they are battling depression. Medication can be used as a short-term solution whilst waiting for therapy or in some cases it can be used in conjunction with psychotherapy or other treatments.
Antidepressants are thought to work by increasing the chemical messengers in the brain known as neurotransmitters. Some of these neurotransmitters, for example serotonin and noradrenaline, are linked to our mood and emotions. Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed type of antidepressant as they are thought to have fewer side effects than other available medicines.
Multiple neurotransmitters are also associated with the sensation of pain. Although not specifically designed to treat pain, some antidepressants, such as tricyclic antidepressants, are used to manage the symptoms of some painful conditions, even when depression is not a factor. These conditions include arthritis, nerve pain, fibromyalgia and lower back pain.
For best outcomes when managing your mental health as part of physical care:
- Take medication as prescribed as medication non-adherence can reduce your quality of life and lead to your symptoms getting worse
- Stick to your care plan, attend your appointments and engage with healthcare professionals
- Report any bad side effects to your doctor – they may be able to adjust your dosage or prescribe an alternative
- Use medication in conjunction with therapy and lifestyle changes
Practical Tips for Improving Both Physical and Mental Health
The Role of Support Networks
When we feel down or unwell it is important to feel that we have people around us that we can count on for help or support. Having a strong support network can reduce isolation and increase emotional resilience.
A support network may consist of any of the following
- Family
- Friends (including online friends)
- Colleagues or classmates
- Medical professionals
Technology can help us to stay connected even if we are far away from one another or on days when we might feel too depressed to go out. Technology that can connect us to the outside world and allow us to engage with others includes:
- Phone calls or video calls
- Sending text messages or using chat apps
- Speaking to others on online forums
- Sharing funny pictures or videos
- Sending voice notes
Having a strong network of people around us can improve our mental health. Being surrounded by people who care makes us feel less alone and provides us with a different perspective when we are feeling negative. Others may also inspire us to get out and try new things and meet people, which in turn boosts confidence.
Building a Mind-Body Connection
Mind-body therapies can help us to feel calmer and more in control of ourselves as they can trigger the relaxation response; this can help to manage stress, regulate our emotions and can also reduce our perception of pain.
Popular mind-body therapies that can help our mental and physical health include:
- Yoga
- Meditation
- Mindfulness
- Tai chi
- Deep breathing techniques
Yoga – yoga has been found to be beneficial for both mental and physical health. It helps with flexibility and balance and can promote a sense of peace and calm. If you don’t feel up to taking a yoga class, consider rolling a mat out in front of your TV or laptop and trying out one of the many yoga videos that can be found online, for example on YouTube.
Meditation – meditation may help to manage the symptoms of depression, anxiety, stress and even chronic pain. Meditation may improve our mental and physical wellbeing in a number of ways:
- Helping us to achieve calm and clarity
- Making us more self-aware
- Improving our concentration levels
- Helping with emotional regulation
- Lowering our heart rate and blood pressure
- Improving our sleep
There are various different ways to meditate, for example mindful meditation, transcendental meditation and body scan meditation. If you are a total beginner and want to try meditation for the first time, you can follow this simple guide:
- Set aside some time (even just a few minutes will do) and find a quiet space
- Sit comfortably and close your eyes or soften your gaze
- Begin to focus on your breath
- Each time your mind starts to wander, bring your focus back to your breath
- Keep breathing and enjoy the sense of calm and peace of being there in the moment
- Once you decide to end the practice, slowly bring your focus back to the present
- Open your eyes slowly and take a moment to acknowledge how you feel before you get up and go back to your day
Mindfulness – mindfulness is a special type of mental focus that teaches us to focus on the present and tune out intrusive and unhelpful thoughts. It is about being aware of your thoughts, feelings, senses and other sensations, but not being overwhelmed by them.
Mindfulness can be incorporated into meditative practices or applied in other ways such as by doing mindful drawing or colouring. You can also practise mindfulness outdoors, by taking a mindful walk where you learn to observe the environment without judging and acknowledge your five senses, such as the smell of cut grass or the sounds of rustling leaves.
Tai chi – tai chi is an ancient Chinese art that involves guiding the body through a series of flowing movements and poses. The physical benefits of tai chi include improved flexibility and balance and it is an accessible form of exercise, especially for people who have reduced mobility or are elderly.
Tai chi can also help our mental wellbeing by promoting a sense of calm and peace and it may help us to focus our minds away from unhealthy thoughts whilst we focus on the deliberate, flowing movements whilst taking deep, slow breaths.
Deep breathing techniques – deep breathing or mindful breathing can help us to focus our attention away from stressors which helps us to calm down. Breathing deeply also increases our blood oxygen levels which can help to improve circulation, boost brain function and improve digestion, as well as reduce the production of stress hormones which can help to stabilise or lower our blood pressure.
Getting Active
If you are struggling to get out and get active due to mental or physical health you should try to find a way to break the cycle of inactivity which can exacerbate symptoms of depression and impact your physical health.
Getting active does not have to be strenuous or high impact; you start small and work your way up to more substantial exercise if needed.
Some practical tips to encourage getting active include:
- Practise a gentle art such as tai chi, stretching or attending a ‘seated exercise’ class
- Make an effort to get out in nature at least once per week for a walk or jog
- Set yourself small, achievable fitness goals (such as taking one ten-minute walk every day)
- Consider using apps or trackers to track your activity and show you that you are getting somewhere
- Try exercising with friends or as a group to make exercise more fun and to keep one another accountable
There may be days when you struggle to motivate yourself to do any physical activity because you feel too unwell or too depressed. In these instances, it is important to be kind to yourself, take small steps, celebrate small wins and rest when you need to. If you are regularly struggling with motivation, it may help you to find an accountability partner who can encourage and motivate you to reach your fitness goals.
Conclusion
The connection between the mind and body should not be underestimated. To keep our bodies healthy and strong and our minds resilient, we should take a holistic view of our wellbeing and engage with a range of treatment options that support us both mentally and physically.