>> Wednesday, April 11, 2012
It’s a classic Catch 22 - ignoring mental health issues could make you sick, and being sick could lead to mental health issues, according to local experts.
Health care providers emphasize the inextricable link between our mental and physical well being. According to Jasen Garrison, L.S.W., the clinic director of the Scioto Paint Valley Mental Health Center in Hillsboro, “The two can't be separated.”
Michelle Dodds, C.N.P., with Adena Family Medicine in Greenfield, agrees, saying,“I believe patients need to be treated holistically. If you don't treat every aspect of that, you're leaving something untreated and not treating the whole person.”
Bob Stinson, Psy.D., a clinical and forensic psychologist from Westerville, says, “Some of the consequences of mental health problems can lead to physical problems. If you're depressed, you're not eating healthy and not exercising and then you get into a cycle. Then you gain weight and you're not sleeping right, which leads to self image issues which make your depression worse.”
Garrison added that if an individual is depressed and has a cold, for example, it could get worse. “But we see the opposite of that,” he said. “We'll see young folks who will have an episode. We'll find out that they've had a cold or some sort of physical ailment that served as trigger for that episode.”
“I've seen many patients come in with chest pain or stomach problems, and after running a complete workup, it comes down to depression or anxiety which is causing their physical symptoms,” Dodds said.
Depression is the number one diagnosis in primary care, Dodds said. “If you look statistically over the course of a week, you would have more people diagnosed with depression than any other chronic health condition.”
One issue people often dismiss is stress, which Stinson said can suppress the person's immune system and they eventually could have a “worse course” for chronic illness.
Garrison said that a presenting problem with which he deals frequently is someone with an adjustment disorder. People have “an adjustment to a physical disability whether that means someone has had a severe break and can't work for several months or has been diagnosed with COPD or heart disease,” he said.
Michael Chopin, of Greenfield, knows firsthand about adjusting to a serious injury.
When Chopin removed a fallen tree limb on the property he managed after Hurricane Ike had blown through Ohio in September 2008, that decision would lead him to years of regret … but also to an opportunity of self-discovery he may not have otherwise had.
Chopin was the caretaker at an apartment complex in Riverside when the storm came through. A tree limb on his property had fallen in the road, impeding emergency traffic. He was motivated by a concern for the general public, and also a sense of responsibility as caretaker of the property.
“I was limited in my access to tools such as a chainsaw to make the work easier and thus jerked, pulled and rolled it out of the road,” he said. “What I didn't realize is that I also jerked and pulled myself, injuring my lower back. I spent what seems like ages alone and isolated worrying if I would ever get any better and have a 'normal' life again.”
The upside for Chopin is that enrolling in group therapy encouraged him to do more things on his own, “to go and get it done and not so much rely on other people to do it.”
Because the mental and physical parts of who we are overlap, the cooperation between an individual's mental health care provider and primary care doctor is important.
“We're moving in the right direction in terms of coordinating health care, but for so long the primary care doctor would say, ‘Get mental health treatment,’ and vice versa,” Stinson said. “We need coordinated care where the two are working together. We're moving in that direction. We're not there yet, but it's extremely important we get there.”
“The cooperation is absolutely vital,” Garrison said. “The thyroid plays a role in mood so that one of the first things we do when people come in if they're meeting criteria for mood disorder, is have them go see their primary care doctor and have a complete workup.”
Garrison puts a final emphasis on how important the mental and physical connection is by saying that almost every single diagnosis in the DSM IV (the diagnostic manual used by mental health care professionals) has this qualifier: “Due to a medical condition.”
Chopin said, “I may never fully heal from that injury, but at least I have learned how to lift” – the physical application – “and when to lift” – the mental choice.
Lora, of Hillsboro, is the health and wellness editor for Salt and the southwest group online editor for Ohio Community Media. She trains and competes in triathlons and blogs about those experiences at theironmountaineer.blogspot.com.