How we feel about ourselves affects our behaviour. Ignoring physical problems can be affecting a person's self-esteem and susceptibility to mental health problems without them realising it.   


Depression

If we are depressed, we may feel tired, lethargic, not want to get out of bed. We may eat more or eat less. We might find it hard to go to work. We might find we do not have the energy to exercise or to cook proper meals. All of these factors can affect how we feel physically and contribute to physical illnesses.

In 2010, the Royal College of Psychiatrists published research that found that if a person was depressed:

• They had a 67% increased chance of death from cardiovascular disease.
• They had an increase of 50% change of death from cancer.
• Double the chance of death from respiratory disease
• Three times the chance of death from metabolic disease.
  
  

As well as the typical psychological symptoms like depressed mood, loss of enjoyment, negative thinking, and slowness there are physical symptoms associated with severe depression and which sometimes occur in moderate forms of the disorder. These include sleep disturbances and, in particular, early morning waking where the person wakes several hours before they normally do and cannot get back to sleep. They are often preoccupied with negative thoughts during this time.  Reduced libido is quite common. Loss of appetite and weight loss are also common but sometimes there is weight gain where food is used to stave off symptoms.

Other physical symptoms include aching of body parts, constipation and fatigue. Those with severe depression may also complain more about the symptoms of pre-existing physical illnesses and conditions.

Although any medical condition can serve as a predisposing risk factor for depressive symptoms, sometimes depression can be triggered by a specific underlying physical illness like brain disease, HIV infection, or endocrine disorders. Often the associated depression is termed an 'organic mood disorder'.  An example is Cushing's disease in which half of all sufferers develop depression. When their raised blood cortisol levels are returned to normal the depression usually subsides.  

HIV infection and head injury can also cause manic episodes. Brain lesions, particularly in the frontal lobes, may also cause depression.


Anxiety

The physical symptoms of anxiety are dysfunctions of the nervous system. They include a range of symptoms, such as:

• Heart palpitations
• Butterflies in the stomach
• Excess sweating
• Nausea
• Vomiting
• Stomach ache
• Diarrhoea
• Choking
• Shortness of breath
• Dry mouth
  
  

These types of symptoms account for a high percentage of GP visits and are often a consequence of an underlying anxiety disorder.

Some physical illnesses produce symptoms which are similar to anxiety and can be mistaken for them. For instance, hypoglycaemia can produce symptoms which are similar to panic disorder. However, anxiety may present as the first sign of an underlying physical illness. The experience of physical symptoms can lead a person to experience anxiety because they are excessively worried about what the symptoms denote.

Sometimes the physical symptoms of anxiety become exacerbated when a person with anxiety is mistakenly thought to have a physical illness. This may occur because the increased amount of testing and doctors appointments increases the person's fears. In these cases it is helpful if the order of presentation of symptoms is known.