Prepared Patient: Managing Mental and Medical Illness

In her 1984 boot camp graduation photo, Adrienne Fitts is smiling. Her hair is neatly groomed, her Navy cap and dress whites are spotless and she is regulation fit and trim.

Flash forward to 2001. Fitts, now a retired Gulf War veteran, struggles with a mental illness called schizoaffective disorder. She is 90 pounds heavier and has developed type 2 diabetes. She is certain her regimen of antipsychotic drugs (“there are so many”) caused the diabetes as well as high blood pressure.

In April 2006, Adrienne Fitts suffers a stroke.

And there's Gloria, a 56-year-old legislative advocacy worker, who also deals with both a major mental and medical condition. Gloria,has long-term clinical depression, neurological problems and on top of that, partial kidney failure.

“Multiple conditions are not rare and they become even more common as people get older,” says Dennis Freeman, Ph.D., the CEO of Cherokee Health Systems in Tennessee.

“Twenty-five percent of people in a primary care practice have a psychiatric illness,” says Wayne Katon, M.D., vice chair of the department of psychiatry and behavioral science at the University of Washington School of Medicine.

Children are vulnerable, too. “Kids with asthma are more likely to have every kind of anxiety and depressive disorder,” Katon says. “This makes more of an impact on school performance and the ability to make and keep friends. Parents and schools have to be especially watchful for the additive effects of having two conditions.”

For many people, physical conditions can contribute to problems with their mental health—problems that are often ignored and untreated. But your emotional health and physical health affect each other. Here’s what you should know.

The stakes are high.

When recovering from a heart attack, it’s natural to be focused on your physical recovery rather than your state of mind, but the two are intertwined, says Eric Goplerud, Ph.D.

“A heart attack produces large amounts of cortisol that precipitates depression,” explains Goplerud, the director of the Center for Integrated Behavioral Health Policy at George Washington University Medical Center.

“At least twenty percent with heart attacks have severe depression—and these people are three times more likely to die if the depression is not dealt with promptly,” he says.

“People who have mental problems often have other health problems and they come together in legion,” Goplerud says.

Drugs that help your mind can harm your body.

In a health care Catch-22, the same drugs that help people manage bipolar disorder, schizophrenia and depression can have serious physical side effects.

As part of her treatment, Fitts has received some heavy-duty drugs, including olanzapine.