The physical side of mental health - You deserve help!

As you’ve probably already read, I have suffered with mental health problems for the last ten years. It all started when I was diagnosed with M.E (not a mental health problem) at 15, which then led to the development of Clinical Depression and an Eating Disorder. More recently I was diagnosed with a Personality Disorder as well. Over the years, I’ve really struggled with my mental health, but have also struggled with some of the physical consequences of poor mental health. The problem I have often encountered is that because I feel so low and worthless (and possibly embarrassed, depending on the problem) I’ve felt I don’t deserve to ask for help with the physical side effects of my mental health problems.

I’ve been with many different mental health services over the last ten years, who generally do a good job of helping you with your mental health problems (when you actually manage to get the help they provide, but that’s another story). However, something that I personally feel they don’t give enough support or attention to is the physical side of mental health problems. I’ve never felt able to talk to my team about my physical problems, and have found it very difficult to go to my GP with these problems because I’m scared about being judged. I wanted to write a post about this because I believe that you do deserve help with ANY part of your mental health problems, so I thought I would go through a few physical symptoms that I’ve come across (either in myself or others) to reassure you that firstly, they are very normal in mental health, but also that you don’t have to suffer with them alone.

This isn’t a particularly easy post for me to write – some of it feels embarrassing, some of it is very private, but I think the only way to break the stigma is to talk about these things. To make it easier for you to read, I thought I’d break it down into each symptom so if you’ve only got a little bit of time you can identify the symptoms you relate to. I also just need to say that I am in no way a medical expert so please don’t use what I say as medical advice instead of seeing your doctor – this post is meant to help you feel able to talk to your doctor about the symptoms you are experiencing. These symptoms can be related to mental health problems, but they can also be related to physical illnesses, so you should never dismiss a new symptom.

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Constipation

This is a massive problem for people with mental health problems. Medications often cause terrible constipation and I’ve found that my eating disorder has also left me not being able to go. The problem is, you stop eating so you don’t need to go as often and when you do it is incredibly difficult. But, even when you start eating again it doesn’t always get better. Suddenly your body becomes flooded with sustenance again and it can take your bowel a while to get back into the swing of things.

It took me a long time to talk to anyone about this because, lets face it, who wants to talk about poo?! But your doctor will have seen it numerous times before and there are so many things they can give you to make you more comfortable. If you’re suffering from an eating disorder it’s a good idea to have a doctor overseeing any laxative medication you are using, but even if you’re not it is important that your doctor is aware of the side effects your medication is causing you.

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Dental problems

These particularly relate to eating disorders, especially if you are regularly making yourself sick. Obviously if this is happening your teeth are being exposed to a lot of acid, which slowly erodes away your teeth. This is something I have found very difficult to talk to anyone about in the past because people can be very judgemental. However, your dentist is bound by the confidentiality agreement your doctors are, so you can talk to them in confidence about your health. It’s so important to tell them how things are because they can advise you on things that can minimise damage to your teeth, such as washing your mouth out with water after purging and not brushing your teeth soon after. If you’re dentist makes you feel uncomfortable about your eating disorder then request to see a different dentist – they have no right to make you feel uncomfortable and should be there to support you in keeping your teeth and mouth as healthy as possible.

Reflux/Indigestion

Again, this can be a problem related to eating disorders, but stress can also cause pain related to reflux or indigestion. It can be incredibly painful and can also lead to tooth erosion, so if you’re experiencing reflux and indigestion on a regular basis please do talk to your doctor. Try and be as honest as possible with them, so they know how to best treat you. If you’ve been purging for a long time they may want to refer you to a gastroenterologist to check for any damage in your oesophagus, but again, they should not be making you feel judged or uncomfortable. I know it can be incredibly difficult to talk to people when you feel like you are to blame for your physical symptoms, but having a mental health problem was not your choice and you deserve help and care just as much as anyone else does.

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Sleep problems

Sleep problems can be a big part of any mental health problem. You may find you sleep too much or you might find that you can’t sleep at all. Either way it can have a massive effect on your day-to-day life and can actually make your mental health problems worse – it’s a vicious circle. Before you go to your doctor there are things you can do to help yourself (so when you see your GP you can tell them what you’ve already tried). Sleep hygiene is really important – it includes getting into a proper bedtime routine, which may include a warm bath, turning off any gadgets and TV’s and perhaps having a warm caffeine-free drink before hitting the sack. If you’re sleeping too much, try and gradually limit the amount you are sleeping. If you sleep during the day, try and only have a power nap of about half an hour, before trying to cut it out altogether. Your medications can also either keep you awake or make you sleepier, so chat to your doctor if you’re having particular problems, as you may need to try a different tablet.

Chest pain

This symptom comes with a massive disclaimer – NEVER ignore chest pain, as it could be a sign of something very serious, so it’s always important to get it checked out. However, chest pain can sometimes be a result of mental health problems, including stress and depression. It can be incredibly scary, especially if it’s happening for the first time. If you’ve been checked out and everything is physically fine then your doctor should be trying to help you learn how to relax and cope with your pain. Often the more anxious you feel, the worse the pain will become, so ask your mental health team if you can be referred for help with coping with anxiety and stress. Things like breathing exercises and relaxation techniques can be incredibly helpful.

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Fatigue

If you’re not sleeping well you’re going to feel tired. But sometimes, mental health problems do give you extreme fatigue, which can be incredibly hard to deal with. As I’ve said previously, medications can make you feel incredibly tired, so chat to your doctor if you’re finding you just can’t keep your eyes open. It might be as simple as switching to a different type of tablet or taking your medication at a different time of day. It’s also important to try and pace yourself so that you don’t do loads at once and then crash after.

Pain

Pain is another symptom that you should never ignore. It’s your body’s way of telling you that something isn’t right, so you need to see your doctor to exclude anything serious. However, unexplained pain can be just as debilitating and is often a common side effect of mental health problems. It’s incredibly frustrating being in pain and not having any answers as to what is causing the pain. But there are so many different pain relief options that your doctor can go through with you including certain anti-depressants, which act on the receptors in your brain, pain management courses and more standard pain relief like Paracetamol and ibuprofen. However, if you’re regularly self-medicating with over the counter painkillers it is so important to see your doctor as they can affect your liver and stomach so having a doctor overseeing what you take is a good idea.

Digestive problems

Lines are hugely blurred between digestive problems caused by psychological problems and those with a physical cause, and often it is a case of both a physical and psychological problem combined. This is something I really struggle with and it’s incredibly frustrating to not understand why my digestive system is making me feel so unwell. I’ve now been told that the nerves and muscles in my gut are not working properly (a physical problem) but that my mental health can exacerbate symptoms so it’s important to address those as well.

It also works the other way – you have digestive problems that consequently cause anxiety and depression – another vicious circle. I’ve kind of come to accept that with my digestive symptoms I need a multidisciplinary approach with both the physical and psychological issues being addressed. It’s not a short-term problem – I’ve been having problems for ten years and am still being looked after by gastroenterology specialists who are doing further tests and looking at diet. In my opinion it is really important not to put your problems completely down to psychological problems, as even something like IBS has a physical component, which is why it’s important to be looked after by your GP or gastroenterologist as well as your psychiatrist.

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Changes in appetite and weight

Obviously with an eating disorder your weight can change, but this tends to be focussed on by specialists anyway, so I’m focussing more on other mental health problems with regards to weight loss or gain. Difficulties like depression, schizophrenia and personality disorders can affect your appetite and cause you to gain or lose weight, which can be very distressing. Being a healthy weight can really help your mental health, so if you’re struggling to eat enough or are eating too much, do have a chat with your doctor, as they might be able to refer you to a Dietician to help with meal planning. They will also be able to advise you on exercise, which is proven to be a vital part of maintaining a positive mental attitude and can help lift spells of depression. It’s not all about going to the gym though – it’s finding something that you ENJOY!

Menstrual disruption

Medications, weight loss or gain and diet can affect your menstrual cycle, so if you notice any problems or changes it is so important to see your GP. If you’ve lost a lot of weight your periods may stop completely, which needs careful medical observation to ensure your reproductive system isn’t damaged, causing long-term problems. You might not link your menstrual cycle to your mental health but if your body is struggling to cope with life in general, your periods are one of the first things your body stops concentrating on. Don’t panic if you notice any changes – more often than not it’s just a temporary blip, but it’s vital to be monitored by your doctor just to make sure everything is OK.

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Dizziness

Dizziness can particularly relate to anxiety and panic attacks – if you’re hyperventilating your brain can get too much oxygen, making you feel lightheaded and dizzy. But even just feeling anxious can cause dizziness. Your heart feels like it’s racing, you feel a bit clammy and your head is spinning – it can have a massive effect on your day-to-day life and stop you doing things like driving, working and socialising. Your doctor may want to check that there’s nothing physical that may be causing you to feel dizzy, but if that’s all clear you may benefit from breathing exercises and learning some relaxation techniques.

I hope this has been interesting and helpful for you, and that you might feel able to talk to your doctor about a symptom that has been worrying you. If you know of anyone that suffers from mental health problems, why not share this with them to help them feel that they’re not alone in this and that they do deserve help, whatever their problem might be.

Have you experienced any of these symptoms and have you been able to talk to your doctor about it?

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