Put the head back on!

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

Mental illness versus physical illness.

For a very long time, physical health practitioners have ignored the connection between mental and physical illness. When someone suggested that the way in which we think can cause physical illness they have been disregarded, or worse. Traditional western medical practice has looked for the cause of physical illnesses everywhere but in our thoughts. That may be about to change.

As I write these words I am getting very nervous. The pictures in my head of cancer patients giving up their meds to participate in some sort of thought workshop scare me. I am not suggesting that some “psychic energy transfer” ought to replace conventional treatment.

But the research, good scientific research, by reputable researchers, keeps pointing to the connections between physical illness and mental illness. No less an authority than the Robert Wood Johnson Foundation has published a report on the subject.

Their conclusion is that the connection between mental health and physical illness is overwhelming and it has huge implications for the direction and cost of healthcare in the future.


Among those with a diagnosed mental illness in the U.S, almost 70% have a chronic long-term physical illness. That might not sound so significant until we notice that in any given year about 25% of the U. S. population has a mental illness. Their conclusion is clear. Those people with a mental illness are not just faking things. The problems are not just all in their heads. The mentally ill are much more likely to develop chronic long-term diseases. But that is only the beginning of the problem.

Almost a third of those people who have a chronic long-term physical illness develop a mental illness. The connection between physical and mental health and illness runs in both directions.

In typical scientific fashion they tell us so far we can’t be sure if mental illness causes physical illness or physical illness causes mental illness. There may even be a third thing that is causing both. What we do know for sure is that very often the two exist at the same time in the same person.

There is a circle or maybe a spiral of risk going on here.

A medical condition with a “high symptom burden” such as migraine headaches or back pain is a risk factor for, which means it is likely to lead to, depression. But the spiral does not end there. Depression is a high-risk factor for heart disease. See how mental illness and physical illness are intertwined?

There is a bigger societal problem in the making here. There are extremely high rates of “uninsurance” among the mentally ill. We also know that many people with chronic medical conditions may lose their coverage if they are unable to work.

Treatment for one problem can make the other worse. Medication for a psychiatric illness like depression or psychosis can result in weight gain making the person’s diabetes worse. Medications for many physical symptoms can make a person’s mental health conditions worse.

In the elderly, and these are the people where we would expect chronic physical conditions to be at their worse, we also have the problem of multiple meds. One hospital study found that among patients who are taking 8 or more meds there was a 100% chance two of these meds were interacting and producing unwanted results. In assessing for cognitive decline in the elderly, a therapist always wants the prescribing doctor to take another look and tell us if part of the problem might be the medications not the client’s loss of mental ability.

Now regardless of how you swing politically, the bottom line here is that those people with mental illness or chronic physical illnesses are at high risk to develop the other condition and then to be unable to work. One way or the other this group of people will end up in hospital emergency rooms and those who can’t pay – well those of us who are still working – we get to pay that bill. This will only get worse as time goes on.

I suppose we could just stop paying for those who are too sick or old to work and pay for their own medical care. It sounds like some are advocating that approach these days. I for one would not care to live in a society that was unwilling to provide care for those who are least able to care for themselves. I also have enough faith in my fellow Americans to think it will not come to that.

But there is another option and support for this option is growing not just in treating the uninsured but also in treating those with the best of insurance coverage. This other option which is growing in popularity is to integrate the treatment of physical and mental health.

Consumers who are less depressed take their heart meds more often and end up in the emergency room less. The reintegration of the two specialties is overdue.

We need to stop treating medical patients as headless bodies and but the head and the feelings back in the equation when it comes to treating the whole person.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

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For videos, see: Counselorssoapbox YouTube Video Channel

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