Before the impact of Covid-19, 1 in 6 British workers (and similar figures for the US and Canada) were experiencing one or more of these conditions – and occurrences have increased through the pandemic.
It is widely accepted that the mind and body are closely interlinked. We hear lots about mental health benefits arising from improvements in physical health – from diet to exercise. However, less is reported on the impact that mental health conditions can have on the body. The impact on physical health and longevity from these common mental health conditions should not be underestimated.
In this article we look at the link between mental and physical health patterns and how these may influence future longevity trends.
Mental health conditions can be divided into two broad categories – either ‘neurotic’ or ‘psychotic’. ‘Neurotic’ covers conditions with symptoms which can be thought of as extreme and destructive versions of ‘normal’ emotional experiences and cover the more common mental health illnesses. Stress, anxiety and depression fall into this category. Less common are ‘psychotic’ symptoms which interfere with a person’s perception of reality and may include hallucinations, delusions or paranoia. In this article we focus on the health implications of the more common, but still very impactful, mental health illnesses of stress, anxiety and depression.
Causes of mental health conditions are complex and vary from person to person. It is known that individual genetics, upbringing and experiences can all play a part in why two people will react differently when presented with identical scenarios. Significant and unexpected life changes, perceived loss of control and feelings of loneliness or lack of support are also known triggers.
Symptoms and severity vary from person to person, but what else is happening? The body responds to signals of the mind. Therefore, it is perhaps unsurprising that mental health illnesses have knock on impacts on the health of the body.
The limbic system is the key area of the brain which processes stress. When there’s a perceived threat (even if it is imagined), the limbic system responds immediately via the automatic nervous system. When faced with stress, the brain stimulates the secretion of adrenaline. This chemical travels to the kidneys and triggers a process in which stored glycogen is converted to glucose, increasing the flow of blood. Blood pressure increases, respiration accelerates (to increase the intake of oxygen) and digestion is impacted. When this process occurs over the long term, it becomes a chronic condition.
A study of over 15,000 older adults was conducted in the United States comparing anxiety and depression to obesity and smoking as prospective risk factors for the onset of certain medical illnesses. The findings suggest that a person with high levels of anxiety and depression is significantly more likely to develop a heart condition, have a stroke, develop high blood pressure or arthritis than those without anxiety and depression symptoms. The increased odds are similar to those who are smokers or those who are obese (and are even higher in the case of arthritis).
A study in Denmark, consisting of over 7.3 million participants was undertaken to investigate mortality associated with different types of mental health conditions. The overall conclusion of this study was that all-cause mortality was more than twice as high among people diagnosed with a mental health condition compared to those without a diagnosis.
The study examined the relationship between different mental health conditions and life expectancy. Focusing again on neurotic disorders, the study showed a lower life expectancy for males of around 8 years and females of around 7 years. This was split further to look at the impact due to “natural causes” and “external causes”. This split showed that people with neurotic disorders have some premature mortality which is attributable to suicide and other external causes of death. However most premature mortality is attributable to causes of death related to general medical conditions, including infectious disease, neoplasms, diabetes, circulatory system disease and respiratory disease.
There is a significant link between mental health, physical health and life expectancy. Any changes to the number of people living with mental health conditions, or our ability to care for people with those conditions, could have significant effects on future longevity improvements.
On one hand, aging populations and lack of funding are causing strains on our health systems, particularly in the field of mental health. On the other hand, we are seeing a stronger awareness across some parts of society of the importance of taking care of mental health. Many companies now offer flexible working and access to mental health support and have a greater focus on work-life balance. However, a study by the mental health network NHS confederation still showed an expectation that by 2030 there will be approximately two million more adults in the UK with mental health conditions than there were in 2013.
In addition, it is possible that the pandemic will cause a step change event in mental health for some people. We do not yet know the full effects of the mass lockdown measures or the fall in economic activity, but their implications for long term mental health could be significant and are likely to be felt differently across society. Whether people are isolating on their own or with their family; whether they are front line workers, can comfortably work from home or have been furloughed or lost their jobs; whether someone lives in a large house with a garden, or a studio flat; whether someone is comfortable with virtual communication or not - all these things will affect overall outcomes.
We know that life expectancy varies significantly across the membership of a pension plan or insurance book due to a wide range of factors. The prevalence of some mental health conditions can also vary between occupations and differences in age, gender and even the size of the company that a person works for can lead to differing instances of mental health conditions.
The pandemic has had, and continues to have, a huge impact on everyday lives of most people in the world. At a time when lives have been changed dramatically, it is our hope that the positive focus on the importance of mental health support continues and strengthens further in the period following the pandemic. We haven’t seen a change like this before, and the full impact is yet to be seen. Pension plans and insurers should be considering whether their population are particularly vulnerable to mental health strains and continue to monitor emerging data for longevity improvements, paying particular attention to how things develop in the coming years following the pandemic.