AIBU to think doctors of patients with MH issues should also look at the physical health?

[OftenHangry]

I sincerely hope no one affected will take this the wrong way.

I have met number of people with MH issues and realised majority has one thing in common.
Extremely poor diet and lack of physical check ups.
I understand everyone is different and everyone's issues are different but I can't help but think that if doctors concentrated equaly on mental health and physical health, many patients would recover better.
One person with extreme anxiety basically lived on chicken nuggets. That's it. Never touched vegetables. Another one drinks a lot. A lot and our suspicion basically is that the alcohol caused anxiety since she was fine before. Many others were on similar diets lacking the healthy food groups. None took any vitamin supplements. That obviously leads to lack of vitamins and minerals, but they don't know because no doctor ever suggested to have it checked and change diets.
Who had vitamin deficiency knows that it can mess you up pretty well physically and psychologically. I myself ended up in horrible state when I had vitamin deficiency.

AIBU to think that MH care should be mixed with physical care to achieve better results for patients?

Being badgered to eat better, take exercise etc doesn't make it easier, in fact makes the depression worse as it's yet another reason to feel crap about yourself, but sorting the depression makes it easier to sort the lifestyle issues.
This ^^. I have autism & struggle at times - when I'm struggling I don't eat properly. I eat crap & comfort food, don't make proper meals etc. I need to have quick things in the freezer like mini pizzas or bags of frozen pasta just so I have something reasonably healthy as otherwise I'll not have the mental capacity to sort something and will end up with biscuits or similar. I know how to eat properly & I can if I'm in the right place mentally. But when I'm not it takes all my mental resources to just cope. Feel free to send a doctor round to cook for me at those times!

Well no one is talking about 'badgering' people into doing exercise etc.
We are talking about some kind of kickstart and most importantly the actual link between body and MH being quite ignored in most instances even by doctors.

I have freezer meals at home for busy days, there is nothing wrong with them, especially if they are on the healthier side.

I personally think the attitude towards health needs to change in general. And attitude of counselling staff. I wonder if it was just these few, but apparently they are there to listen. Not come up with things like tools to cope, how to slowly change lifestyle and other things. Is that truth? From what I heard from these few people I mentioned before, it sounds like counselling basically just gave them pills and place to talk about their issue, but no kind of solution or advice.

For ages gps have run registers of patients with severe mental illness (because of premature deaths) - they drag you in once a year and check you over for diabetes and stuff and get a few £££ per person in return.

I feel like every time I have an issue physically, it's put down to my history of mental illness. 2 years ago I was having terrible pain under my right rib cage, vomiting, stomach upsets, even a slight temperature. My GP told me it was anxiety and medicated me as such, 3 months later I collapsed and was rushed to a&e and had a massive gall stone which was now lodged and causing my pancreas and liver to start failing. I had emergency surgery and am fine now, however the 3 times I saw a GP they didn't look deeper than my MH problems. I wasn't suffering with depression or anxiety at the time, just pain and illness, and I know the difference, but no one wanted to listen.

No, counsellors don't just let people talk, or offer medication, depending on the type of therapy offered. This differs for each condition and also for each region of the country. Some see the person as a whole, addressing each need, some don't.

One of the best types of help I got years ago was 'Gym on prescription'. Gave me the opportunity to exercise in a safe space, tailored to my diagnosis. Only short term but v v useful.

What I DO hate is the Public Health messages about running or whatever being good for your mental health and why aren't you out there doing it (etc etc). If I was feeling well enough, I would give it a go, but when you're so low, running or exercise is the last thing you want to do.

Blood works a good idea, but the additional cost to the NHS would be huge. Holistically trained GPs would be a good start.

There are national initiatives about looking after physical health in mental illness
All inpatients where I am get all bloods including lipids and bmi and regular blood pressure checks
Patients in community on antipsychotic medication get yearly bloods and ecg from me and discussion of healthy lifestyle and signposting to help (walking groups, local cooking skills workshops and other local initiatives)
It is big on our agenda

I wonder if it was just these few, but apparently they are there to listen. Not come up with things like tools to cope, how to slowly change lifestyle and other things.
More often than not though someone with mental health issues needs someone to listen more than anything else. It gets the thoughts out of their head so they can see them more clearly (and then address them) AND they get to feel like someone actually gives a toss. Once you've started talking things through then a counsellor can start helping the person come up with coping mechanisms, but until the counsellor knows what the problems really are then any coping mechanisms offered are likely to be skewed, plus the person isn't going to be ready to even consider them.
You're making it sound as if getting everyone eating their 5 a day will make everything okay. 'Have an apple and a long walk and you'll be fine' rather than 'Tell me what seems to be the worst thing right now, and maybe we should discuss some sort of medication so we can stabilise your moods (if appropriate) and put in you in a better position to sort things out.'

I think too many people see mental health and physical health as entirely separate and unrelated when of course they impact each other. The whole thing about us being a mindbody rather than Mind. Body. can help.

Theres a lot of evidence to suggest poor gut health can impact mood as well as other physical ailments.

Ive had doctors tell me that food can never impact my mood or skin conditions in the past. There needs to be more education.

(It can and did..better diet led to improved symptoms in mood and skin)

All that being said its hard to cook decent nutritious meals when really depressed. I try and make extra portions when im feeling more on top of things and freeze them.

With respect Nike I believe saying one or the other is what people need more is what leads to this idea of a separation. I think people need talking therapy AND practical help to heal the physical side to things and support their brain health..which is, after all, just one more organ in the body.

My GP/CMHT has been doing this for years. My pdoc is very good about picking up on things that may have a physical cause (eg he was the one who found I had low vitamin D levels).

I’m in Scotland—don’t know if that makes a difference.

A final point is that I think you need to make a difference between those who have mild MH problems that can be/are treated by a GP (& they have a good chance of ‘recovering’) And those who are classed as having ‘severe and enduring mental illness, and have weekly CMHT appointments and take a shit-load of meds. For example, many of the meds that are used for bipolar and schizophrenia have weight gain as a side effect (& it can be a hundred time harder to not gain weight.)

PS, sorry, I meant to add that my GP calls people in with severe and enduring mental illness every year and do blood tests etc.

Exercise and balanced diet definitely help. The issue is when you’re suffering with poor mental health, it seriously affects your motivation. I focus on getting to work as I need to provide for my child, so my eating really suffers. It’s hard to get it all right plus hiding your poor mental health for fear of ridicule is also a challenge. It’s a vicious circle. I now have a long break so have been exercising and eating healthily. I still suffer with anxiety and depression, but it’s much better with exercise and good food.

You're making it sound as if getting everyone eating their 5 a day will make everything okay.
That wasn't my intention. But tbh. It sounds from other people on this thread that it can help to some. Not all but some.

@Nikephorus I get that listening is very important and having someone to talk to can really be groundbreaking for some patients. Though a girl I know had counselling for years and years and yet they haven't apparently given her any coping tools. Just listened to her. I feel like there should be more balance.

@MissusGeneHunt it would be more expensive when starting, but considering there is already few of us who had physical conditions confirmed causing the MH issues, it might actually save money on therapy in long term. Plus it could potentially take some strain off the support services if they had fewer patients. Not massive number I assume, but every space counts?

@abitoflight That's great to hear! Has it made any difference?

Yanbu.

Doctors act like depression is the only thing that could be making you ill ime.

This thread has struck a chord, a big hefty one and the diet/MH connection has been discussed consistently because I cannot prepare my own food now. As you can see by my username, I'm not working now, because despite me asking, until 2 years ago I wasn't taken seriously. I became suicidal and my energy levels so bad I was unable to make a cup of tea. I was (still am) being treated for depression, but, in comparison to other issues that is a fly itching my nose. If they had listened when I said "I can see 6 of everything" and "I can't swallow properly and keep choking" and countless other comments I may have benefitted from appropriate treatment in a timely manner.

I worked hard in my work, I had a brilliant career and I absolutely loved it. I was studying my 2nd masters, travelling as a solo female to weird wonderful places BUT I knew I was unwell and noone would listen. "When you have depression..." or "if you stopped drinking coffee" (I don't, they assume way too much!) there was always some annoying phrase.

I cannot tell you haw sad I feel right now. Because everything was wrongly attributed to depression, they missed motor neurone disease and an extremely rare eye condition so I am now legally blind to boot (please, don't start the old 'how can you type on mumsnet' jokes/questions).

As soon as the motor neurone was diagnosed I saw an amazing team of therapists (OT/PT/SPEECH) and within a week they got me eating properly again and my energy levels increased. My GP has ASSUMED I wasn't eating because of depression. He needn't have assumed because I kept bloody well telling him!

My low energy was also put down to depression, only it wasn't, it was muscle weakness caused by motor neurone disease. And on it went, all those symptom and none of them were depression.

I know that with my condition an early diagnosis wouldn't change the outcome. However, my my eye condition could and should have been picked up and treated and I wouldn't be blind.

I joked with a colleague after my motor neurone disease diagnosis "at least I don't have to continually obsess about my suicide plan now! I get the end handed on a plate, no fuss, guilt or blame". Except, it isn't really funny, is it?

YABU. The people I know with MH issues (myself included) have the same healthy diet and lifestyle as everyone else. It would be incredibly patronising, pointless and time-wasting for doctors to put their MH problems down to diet/lifestyle. Unfortunately, pure mental illness often exists when there is no physical "reason".

I have depression, GAD and PTSD. I haven't seen a GP in 8 years for myself (seen them in passing at 2 x 8 week checkups for my children).

Neither my Psychiatrist or Psychologist have said anything about my physical health.

Half the time I don't eat properly at all. I cook healthy food for my 3 year and dh but cooking and touching food revolts me when I'm at my worst. I also have a lot of body issues. I walk a lot with the pram but I struggle with actual exercise because it makes me feel hugely self conscious and worse than ever because I'm so unfit compared to where I used to be.

At my worst though, I would not engage with anything pushing the physical side because trying to self destruct is a feature of my illness. I know I don't eat to punish myself, I don't need anyone else to tell me that or suggest healthy recipes. Ditto exercise, I push myself beyond the hurting point to remind myself of how useless I am. I use it as sanctioned form of self harm. Neither of those things make me feel better but there is a definite assumption they should which just makes me feel worse.

YANBU.

This actually happened to me. I've been depressed for a year. Finally went to the GP and they actually did a full blood test as well as prescribed anti-depressants. I was severely anemic which then led me to get treatment for other health problems I'd been neglecting since having kids.

I don't know if I was depressed because of my health problems or my health problems were caused by being depressed. Last thing I wanted to do was actually look after myself by eating and exercising. There are also lifestyle factors as well. I know my current lifestyle is creating a lot of my issues. I'm not sleeping enough, my job is stressful and I have little, if no time for myself. No amount of antidepressants will help if I don't make changes to my life style as well.

So yes, I agree a more general holistic approach is needed for mental health.

I'm not saying that improving physical health CAN'T help mental health, I'm saying that often UNLESS you improve mental health a certain amount the person CAN'T work to improve their physical health. Hence if someone gets the opportunity to talk or have appropriate medication then they might sort things out in their head enough to be able to start looking at taking a bit more exercise or eating better and then that might in turn improve both physical & mental health.

If you have problems eating, which is at some point really understandable, have you considered vitamin & minerals supplements? I think that can be a great help.

Walking with pram is much better than running! Walking is actually healtier than run.

It's really interesting to read all the opinions and experiences. Though sometimes like in case of @ReluctantBenefitClaimant they are actually horrifying...

@Quangot I am not sayin all MH issues can be influenced by physical helth/illnesses. I am using 'some' basically all the time to make sure it doesn't sound like I mean 'all'.

there definitely is a need for mental health care and physical health care to be better integrated. It doesnt help the way services are set up, or how staff are trained. In mental health teams across the country they do look at bloods, get dietitians involved, look at risk factors for diabetes / heart disease etc. Also encourage activities and exercise for health and mood.
In GP this might not happen but should, though GP resources are so pushed.
Whilst physical health care is a huge agenda for those working in mental health, it hasnt gone the same way. Those in physical health care (for example a&e) arent always tuned into mental health and can be dismissive. Also diagnostic overshadowing - youve got anxiety so therefore the pain is anxiety etc

Couple points.

Agree with PP that a holistic view is good
But also that poor diet etc can be a symptom not a cause

Further

Too many people - and actually this seems to be mainly an issue for women - are diagnosed with mental health problems when they actually have a physical illness (sometimes serious, I actually know someone whose wife died recently, she was considered to be anxious and depressed, she had cancer)

Also that mental health issues can be an understandable reaction to other stuff, but the other stuff is not added because it is too big a thing. Eg friend worked with girls with severe mental health issues, she said that they had all been subjected to severe sexual abuse, but this was never really acknowledged or addressed, they were just seen as troubled, unstable, difficult, off the rails.

Another family member worked with people getting ect they said that for some of the women their partners were right bastards and she wasn't surprised they were miserable....

Of course there are depressive conditions etc that just occur but I really think there is stuff that is failing people tbh

You've also got to consider the impact mental health has on physical health. I lost interest in food, exercise, going outside when I was at my worst - if one more person had told me to drink more/exercise/whatever else to cure my depression and anxiety I'd have exploded.

Also I appreciate you're not trying to offend, but you're essentially blaming people for their MH! And piling onto someone with one illness telling them yet another thing they're not doing right (how it feels when someone is trying to help but smashing any self worth) and it won't help. If my GP had told me my diet was part of why I was anxious, I wouldn't have felt safe or heard.

Can I ask you here with MH if you ever had the [blood] tests done? Or if doctors, not just gps though, suggested any vitamin supplements, diet etc? Or have you yourself asked for them?

I did, but it wasn't to do with MH - just levels of vit D and other blood checks. Since I'm not overweight, always had some sort of exersize (swimming) and ate healthy stuff, the main GP help for me was the pills. It worked. If I came with anxiety/ tears/stress and all they said was "eat healthy, exercise, have a cuppa" I'd thought it was a shit GP.

but you're essentially blaming people for their MH
No one in here is blaming people for their MH. The discussion is basically about the possible lack of looking at physical side as much as the psychological side and considering them both by doctors when diagnosing and treating.