One of the conversations between doctors and patients that doesn’t work well from either side often starts along the lines of: ‘So you think it is all in my head doctor?’ As a society, we still have a stigma about mental health. This means that talking about mental health and feelings is still hard for a lot of people.

It is particularly hard for people in certain jobs (you know who you are). It is still easier to talk about physical health.

What we realise more and more in healthcare, is that the dividing line between physical and mental health is much more blurred than first thought.

I would go even further and say that pretty much all significant physical health problems have an effect on mental health and mental health problems have an effect on physical health.

We know that those who have serious mental health problems can have life expectancies 15 years less than people without those problems.

This makes sense (but needs to be addressed) when you think that if someone has mental health problems it is much harder to look after physical problems – for example exercise, nutrition or smoking problems.

It simply is much harder and less of a priority.

I believe the same applies (to a lesser extent) for those with high levels of stress or milder forms of depression and anxiety.

It is more likely that you will suffer from long term pain, heart disease, infectious diseases if you are under sustained mental pressure. Similarly people going through a lot of stress at work start getting headaches, neck pains, tiredness. I’m sure this all rings bells….

Likewise we know that one of the impacts of physical illness can often be a deterioration in mental health. For example, people being diagnosed as being diabetic can often get symptoms of depression, and people with chronic obstructive airways disease (COPD) frequently have a diagnosis of depression (about a quarter).

Again, perhaps to a lesser degree, we know that people suffering a period of lower back problems will often become quite low and mentally less well at the same time.

The important point is that it is pretty impossible to determine cause and affect. Mental health and physical health problems go together so lets look at them together.

What this means in practice is that we all need to be more comfortable discussing the impact of a problem on both the body and the mind.

We need to address the causes of both sets of problems, but make sure that we provide good medical care to treat the whole person.