One in five aches and pains caused by stress-related mental health issues, says psychiatrist

One in five of all physical complaints seen by GPs and consultants are related to mental health issues, a leading consultant psychiatrist has said.

Prof Jim Lucey, director of St Patrick's Mental Health Services and professor of psychiatry at Trinity College Dublin, has said many common physiological symptoms including muscle aches, joint pains, headaches and even dental pain can be caused by stress-related mental health problems.

He has urged doctors not to shy away from raising mental health issues with their patients when they present with physical pain.

Threat and hazard
Speaking ahead of an Irish Society of Rheumatology conference in Co Meath yesterday, Prof Lucey said the bulk of mental health disorders could be seen as stress-related. Responding to threat and hazard, the body pumped out chemicals including adrenalin and steroids, he said.

“The consequence of that in long-term distress is toxic for you in terms of your ability to function and relate, to lift your spirit, to react, and is also toxic in terms of your body.”

Those who came to the doctor with many common physiological symptoms, such as muscle aches, joint pains, headaches and chronic fatigue, could have a problem based partly or wholly on stress-related mental health issues.

The physical symptoms were very real and the physiology of these stress-related phenomenon was very sophisticated, Prof Lucey added. It may be a combination of stress, infection and recent trauma.

“All those things are in a soup and the outcome might be joint pain. Proper management comes to a point where you have unexplained medical symptom in about a fifth of cases.”

While doctors were becoming aware of this, they often did not engage the patient on the subject or help them address their mental health problems.

Recent research had shown that just under 20 per cent of physiological complaints have a root either entirely or partly linked to mental health issues.

Recovery rate
A person who has a heart attack and is not depressed has a very good recovery rate, but "if you have a heart attack and are depressed, you are four times more likely to succumb".

Prof Lucey said a holistic view was required that recognised that high stress, high steroidal involvement and high levels of inflammatory chemicals in the system delivered a result that is deeply distressing; everything was not down to a test and a pill.