The Physical Cost of a Mental Health Diagnosis.

This isn’t anything about my book. It’s not anything about me as a writer. It is about me as a person. A person with Borderline Personality Disorder, Anxiety and Depression.

There are many academic studies about the links between poor mental health and poor physical health, I’m not offering anything new, I’m just documenting my own experience.

I first started to think about this whilst walking to my GP this morning, I was seeing her mostly for a mental health review but was also thinking about some of the physical ailments that are plaguing me. I’ve long given up trying to get these addressed by my GP, I’ve become used to issues being put down to ‘stress’ but as I walked there I pondered on just what the physical cost has been for me.

I first got acutely unwell with a mental health condition two years ago and since then have continued to be so unwell that I have not been able to work, over this time I’ve noticed many changes to my physical health, many of which have become chronic. This isn’t a ‘woe is me’ call for self pity but it is a documentation of my own experiences that I guess I hope might make some people see the complexity of living with a mental health condition and might make others realise that it’s not just them that are caught in the catch 22 of mental health issues impacting on their physical health and vice versa. Perhaps there is even a part of me that hopes that by mapping it all out I manage to find a way of breaking my own cycle of ill health.

I have noticed that my physical health problems seem to stem from three areas: 1) The direct impact of stress/mental ill health on your immune system, 2) Self neglect, 3) Self harm. There is some overlap and I don’t claim to be an immunologist so a lot of this is anecdotal.

1) There are many resources about how stress affects immunity but in very simple terms stress hormones lead to the suppression of the immune system as it lowers the numbers of lymphocytes that you produce.

In me this has manifested in an increase in viral infections such as colds and vomiting bugs and a delayed recovery from such bugs. I also suffer with an increased number of mouth ulcers and skin infections; these are made worse by self neglect and in turn feeds into a negative self image and esteem issues.

I have digestive issues that are consistently put down to stress. At times of acute stress your body goes into fight or flight mode and part of this response can be to slow your digestion down, when the stress passes somewhat your body tries to compensate with speeding digestion up again. For me this affect manifests itself in alternating constipation and diarrhoea, bloating and sluggishness and gastric reflux, heartburn and frequent vomiting. It’s not much fun, and is something that I have to contend with daily.

I get eczema on my hands and feet at times of high stress. I have panic attacks that can aggravate my asthma. I get painful and ugly areas of psoriasis at the back of my head.

I also suffer with frequent headaches, insomnia and subsequent exhaustion, all of which are caused by the effects of stress and anxiety on the immune system.

2) Self neglect. This is a difficult one for me to admit to and is something that causes me a lot of shame. I’m not even talking about wilful self neglect, the issues I have are more caused by exhaustion and memory issues. A combination of my medication regime and my constant tiredness has had a negative effect on my short term memory, this can cause my hygiene regime to slide, I can forget to brush my teeth for days on end, leading to gingivitis, mouth ulcers and receding gums. It’s not that depression makes me not want to care for myself it’s literally that I forget to, then I see my poor dental health and I give myself a severe talking to and I decide it will change. Then I forget. It’s a difficult thing to explain and a painful thing to admit to. I suspect the small skin infections that I get, especially small spots that have plagued me across my breasts for over a year now, are down to me lacking in a good hygiene regime. It makes me feel disgusted with myself and yet is ongoing.

Lack of good diet and inactivity have led to me gaining four and a half stone over the last two years. I have no doubt that my poor diet and lack of exercise regime also impact on my digestive issues. My weight has caused an increase in joint issues and back pain. I’m noticing that I get increasingly out of breath, especially in the cold weather. I know what I should be doing but struggle with exhaustion and inertia, I suspect with large doses of shame stopping me from wanting to get out and exercise too.

Poor compliance with medication is something else I struggle with; I sometimes think that this falls into the next category of self harm but nine times out of ten it is due to either a bad memory meaning that I simply forget to take them and then a vicious cycle of a fear of side effects once I get back into following my drug regime. The biggest side effect I get comes when I miss just one dose of my quetiapine, I get drowsy, will sleep all day and this then impacts on my ability to eat well and be more active.

3) Self harm. I’m not really talking about cutting myself or overdosing; those are often elements of mental health issues and have featured in my mental health history but I am mostly talking about daily things that I do that I am doing to hurt myself and that I know impact on my physical health. Over eating is an obvious one. I hate my fat and yet I binge, I binge eat so that I feel even more justified in hating myself. Sometimes I binge eat until I’m sick. I tell myself that this is me trying to retain some form of control but I suspect it’s another way of me justifying self loathing. Self sabotage is another frequent mode with which I cause myself psychological harm; I understand that it is quite common with personality disorders, you set yourself up to an emotional situation that you know will cause you harm, you pick fights, you become needy, you put yourself in situations that you know you won’t be able to manage, By putting pressure on yourself and failing you then feel more justified in your negative images of yourself.

There are probably other things that I do, things that either I won’t admit to myself or just can’t see as harmful behaviour but I do see how my destructive streak can cause me to binge drink, binge eat and partake risk taking behaviours all of which have a negative impact on my life as a whole.


As I say I’ve not written this as a request for help or for a search for sympathy. My mental health follows peaks and troughs and as much as I know that I have a long way to go before I feel ‘well’ I know that I am taking steps towards recovery. Maybe me acknowledging how all encompassing it has become will be another step. I can but hope.