When Health Conditions Co-Occur: The Complex Relationship Between Comorbidities And Mental Health

Medically reviewed by Julie Dodson, MA, LCSW
Updated October 18, 2024by BetterHelp Editorial Team

Comorbidity is a term typically used to describe when a person has more than one medical condition at the same time. This can be quite common in the world of mental health. For instance, a person might be diagnosed with a mental disorder like anxiety and later be diagnosed with a physical illness, such as fibromyalgia. Similarly, they might be diagnosed with multiple mental disorders simultaneously. Because co-occurring conditions can sometimes amplify both mental and physical symptoms, having more than one health concern at the same time may complicate the treatment process. One or more healthcare providers may work together to personalize treatment and improve symptoms. A licensed therapist, whether in person or online, can be a vital part of this treatment team.

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Are chronic diseases taking a toll on your mental health?

How common are comorbidities with mental health disorders?

While it’s difficult to say exactly how often comorbidities happen among people with mental health disorders, research suggests they can be quite common. In one study, nearly one in five adults in the United States was found to have a mental illness, and many of them experienced comorbid conditions. 

Another study found that around 45% of people living with mental illness have a diagnosis of at least two mental or psychological disorders

Additionally, almost 20% of people with a mental health condition may also have a substance use disorder.

Some common examples of comorbidities can include the following:

  • Depression and anxiety disorders
  • Substance use disorders and mood disorders
  • Post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD)
  • Eating disorders and obsessive-compulsive disorder (OCD)

However, comorbidities aren’t just limited to mental health conditions. Having certain mental health conditions, such as depression or bipolar disorder, may also increase the risk of chronic physical conditions like diabetes or heart disease. 

Coexisting conditions can interact with each other, often affecting the symptoms and severity of both disorders. The National Institute on Drug Abuse acknowledges that comorbidities can be a severe problem, especially when it comes to mental health conditions and substance use disorders. People with multiple mental health disorders typically need a well-rounded treatment plan that considers the interactions between multiple conditions. 

The effects of chronic conditions on mental health

People living with chronic conditions, such as heart disease, diabetes, and cancer, often find that these challenges affect their mental health. The emotional toll of managing chronic health problems may contribute to feelings of sadness, stress, or nervousness. In some cases, these emotional challenges might even lead to the development of mental health conditions like depression, anxiety disorders, or substance use disorders.

The link between multiple chronic conditions and mental health can be complicated. People living with chronic illnesses may feel swamped by the demands of their conditions, such as following strict medication schedules, going to various medical appointments, and making changes to their lifestyles. 

Living with a chronic illness can also affect someone's quality of life and lead to feelings of loneliness and fear about what's to come. On the other hand, poor mental health can worsen the symptoms of chronic conditions, potentially creating a cycle that may be hard to break.

If you’re living with a chronic disease, your healthcare team may support you in the most comprehensive way possible. This generally means they will consider not just your physical health, but also your mental well-being. You may be referred to various services in mental health, primary care, family medicine, and other specialized services. Although it can be difficult to manage both physical and psychological challenges, support and treatment are often available to improve outcomes and overall quality of life. 

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Risk factors for mental illness comorbidities

In general, there are various risk factors, including environmental, genetic, and socioeconomic factors, that can influence the development of comorbidities. Some risk factors may be preventable and within our control. 

However, there are often factors we can’t control, such as our genes. A healthcare provider may assess an individual’s risk factors to get a complete picture of their health condition. 

Some potential risk factors include the following:

  • Genetics and family history: Just like hair color or height, our genes and family background can sometimes make us more likely to have certain health problems. If an individual’s family has a history of mental health disorders, that person may be more likely to have comorbidities.
  • Substance use: Using substances or alcohol can increase the risk of developing other mental health disorders. For example, a person with a substance use disorder might also start to experience anxiety or depression.
  • Environmental factors: The environment in which we were raised, and currently live can affect our health. People who went through major stress, trauma, or difficult experiences in their childhood may be more likely to develop comorbidities.
  • Access to healthcare: If a person doesn't have sufficient access to healthcare, or if their mental health condition isn't being treated properly, they could develop co-occurring health problems.

Every healthcare professional involved in a person's care, from therapists to family doctors, can be important in managing risk factors and treating comorbidities. They might work together to give the most effective care possible. However, knowing the various risk factors may also be helpful in avoiding or managing additional health problems. 

Strategies for managing comorbidities and mental health

Living with more than one disease at a time, especially when mental health is involved, can be difficult. However, there may be effective strategies to manage comorbidities and mental health. 

One way to manage multiple conditions can be to treat physical and mental health problems together. This route might involve different healthcare workers sharing information and working together to create a care plan that takes all of a person's health concerns into account.

Another helpful method could be using what's known as a collaborative care model. This generally involves a team of healthcare professionals, such as a primary care doctor, mental health specialists, and others, all working together to provide proper care. By keeping lines of communication open, individuals with complex health problems can receive treatment plans personalized to their needs.

In addition, disease management strategies may involve managing the risk factors that can lead to both physical and mental health challenges. Engaging in healthy habits, getting educated about health, and finding early treatment may lower the risk of living with more than one health problem at a time.

Support systems in managing comorbidities and mental disorders

When a person is living with multiple health problems, a support system can be key to overcoming various symptoms and maintaining a positive outlook. A support system could include family, friends, support groups, and mental health professionals who can provide emotional assistance, resources, and practical help. People with a strong support network may experience less stress, which could assist in improving their mental health. 

Having someone to talk to or ask for help can make it easier to work through the challenges of having multiple health conditions. Support groups, whether in-person or online, can also create a sense of community and shared experiences. As a result, people with multiple conditions may feel less alone.

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Are chronic diseases taking a toll on your mental health?

Benefits of online therapy

Living with a mental illness can be challenging on its own, but combined with a physical condition, life can feel even more difficult. If you’re having a hard time coping with a mental or physical health condition (or both), online therapy may provide a convenient and effective way to access support. Instead of commuting to an office location, which can involve long drives and heavy traffic, you can connect with a therapist from the comfort of your home. Platforms like BetterHelp generally allow you to choose from video chats, phone calls, or in-app messaging to speak with your provider. With a wide network of licensed therapists who focus on different areas, you can find the right match to help you manage your mental health and cope with comorbid conditions. 

Effectiveness of online therapy

Research has frequently shown the effectiveness of online therapy in treating a range of mental health disorders. In one study, researchers found that an online cognitive behavioral therapy intervention could effectively manage and treat conditions like depression, anxiety, OCD, bipolar disorder, PTSD, chronic pain, phobias, and more. Researchers also explored ICBT’s role in treating comorbid medical conditions like diabetes. From the research they compiled, they concluded that ICBT could be effective in treating mental health and medical illnesses with psychiatric comorbidities

Takeaway

Comorbidity generally means that a person is living with two or more physical or mental health disorders at the same time. Comorbidities in mental health can be common, with studies showing that nearly half of people who have one mental health disorder may also have at least one more. As a result, comorbidity can make diagnosis and treatment harder since the symptoms of one disorder can blend with or worsen the symptoms of another. It can be vital to work with a team of providers who can address all of your diagnoses, and a licensed therapist can be an important part of that team. A convenient way to connect with a therapist may be through an online therapy platform like BetterHelp.
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