The Hidden Side of Mental Illness: Physiological Symptoms

So this is the second instalment in my series of posts headed ‘The Hidden Side of Mental Illness’. Where the previous post was about sensory difficulties, this one covers the physiological side of what are otherwise considered psychological/mental/emotional illnesses.

Living with mental illness takes a toll on your body as much as it does your mind and this is where confusion lies. There is often not immediately an obvious connection between the physical symptoms and whatever mental health problem(s) the person has, and subsequently people can spend years going through tests, consultations and the hopelessness of not being able to find a “reason” for their problems. In this case, there IS actually a valid “reason”, it’s just not what you may be expecting i.e. you may be experiencing a secondary effect of mental illness rather than a separate illness.

Please don’t get me wrong, it isn’t as cut and dry as mental illness CAUSING or being responsible for these symptoms in all cases; a lot of the time they co-exist or one initially causes the other but it ends up as a self-perpetuating cycle. For a start, health anxiety is a real and very debilitating problem in itself. And if you do experience any physical symptoms then do get them checked out with a medical professional to eliminate other causes. But these are some examples of physical symptoms that can be a key part of mental illnesses, where the link is often overlooked. 

• Depression and anxiety are both linked with a lack of appetite, while nausea and other gastric/digestive problems are very common in anxiety disorders (that gnawing feeling in your stomach when you’re nervous can be almost constant and severe if you have an anxiety disorder, and a “nervous tummy” is a frequent difficulty).
• Many mental illnesses are associated with sleep disruption (either sleeping too much, or insomnia) e.g. depression, anxiety, ADHD, PTSD. Sleeping excessively can interfere with all aspects of life – it can lead to missing work/other important commitments, loss of social interaction and reduced exposure to natural sunlight and Vitamin D (which can all perpetuate and worsen depression). Insomnia and resulting sleep deprivation in turn reduce resilience and physical stamina, making it harder to deal with aspects of daily life and can actually worsen or even cause other mental symptoms e.g. paranoia, irritability, and hallucinations (temporary psychosis can develop as a result of severe sleep deprivation). Sleep deprivation for whatever reason is, in short, dangerous and needs to be addressed with medical and/or mental health professionals – on a basic level, after even one night of poor/little sleep, it can lead to a lack of attention in key tasks like driving, with the potential for traffic accidents!
• During a panic attack, you can end up with more than ‘just’ hyperventilating and a tight chest. For example, I get tunnel vision and hearing, dizziness, chills and/or overheating, pins & needles, fainting, intense nausea and sometimes vomiting and collapsing. Unfortunately, because these symptoms are so physical and can often occur without the typical hyperventilating, it is difficult to identify them as a panic attack until after I recover. One of my triggers for a panic attack is crowds but my body doesn’t recognise that just feeling uncomfortably hot whilst standing is different to being in a crowd, so that can often result in a panic attack, seemingly out of nowhere. If you get physical episodes like these, it is always worth logging them (what you were doing beforehand, where you were, what you felt like, what happened and how you recovered) to see if there is a pattern. After eliminating low blood sugar, low blood pressure etc. in these circumstances, I used my log to identify mine as panic attacks.
• There is also a wide scope for a variety of side effects of any medications you might take to help the symptoms of your mental illness. Common side effects of anti-depressants include dry mouth, upset stomach, while anti-psychotics can have the nasty effects of tremors, stiffness, shakiness, restlessness, muscle spasms and slowness. Both can affect sexual function/drive and lead to drowsiness and sometimes extreme changes in weight (severe weight gain and even diabetes has been linked to treatment using certain commonly-used atypical anti-psychotics – read more here). These side effects can lead to fairly significant impairment in daily functioning but without the medication itself some people would be unable to function, would be at great risk to themselves and, less commonly, to others. It is complicated as you end up in weighing up how effective the medication is and and whether it is worth the side effects – the result varies from person to person, and even from one year to another, which is why medications must always be reviewed regularly.

Stress of any sort, especially when experienced long-term, has wide ranging effects on the body, basically impacting the functioning of most bodily systems! So it’s not a surprise that many mental illnesses are associated with seemingly unrelated physiological symptoms. Just look at this image, showing how stress affects the body:

This is just a basic overview of some of the main hidden physical effects of mental illnesses but it is far from all of them, it is probably a never-ending list, given the variety in how people experience any form of illness, physical or mental!

If any of this rings a bell for you or you have anything to add, I’d love to hear from you.

In the meantime, you can read more from me about the hidden side of mental illness in my first post about sensory difficulties here.

The Hidden Side Of Mental Illness: Sensory Difficulties

If you know anything about mental illness and/or know someone with it, then you will likely have heard of the “typical” or common symptoms (if there can be such a thing!) such as low mood and sadness (depression), anxiety and panic, and that people may have difficulties with motivation, regulating eating and/or socialising. But that isn’t where the effects of living with mental illness end – it can have a much more subtle but far-reaching impact and often makes some of the seemingly most simple aspects of life incredibly difficult.

A lot of these effects/symptoms come under the heading of “sensory difficulties” so that is the bulk of this particular post but I will also cover a couple of others in subsequent posts.

I have gradually got a better understanding of these problems over the past year or so and this was actually what prompted me to write this. For me, there is a crossover between symptoms of headaches/migraines and the sensory difficulties I have which are associated with mental illness but I realise how much it makes sense for these to be triggered or worsened by my mental health problems and in turn then increase anxiety and panic! Take a moment to imagine everything being louder, brighter, stronger smelling and more uncomfortable to touch/feel, and you are on your way to an idea of how sensory difficulties affect your experience of your environment. It doesn’t take much to become overwhelmed, does it?

I always thought “sensory problems” were exclusively to do with Autism Spectrum Disorders etc., but they’re surprisingly common and there is also a recognised group of symptoms termed Sensory Processing Disorder (SPD) which can be diagnosed independently or in combination with other illnesses e.g. OCD, PTSD, Autism Spectrum Disorders, Learning Disabilities, Anxiety, ADHD etc. Below is a list of possible signs/symptoms of SPD as recorded by Ascent. I haven’t been diagnosed with, or assessed for, SPD  – but I do experience sensory overload on a frequent basis and I am hyper-sensitive to sound 24/7 so a lot of the below list rings incredibly true for me! As you can see from the amount of symptoms not crossed out, it is very possible for someone who isn’t diagnosed primarily with Sensory Processing Disorder to have a lot of sensory difficulties. I know for me, a lot of my struggles are a result of anxiety and hypervigilance (one of the most disabling symptoms of PTSD that I experience).

Behavioural Symptoms:

• Withdraw when touched (if not by carefully chosen safe people)
• Behavioural problems
• Difficulties calming oneself after exercise or being upset
• Refuse to eat certain foods due to the textures of the foods
• Be hypersensitive to certain fabrics
• Only wear soft clothes or clothes without tags (sometimes sensitive to this)
• Dislike dirtying his or her hands
• Do not engage in creative play (or anything creative really)
• Lack variety in play – may watch the same television program over and over
• Oversensitivity to sounds, especially hair dryers, washing machines, or sirens
• Be oversensitive to odours – strong or mild
• Have challenges with certain movements, such as swinging, sliding, or going down stairs
• Notice or hear background noises that others cannot
• May harm others during play accidentally
• Dangerous behaviours (history of risk-taking)

Physical Symptoms:

• Have odd posture
• Clumsiness
• Poor balance
• Delayed fine motor control, such as handwriting challenges
• Delayed gross motor development
• Impairments in sleep, eating, and elimination patterns (periods of this)
• Be in constant motion
• Jump, swing, spin excessively
• Fatigue easily
• Alternate between constant motion and fatigue
• Poor coordination
• May fall often
• High tolerance to pain

Psychosocial Symptoms:

• Decreased ability to interact with peers (sometimes)
• May stand too closely to others
• Social isolation
• Depression*
• Anxiety*
• Aggression
• Fearful of crowds
• Avoidance of standing in large groups
• Fearful of surprise touch

(*Some of these symptoms can be also identified as distinct disorders/illnesses, which is where it is often difficult to distinguish what is the root cause and what is an effect.)

If you don’t experience sensory difficulties yourself, below are some important things that might help you to understand what life is like when you frequently experience sensory overload for whatever reason:

1. Unless you experience it, you can’t possibly understand exactly how it feels, and that’s totally okay.  On our end, we will try not to expect you to, and we wouldn’t wish it on you either. But all we ask is that you try, and that you give us the chance to do what we need to do to make our environment more comfortable (within reason).
2. It doesn’t discriminate – although associated with children, sensory overload including Sensory Processing Disorder affects adults as well but unfortunately that doesn’t stop it being largely misunderstood particularly in adults. People can be judgemental when they see an adult doing things that are “childish” or having a tantrum of sorts. Try not to judge what you don’t know.
3. Some of the simplest coping tools can be the most effective; for example headphones, earplugs, stress balls, fidget toys, play-doh.
   “I discovered that by wearing earbuds, or better yet, big puffy headphones, I can control one channel of sensation. It is such a powerful tool that I can do things I once thought were impossible.”  Renee Barker (read more from her at The Mighty here)
4. Don’t underestimate how severely it can affect your life – it can make even the seemingly simplest, daily tasks a challenge for someone and therefore reduce their confidence and independence. Take grocery shopping at the supermarket for example (something I personally find difficult). You have loud trolleys and carts banging, wheels squeaking, children screaming, background music playing, lots of people having different conversations all at the same time, food smells, perfumes/aftershaves/smoke smells as people walk past you, bright colours with lots of different (and often disorganised) packaging, textures of foods and packages, crowds of people who are focused on their own mission of completing their shopping, and that’s all before you even get to the checkout where there is endless (and may I add, HORRIFIC) beeping and sounds of plastic bags rustling. This overwhelming environment can make it impossible to complete the task you set out to do and lead to you leaving the store without anything you wanted or needed to buy!

If you have any questions about anything to do with this topic, feel free to ask and if I don’t know (or I’m not the best person) then I can direct you to some great sources of information/help. Alternatively, if any of this rings true for you or you feel like sharing your experience, I’d love to hear from you.

The next post will be covering the physiological effects/difficulties associated with mental illnesses.