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Around 4 in 10 adults in the U.S. with with chronic conditions. Instants/Getty Images
  • New research finds that having multiple physical health conditions raises a person’s chances of developing depression and anxiety.
  • Risk of depression was particularly high in people with multiple respiratory conditions, such as asthma and emphysema.
  • People who had three physical health conditions were nearly twice as likely to develop depression within 4 to 6 years, compared with people who had no or only one physical health condition.

Roughly 4 in 10 adults in the United States live with two or more chronic health conditions, such as heart disease, diabetes, cancer, or chronic lung disease.

These conditions may affect not only physical health, but also mental well-being.

According to new research from King’s College London (KCL) in the United Kingdom, having multiple physical health conditions raises a person’s chances of developing depression and anxiety.

“Our large-scale analysis has shown that people with two or more physical health conditions are at greater risk of developing depression and anxiety later in life, compared with those who have none or one physical health condition,” lead author of the study, Amy Ronaldson, PhD, said in a statement. Ronaldson is a research associate at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at KCL.

The risk of developing depression was particularly high in people with multiple respiratory conditions, such as asthma and emphysema.

The risk was also notably high in people with a combination of gastrointestinal and pain disorders, such as irritable bowel syndrome and arthritis.

“What is really interesting is that this risk seems to be greater in those with certain combinations of physical conditions,” said Ronaldson. “[This] has implications for how the integration of mental and physical healthcare should be implemented.”

To conduct the new study, scientists analyzed data from more than 150,000 middle-aged adults in the UK Biobank. This is a large biomedical database that allows researchers to study changes in participants’ health over time.

The researchers adjusted their findings for factors such as age, sex, ethnicity, education, employment, body mass index, activity level, smoking status, and alcohol intake.

They found that people who had three physical health conditions were nearly twice as likely to develop depression within 4 to 6 years, compared with people who had no or only one physical health condition.

People with multiple respiratory health conditions were more than 3 times as likely as those with no physical health conditions to develop depression later on.

The more physical health conditions a person had, the more likely they were to develop depression.

Multiple physical health conditions were also linked to increased risk of anxiety.

“The bottom line is we need to stop thinking about mental health and physical health differently: They are one and the same,” said Dr. Julian Lagoy, a board certified psychiatrist with Community Psychiatry in San Jose, California, who wasn’t involved in the study.

“Our body is a very complicated and integrated system. Any effect on a particular part of the body physically or mentally will have other effects on other systems,” he added.

More research is needed to learn why physical health conditions are linked to depression and anxiety.

The day-to-day challenges of living with physical health conditions may account for some of the link.

Many people with physical conditions cope with fatigue, pain, and other symptoms. They may find it harder to do activities they enjoy, maintain social relationships, and keep up with responsibilities at home or work — which can take a toll on their emotional well-being.

Inflammation may also act as a shared biological driver of physical and mental illness, helping to account for the link between physical health conditions and depression and anxiety.

The authors of the new study found that C-reactive protein (CRP) levels were higher in people with multiple physical health conditions. CRP is a sign of inflammation, an immune response that plays a role in many conditions.

Although more research is needed, several past studies have found that people with depression and other mood disorders have elevated levels of CRP and other markers of inflammation.

“This body of research is complex and as yet has not allowed us to determine the degree to which inflammatory conditions cause or merely aggravate, along with other risk factors, the onset of depressive illness,” Dr. Timothy Sullivan, chair of psychiatry and behavioral sciences at Northwell Health, Staten Island University Hospital in New York City, told Healthline.

“[However], it is clear that an activated immune system — as occurs in patients suffering the medical conditions studied here — plays a significant role in the development and worsening of mood disorders such as depression and anxiety,” he continued.

To support physical and mental well-being, Lagoy said it’s important for people with physical health conditions to attend regular check-ups with their doctors.

“I would advise them to see a physician regularly so they can sufficiently manage their physical health conditions,” said Lagoy.

Taking steps to manage physical conditions may help lower your risk of developing complications, like the mental health effects.

During check-ups, your doctor should screen you for signs of depression and anxiety, Sullivan told Healthline.

Your doctor should also educate you on strategies to reduce your risk of mental illness, such as “decreasing alcohol intake, stopping smoking, addressing poor sleep habits, getting more exercise, and avoiding isolation and loneliness,” said Sullivan. Some people may also benefit from changes to their diet.

If you think you might be experiencing anxiety or depression, let your doctor know.

Common signs and symptoms include:

  • frequent feelings of worry, hopelessness, worthlessness, emptiness, irritability, sadness, or anger
  • loss of interest in relationships or activities that previously mattered to you
  • difficulty concentrating, remembering things, or making decisions
  • changes in sleep habits, appetite, or weight
  • fatigue

To treat anxiety or depression, your doctor may prescribe medication, counseling, or a combination of both.

“The stigma against mental illness needs to end so we can help those in need and not turn anyone away who thinks they might be mentally ill and would benefit from getting help,” said Lagoy.