Tuesday, November 2, 2010

Mental health and mortality

By Richard P. Holm, M.D.

Mental and emotional problems are everywhere. More than half of what I do, as a general internist, is to help people deal with emotional problems. It comes with the heartbreak and suffering of loss, pain, or growing old, with debilitating illnesses, and with the burden of mental illness itself. It is truly a challenge to try to help people cope with such trouble.

This September a large, 13-year Canadian study reported a 322-percent higher death rate in people taking minor tranquillizers compared with those not taking such medicines. Use of this type of drug can be taken as an indicator of emotional problems. Looking closer, there were huge socio-demographic and lifestyle differences between groups.

The study implied that if one comes from a tough neighborhood, drops out of school, struggles with addiction, abuses alcohol, smokes, does not exercise, and has mental health problems, then the risk of premature death is more than three times higher than one without such problems. In other words, emotional illness often walks side-by-side with tough social, economic, and health problems. And the combination is associated with premature death.

There was also an inference from the study that the use of minor tranquilizer-type sleeping medicine might alone carry some risk to one’s physical health. My personal interpretation from the data is that sleeping pills and anti-anxiety medicines can cover up or make worse an underlying depression. What’s more, these tranquilizers often put off or prevent appropriate therapy, such as counseling, exercise programs, and very effective antidepressant medicines.

Mental health is truly an important ideal but it comes and goes for each of us as we struggle and meander through our lives. Physicians and care providers have tools to help, including ears to listen, words of advice, and sometimes even good medicine to prescribe. To ignore indicators that there might be a mental health problem could mean the difference between life and death.

Dr. Rick Holm wrote this editorial for “On Call®,” a weekly program about health on South Dakota Public Broadcasting-Television that is produced by the South Dakota Cooperative Extension Service. “On Call” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain.

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