Mild Psychological Distress May Shorten Your Life

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Clinicians have long suspected that anxiety and depression aren’t good for overall health, but a new report in the BMJ (British Medical Journal) not only turns our suspicions into fact, it gives us reason to worry even more (and that’s not helping matters!).

A meta-analysis of 10 prospective cohort studies looked at over 68,000 adults over the age of 35 who filled out a 12-question health survey aimed at identifying individuals with underlying psychological distress. Respondents were asked, among other things, whether they had been troubled in recent weeks by poor concentration, disrupted sleep, stress, and loss of confidence. Those who scored zero were presumably psychologically healthy; those who scored 1 to 3 were considered mildly distressed, but didn’t meet the rigorous diagnostic criteria for full-blown anxiety or depression. The investigators then followed these folks for 10 years.

Among the key findings, the study found that the higher the score, the higher an individual’s risk of death. But perhaps more surprisingly, even mildly distressed people were 29 percent more likely to die of heart disease or stroke than people who scored zero!

Interpreting the Findings

You may ask: Aren’t distressed individuals more likely to smoke, drink, exercise less, and in general take poorer care of themselves than nondistressed people? Doesn’t this explain the association? The answer is no; at least, these results held up even after the investigators adjusted for differences in all of these factors.

You might also be tempted to invoke reverse causation; that is, we know that heart disease can lead to anxiety and depression, so isn’t it likely that the people who tested positive for mild psychological distress had pre-existing cardiovascular disease and thus were more likely to die of a heart attack or stroke? The investigators thought of this, too, and discounted deaths in everyone who died within five years of entering the study, making it unlikely that underlying, pre-existing disease was responsible for their psychological distress.

What You Can Do to Mitigate Psychological Distress

So what can you do to reduce your risk? Well, although there’s no evidence–as of yet–that treating psychological distress improves cardiovascular outcomes, there is little harm and perhaps much to be gained by learning how to manage anxiety, stress, and depression through relaxation techniques, exercise, and meditation. For those who can’t manage it on their own, trying interventions such as cognitive behavioral therapy may be helpful.

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The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.

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