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Guest Essay
Dr. Ouyang is an emergency physician and an associate professor at Columbia University.
“Do you think my symptoms could be from stress?” This is a question more and more of my patients have been asking me when seeking care for problems such as stubborn colds and aching backs.
For other patients who don’t first raise the idea, when I propose that their mental health could be worsening their physical symptoms, they no longer bristle at that suggestion. An idea that was once dismissed as New Age fluff is now being embraced.
Our health care system, however, has yet to catch up to this connection. While it promotes preventive care, the emphasis has largely been on physical health, overlooking the significant influence of mental well-being on our overall health and vulnerability to illness. For people to truly be healthy, modern medicine must prioritize the prevention of mental ailments alongside physical ones.
It wasn’t long ago that even hinting at the notion that a relationship exists between our mental and our physical health would inevitably seem to frustrate, even infuriate, patients, as though their suffering weren’t real. And for good reason. Women have endured the dismissal of their symptoms for centuries, resulting in missed and delayed diagnoses, even death. Pain in Black patients is often undertreated. Doctors in the past would offhandedly call certain symptoms supratentorial — meaning “in one’s head.”
But our understanding is evolving as a growing stream of research challenges old assumptions. Psychological disorders such as stress, depression and loneliness are now known to be associated with impaired immune defenses, leading to increased infections and weakened responses to vaccines. Chronic stress can disrupt our gut function, slow our wound healing and age our cells.
The mind’s potential to unravel the body goes even further: People with symptoms of depression have a greater risk of developing coronary artery disease. Among patients who already have heart failure, those struggling with loneliness have a significantly higher death rate. Job stress has been linked to strokes.
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