Wellness Parity

My NAMI support group co-facilitator and I recently talked about health and wellness—and she suggested that I request a check of liver function from my primary care physician the next time I get a physical.

 Let’s talk about life expectancy, shall we? According to a study of people across six continents highlighted by Thomas Insel, former director of the NIMH, people with mental illnesses, on average, live 10.1 years less than people without mental illnesses.

Most of these early deaths could be attributed to “natural” causes  such as acute and chronic co-morbid conditions like heart disease, pulmonary disease, or infectious disease. An additional 17.5 percent of deaths appeared related to "unnatural causes" such as suicide and unintentional injuries.

The authors of the study asked a question: How many deaths would be averted by eliminating this increased mortality? The answer, based on the prevalence of mental illness globally, is staggering: 8 million people die each year due to mental illness. That is, 8 million deaths could be averted if people with mental illness were to die at the same rate as the general population.

Insel writes that people with mental illnesses tend to die of the same conditions that the rest of the population does. And he calls for wellness parity:

“This is an important insight because it means that mortality may be reduced by addressing the high rates of behaviors such as smoking, substance use, physical inactivity, and poor diet that contribute to chronic and deadly medical conditions. In this new era of parity, equity must be defined not only by equal treatment for mental and physical disorders; parity requires equal treatment of medical disorders in people with mental disorders.”

I had a "come-to-Jesus" moment several years ago regarding my health. I couldn't walk up a hill without huffing and puffing and my side hurting. I was 40 pounds overweight. I didn't smoke or abuse substances. But my pre-diabetes tests were coming back nasty. 

Over time, I lost some of the weight. I try—the operative word being “try”—to exercise. In the spring of 2017, I made a commitment to get to the gym three times a week and to walk on the weekends. In the fall and winter, because of my seasonal affective disorder, this is a tall order. Sometimes, a week goes by and I haven’t made it to the gym. But next week is a new week. Making it there is half the battle.

I know I feel better when I exercise. There is more of a bounce to my step. My mood is lighter and brighter. I don’t get stressed as easily.

After trying several different types of exercise, I now have found a combination that works for me: exercising on an elliptical for a short period of time, followed by weight-lifting. Truth be told, I dislike the elliptical, but I blast my cheesy “Girl Power” playlist. I power up Beyonce and “Run the World” and really start moving: “Who runs the world? Girls!”

And I love the weight-lifting. The concentration it takes and the repetitive motions are calming. I like listening to the whoosh of my breath, feeling the slow burn as my muscles tire. It is my moment of Zen.

I am committed to exercise. And yes, part of this is vanity—the mood stabilizers that are used to treat my bipolar cause weight gain, and the only way I have found to combat this is to exercise regularly. I exercise because I want to feel confident about the way I look, to be comfortable in my own skin. This is no small thing.

But it is even more than that: How long do I want to live? What kind of quality of life do I want to have? Can I avoid some of the pitfalls of a severe and persistent mental illness, diabetes and cardiovascular disease being high on the list? My medications have side effects, raising blood sugar level and cholesterol; also, processing them is tough on the body (thus, the liver test). I am in a Catch-22: I need these medications to survive and I am grateful for them, but the side effects are punishing.

However, left untreated, mental illness robs us of our agency in a cruel way. With treatment, I am in the driver’s seat—and I am in the driver’s seat when it comes to the lifestyle choices that impact my health.

For people with mental illnesses, these statistics on life expectancy can be a wake-up call, a call to care for our bodies as well as our minds. For us as a society, they are a call to pursue and commit to wellness parity.

There is a lot of work to be done, both individually and globally. We are up to the challenge.


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