We Need to Talk About Comorbidity With Mental and Chronic Illness

Anyone out there who was diagnosed with chronic illness before they were diagnosed with mental illness? That was me. However, that didn’t mean there wasn’t signs of the mental illness earlier on. Quite honestly, when I look back, I see more signs of my mental illness in my childhood than the chronic health issues I was diagnosed with in high school. And I wasn’t officially diagnosed with generalized anxiety disorder (GAD), social anxiety and major depressive disorder (MDD) until recent years. Doctors focused on my daily chronic migraine and my postural orthostatic tachycardia syndrome (POTS) long before anyone mentioned there might be more going on. I had to take the initiative myself to go and see a counselor to finally diagnose me and help begin treatment.

Why am I getting so personal so quickly? Due to stigma, people often avoid discussing their mental health struggles and even their struggles with chronic illness. Though “physical” illnesses are more accepted by the general population than mental ones are, that doesn’t mean there is still stigma around something that people not experiencing it cannot understand.

“It’s all in your head” is a phrase told to me by more than one doctor and more than one friend or acquaintance. What a thing to say to someone who is in pain. What a thing to say to someone who is mentally ill. It’s not something we would say to someone with a broken leg.

But I still wonder sometimes why it took so long for my mental health to become a topic of conversation at doctor appointments. I had to learn the term “comorbidity” on my own, reading articles from medical journals about my conditions. So, what is comorbidity and why do we need to talk about it?

1. Comorbidity is the presence of more than one disorder present in a person at the same time.

That is from the National Institute of Drug Abuse. Some conditions are more predisposed to comorbidity with specific other conditions. For example, POTS is often accompanied by migraine. In my appointments, this information was briefly relayed to me, but mental health was never mentioned.

2. Mental illnesses are often comorbid with another disorder.

I started to realize I had anxiety in high school, but it was harder for me to grasp my diagnosis with major depressive disorder once I reached college. While I was first displaying the symptoms of my POTS and was often bedridden, searching for a diagnosis, it was often brought up to me that I was “just” depressed — that I needed to get over it and just get out of bed. And if those words weren’t always said, they were often implied. So, when I learned from several scientific studies that anxiety and depression were common for POTS and migraine patients, I didn’t want to immediately embrace it. Would embracing my depression lessen the validity of my neurological conditions?

I was scared. I was worried. I was anxious. I was frustrated. And yes, I was depressed. I am depressed. And it was getting worse the more I didn’t want to address it and the more I felt like a doctor’s appointment was not the place to do it.

I don’t think this is right. Chronically ill patients also dealing with mental illness need to know it is normal to feel anxious or depressed when you are sick for the long term. You are not the only one. And so, I think we need to talk about comorbidity because it validates those of us who have felt like we didn’t have the right to talk about our mental-health/”>mental health with our doctors or the people in our lives. We shouldn’t have to live in fear of being accused of making up health symptoms just because we receive a diagnosis of anxiety/”>anxiety, depression/”>depression or any other number of disorders. It is an injustice and it can only be righted if those struggling are given the opportunity to speak out without shame.