Our bodies and minds are connected, so when we experience two serious health issues at the same time, it’s easy to feel overwhelmed.

WellTuned checked in with Dr. Stacey Dixon, licensed psychologist and behavior supports director for BlueCross BlueShield of Tennessee, to learn about the medical term for the phenomenon: comorbidity.

What is comorbidity?

Comorbidity is a term used when a person has 2 or more health conditions.

Comorbidity:

• Describes illnesses or disorders that are mental or physical
• Which occur at the same time or one after the other, and
• Implies interactions between the illnesses that can worsen both.

Comorbidity often occurs with:

• Chronic health conditions such as
  • Heart disease
  • Diabetes
  • Obesity
  • Arthritis
• Substance abuse (alcoholism, opioid addiction, etc.)
• Mental health disorders such as
  • Depression
  • Anxiety
  • Schizophrenia
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Intellectual disabilities

“One common misconception about mental health is that it is separate from physical health,” says Dr. Dixon.

“In reality, all of our organs and nervous system are interconnected. The brain is just one organ, but it sends and receives messages that affect how we feel, think, experience pain, respond to stress and regulate sleep, eating and activity. So it’s important to look at the whole person when diagnosing and treating any health conditions.”

Why should you be concerned about comorbidities?

Chronic medical conditions, substance abuse and mental disorders can worsen each other, which can lead to other symptoms or issues:

• Obesity and a sedentary lifestyle
• Smoking
• Lack of self-care
• Fear of being a burden to the ones you love
• Permanent or extended disability
• Lower quality of life
• Suicide

In the U.S., comorbidities are often related to mental illness and substance abuse, which 1 in 4 adults experience. Nearly half of those people also have at least 1 chronic medical condition.

Mental illness in Tennessee

• At least 20% of Tennesseans experience mental illness
• 4.4% of adult Tennesseans have a serious mental illness

If you aren’t sure if you or someone you love is struggling with mental illness, ask for help.

“A good measuring stick is to ask yourself: How much is this interfering with my ability to function?” says Dr. Dixon. “If the answer is significantly, talk to someone. Often, a mental illness can present as physical symptoms. For example, you may not be able to identify feeling ‘sad,’ but you may notice problems sleeping or eating, stomach issues, pain or fatigue. All of those may indicate something is going on in your mind or with your emotions.”

Mental illness is more common than cancer, diabetes or heart disease.

Adverse Childhood Experiences

Adverse Childhood Experiences, or ACEs, are another factor in comorbidity. Traumatic experiences from childhood can create toxic stress, which could lead to negative health outcomes later in life. The more ACEs you have, the more likely you are to experience these negative effects.

In Tennessee, 61% of people have at least 1 ACE, and nearly 25% have 3 or more. You can find your ACE score here, and visit the ACE Awareness Foundation or your doctor for help addressing your ACEs.

What should you do if you have multiple health conditions?

Counseling, medication, inpatient treatment, support groups and care management are all effective ways to manage multiple health issues. The most important step is getting diagnosed.

Tennessee ranks 20^th out of 50 states in prevalence of mental illness but 45^th in access to care. In the U.S., 60% of adults with mental health issues don’t receive the treatment they need, so the problem isn’t unique to our state. There are many reasons people don’t get care, says Dr. Dixon, and a lot of them are cultural.

“If your family and friends don’t believe in mental health care, they may tell you it’s not something you need,” says Dr. Dixon. “Likewise, your support system may not see your behavior as symptoms of a mental health condition. They may see fatigue as laziness, or complaints of pain as ‘whining.’ It’s important that you connect with a healthcare provider who understands the connection between mental and physical wellness.”

The other challenges are practical:

• Navigating the health care system
• Finding a provider
• Accessing insurance
• Overcoming language barriers
• Covering costs

“No matter your circumstance, if you feel like you need to talk to someone about your mental health, do it,” says Dr. Dixon.

To get confidential help now, call 855-CRISIS-1 or 855-274-7471. For more information on when and how to seek help for mental health issues, click here.

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.