Individuals with mental illness issues live shorter lives than those without. Recent research helps explain this. Blood metabolites that correlate with greater biological age that a person’s chronological age are found in persons with anxiety disorders, bipolar disorder, and depression. This is an unseen impact of mental illness. What researchers are not clear about yet is if successful treatment of mental illness reverses the effect of mental health and premature aging.
Mental Illness and Life Expectancy
According to the World Health Organization, people with severe mental illness live ten to twenty-five years fewer than others. Over the years the assumption has always been that lifestyle issues related to mental illness were the cause of shorter lifespans. Certainly we know that depression, PTSD, and substance abuse disorders are major suicide risks. But the sum total of self-neglect issues that can accompany mental illness are likely to contribute to living fewer years. What is new is that biochemical research shows that there is more to the story.
Metabolic Markers of Aging
Researchers have uncovered numerous biochemical markers that distinguish youth from advanced age. Antioxidants are at the forefront of the chemicals that decrease dramatically in older people. Researchers at King’s College London studied 168 blood metabolites from more than 110,000 individuals. The levels of the various metabolites varied predictably according to age. When individuals were separated according to a history of mental illness or not, significant differences were seen. Individuals with lifelong mental illness issues routinely had metabolic levels consistent with people who were older. For bipolar disorder the average was a biological age two years older than chronological age.
Mental Illness and Age-Related Diseases
The metabolic research helps us understand why people with mental illnesses have higher incidences of problems like coronary artery disease. The assumption has always been that worrying and being depressed lead to heart problems. The recent research indicates a deeper connection on a biological and physical level between mental illness and heart disease as well as other physical health problems. The mental health problems with highest risk of coronary artery disease are schizophrenia, major depression, and bipolar disorder. The research does not say that having some biological defect condemns a person to mental and physical health problems. It does tell us that the connection runs deeper than having a lot of stress in life and therefore having physical health problems.
Does Treatment of Mental Illness Prolong Life?
Virtually all investigations of longevity and mental illness have focused on lifestyle, access to health care, poverty, social isolation, and all of the “fallout” issues related to mental health problems. To the extent that a person gets effective treatment for a mental health condition they tend to live longer. Credit for this has always gone to improvement of the “fallout” issues. What we do not know is if metabolic markers of aging are improved in these cases or not. If they are, it would point to a deeper set of biological factors relating to conditions like depression, PTSD, and other mental health issues.
In recent years we have learned a lot about the brain and how it is affected by depression and PTSD. Research into how psychedelic medicines work shows us how physical connections in the brain can be multiplied and changed. These changes can lead to dramatic improvements in depression, PTSD, general anxiety disorders, and substance abuse problems. Adding screening of metabolic issues and longevity to these studies for follow up would be instructive and make a huge difference in the longevity of folks like the many military veterans who suffer from mental health issues.
Does Mental Illness Treatment Prolong Life as Well as Improving Life?
To answer this sort of question studies of treatments with medicines like the new psychedelics need to have long term follow-up lasting decades. These sorts of studies are rare as researchers are commonly looking for answers to shorter term issues and research programs are commonly not funded for decades or generations.
An example of what is needed is the Framingham Heart Study. In 1948 the National Heart, Lung, and Blood Institute joined Boston University and signed up over 5000 people from the town of Framingham, Mass. Their long term cardiovascular survey demonstrated how cigarette smoking increased risk of heart disease, identified the dangers of high blood pressure, and found risk factors for Alzheimer’s disease. The study is going on with its third generation of participants after 75 years. This is the sort of long term, patient study needed for the issue of mental illness, treatment, and longevity.