It's not all in the mind

"People with severe mental illness die on average 20 years younger than the rest of the population, largely owing to physical health. People with severe mental illness are more likely to develop preventable conditions like diabetes, heart disease and some cancers." (Rethink mental illness) This statistic shocked me when I first saw it as part of the Rethink campaign "20 years too soon". However, recently I am beginning to associate this trend with my own treatment by doctors. Rethink assign four main reasons as to why this might be the case: medication side effects, life style factors, lack of physical health checks and most interesting to me, diagnostic overshadowing. Many of the medications prescribed for serious mental illness include some very serious side effects. One of the drugs I take is lithium. It is the most effective mood stabiliser used for people with Bipolar disorder, a salt originally designed for epilepsy and whose workings are not fully understood. There are potentially many weighty side effects to lithium, including kidney failure, thyroid malfunction and lithium toxicity. These are tested regularly through blood tests, and in my experience taken very seriously. In a similar manner once a year I have a full check up, in theory. In reality I have my blood pressure checked, height and weight measured and a nurse asks me bizarre questions about my family support, crisis help knowledge and work situation. Not exactly a full MOT, but it ticks the boxes. I have written before on the issue of being defined by your mental illness and this includes by health care professionals. Diagnostic overshadowing is when any physical symptoms you report are associated or dismissed as being a symptom or manifestation of your mental illness. On many occasions I have explained a physical symptom (headache, stomach pain, muscle pain) to be immediately asked "and how are YOU?" The emphasis on the 'you' designated the social shorthand for- you know, mentally? Another favourite is "are you stressed at the moment?" (I'm a teacher and have two small children, stress is relative!) It is entirely possible and likely that some or all of these symptoms may be a response to stress or mental health issues, but even when I am entirely well and can discount any extra stress I can sense that I am not believed. And on most occasions no further physical tests or investigations can take place. Today I experienced this dismissal in its fullest, leaving me feeling angry, ignored and still suffering symptoms. It was also a great example of the strange bureaucracy that slows down treatment. My most recent blood tests show that my lithium level is below the therapeutic level, meaning I am effectively unmedicated at present. Not good, and understandably triggering an appointment with my GP. Sadly, my GP can't actually alter my dosage, I have to contact my Psychiatrist for that. I'm waiting for the call back, and the letter to GP which will allow them to alter dose. However, the main issue for me (I'm so used to the bureaucracy) was the way my other physical issues were dismissed. Along with lithium, my kidney function, thyroid function and haemoglobin levels were checked because I have been unnaturally tired recently and I need to urinate very frequently (every 15 mins and 4-5 times a night!) When the tests were reported as normal I asked the GP about these symptoms. I was simply told these were probably 'just' a side effect or perhaps next time I could get my blood sugar tested. Next time, so in about 2 weeks minimum. It is very possible that these are side effects, perhaps from medication or low lithium levels. It could be something simple like an infection. But for me these are real physical symptoms causing me daily problems and potentially something completely unrelated to my mental illness. I and other sufferers deserve to have these physical issues taken seriously even if they are side effects, but especially investigated in case they are not.