Statistically Speaking Regarding Life Expectancy
We’ve heard this before, but here it is again – those who live with mental illness have a lower life expectancy than the national average. A previous report I cited back in March stated that the life expectancy of a person with bipolar disorder is 9 years less than the national average. Here’s a new report out from Oxford University which states that the average is 9 – 20 years. Now, I gotta say that I have serious issues with a gap as large as 9 – 20 years. When I was working, if I turned in a report with that large of a gap, I’d be emptying my desk by the end of the day. Nonetheless, it gets the point across, especially in comparison with the average life expectancy of a smoker being 8 – 10 years less. Yes, statistically speaking, smokers have a longer life expectancy than those of us with a mental illness.
Despite the staggering numbers, mental health has not seen the same public health priority as smoking. Oxford researchers say their figures on life expectancy should galvanize governments and health and social services to put a much higher priority on how mental health services can prevent early deaths. One in four people in the UK will experience some kind of mental health problem in the course of a year, it is estimated around 21% of British men and 19% of women smoke cigarettes. According to the Center for Disease Control, U.S. numbers are similar with estimates of 21% of men and 16% of women. Clearly this is a problem on both sides of the pond.
A Multitude Of Reasons
The researchers searched for the best systematic reviews of clinical studies which reported mortality risk for a whole range of diagnoses — mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioral disorders. Twenty review papers were identified, including over 1.7 million individuals and over 250,000 deaths.
They repeated searches for studies and reviews reporting life expectancy and risk of dying by suicide, and compared the results to the best data for heavy smoking.
Bipolar disorder is not the only form of mental illness with such staggering numbers. The average reduction in life expectancy is 10 – 20 years for schizophrenia, 9 – 24 years for drug and alcohol abuse, and around 7 – 11 years for recurrent depression.
My mother was a heavy smoker and died in her mid 50’s. She was far too young to die. The average life expectancy for men in the USA us 77 years. Subtract 20 years from that and statistically I could die at the age of 57 years. That’s just 7 years from now. I can assure you that I have no intensions to die so young.
Dr Seena Fazel of the Department of Psychiatry at Oxford University said:
We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day. There are likely to be many reasons for this. High-risk behaviors are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide. The stigma surrounding mental health may mean people aren’t treated as well for physical health problems when they do see a doctor.
One problem is the tendency to separate mental and physical illness, explains Dr Fazel.
‘Many causes of mental health problems also have physical consequences, and mental illness worsens the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer. Unfortunately, people with serious mental illnesses may not access healthcare effectively..
You Can Improve The Odds
The article I wrote on March 17, 2014, validates Dr Fazel’s comments. In that report, from Stanford University, they state that bipolar patients are at greater risk of dying from heart disease, chronic obstructive pulmonary disorder, the flu and pneumonia because they ignore the symptoms. The good news is that bipolar patients who were aware that they had those physical illnesses, however, had death rates similar to people who were not bipolar, according to the researchers, who suggested “that timely medical diagnosis and treatment may effectively reduce mortality among bipolar disorder patients to approach that of the general population.
Dr Fazel is certain:
All of this can be changed. There are effective drug and psychological treatments for mental health problems. We can improve mental health and social care provision. That means making sure people have straightforward access to health care and appropriate jobs and meaningful daytime activities. It’ll be challenging, but it can be done.
Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, said: ‘People with mental health problems are among the most vulnerable in society. This work emphasizes how crucial it is that they have access to appropriate healthcare and advice, which is not always the case. We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.’
So we aren’t doomed. We need to be aware of what’s going on with our bodies, get regular check-ups, and see a doctor if you have any signs of illness. We also must demand change from our politicians. We must demand that mental illness be treated with the same respect as physical illness. Until that happens we are likely to see the low life expectancy continue to remain so low. No one should die so young simply because the services they need are not available for them.
University of Oxford. “Many mental illnesses reduce life expectancy more than heavy smoking. ScienceDaily, 23 May 2014.
Self care and advocacy for the state of our health isn’t primary with too many of us. Mental illnesses are physical illnesses, aren’t they?
Good point, Jean. The brain is nothing more than another organ in the body. An astonishing organ, but still an organ. As long as physicians, insurance companies, politicians and the general public see it as different we’re going to see it classified as something different. In addition we’ll continue to see the stigma which comes with it.
Yes, I would say that mental illnesses are indeed physical illnesses. The brain is part of the body and, therefore, physical. What I wonder is if the medications that we are given to manage the illnesses aren’t, in some respect, helping our life expectancy to be shortened? I do not think that atypical anti-psychotics (which is what finally managed my treatment resistant Bipolar Type I) are particularly good for “physical” health even while they work to manage symptoms of several serious psychiatric conditions.
People with mental illness are also more likely to be substance abusers even while on medication. We also have a tendency to off our meds when feeling well only to find that the meds were what was keeping us from falling down the rabbit hole. Many younger people with psychiatric conditions feel they are “cured” when, in fact, they are simply in remission.
Suicides, both completed and attempted, also contribute to a lower life expectancy, in my opinion. Completed suicides obviously lower life expectancy, but attempted suicides often involve overdoses of psychiatric medications which can damage organs including the brain. Organ damage would also contribute to lower life expectancy.
So, what do they say about the multitude of people who are mentally ill and smokers? Maybe that’s why the gap is so big. Substance abuse combined with smoking and mental illness cannot be a good combination.
I’ve never seen any studies that show that psych meds are another cause of shorter lifespan, but its always been my assumption that its true. We take some pretty heavy duty stuff.
There are many things that add up to reducing life expectancy. I just focus on the things I have control of, such as taking care of my body. I don’t do a great job of it, LOL, but I keep trying.
As far as whether psych meds shorten lifespan… I’d like to give my 2 cents.
There’s a huge range in statistics about mental illness and mortality rates, and it’s important to get the word out so we take mental illness seriously. But. Using the example of bipolar disorder, the really big scary numbers (50% attempt suicide at some point and 1 in 5 kill themselves) while not made up, are either *including* untreated individuals (the first statistic) or *just* referring to untreated individuals (the second one). Some publications tend to leave that bit out.
Meaning: however you splice the numbers, treated bipolar disorder has a lower mortality rate — some say much lower. Right?
So my question for you, then, is: even if meds were shown to shorten your lifespan by a couple years, would you take them to increase your chance of living?
For me, it’s not academic. Well, first because I have bipolar, but also because my husband has diabetes and a kidney transplant. Insulin and anti-rejection meds are hell on your body, up to and including (statistically) a shorter lifespan. But how much of that’s from the meds and how much the diabetes and/or transplant? Either way, it doesn’t matter on a day-to-day basis. Whatever the statistics, his chances if he stops taking insulin or anti-rejection meds make the question moot. And we’re okay with that! We just celebrated the 15-year anniversary of his healthy ‘adopted’ kidney.
And while I can’t change statistics, I’m going to keep taking my meds, and improve my own chances of staying healthy (and alive).
Hi Rosetti
“So my question for you, then, is: even if meds were shown to shorten your lifespan by a couple years, would you take them to increase your chance of living?”
I never want to go back to what my life was before being properly medicated. I’m all for better living through chemistry.. I would continue taking the meds w/o hesitation even if what shown the meds do result in an earlier death