Metabolic Syndrome, Complicated With Mental Illness

Metabolic syndrome nearly affects 50 million people in America. Anyone with 3 or more of the following attributes is most likely affected by metabolic syndrome:

• Women: waist size of 35 inches or more, men: waist size of 40 or more.
• Blood pressure of 130/85 mm Hg or higher.
• Good cholesterol (HDL) of less than 40 mg/dL in men, and less than 50 mg/dL in women.
• High fat in the blood – triglycerides of 150 mg/dL or higher.
• High blood sugar, a fasting level of 100 mg/dL or higher.

People with mental illnesses such as bipolar disorder or clinical depression are especially vulnerable. This vulnerability is partially due to medications prescribed for the treatment of mental illnesses, but it is also because of smoking, inadequate nutrition, lack of exercise, and limited access to quality health care. Most people with mood disorders such as depression and bipolarism report that it is difficult for them to get going with exercise, to stay quite from smoking, or to not eat comfort foods such as sugary and starchy foods. Such health habits lead to weight gain, which in turn can domino into insulin resistance, – a condition in which the body cannot use insulin (the main hormone that enables cells to convert blood sugar into energy). As insulin resistance gets worse over time, it takes a toll on the pancreas which then leads to chronically high blood sugar levels. That can cause diabetes which is one of the main risk factors of heart disease.

What to do?

3 ways to keep metabolic syndrome worsening to heart disease.

1. If you’ve been prescribed antipsychotic medications, ask your doctor to give you antipsychotic medications that are least likely to increase risk of metabolic syndrome such as Geodon or Abilify.
2. Monitor the risk factors such as your weight, waist circumference, blood sugar, cholesterol and triglyceride levels, and blood pressure. You can do some of this on your own such as weighing yourself on a scale at home once a week, using a tape measure and a piece of paper to log your waist circumference on it once a month. You can also buy an over the counter blood pressure machine, and maybe even a diabetes kit which is aimed to measure the blood sugars. For the cholesterol and triglyceride levels you’d need your doctor’s help, ask them to help you monitor those by writing a lab order and having those levels checked twice a year.
3. In terms of eating nutritious food, taking up exercising and quitting smoking, you can either use a variety of self help materials such as books, tapes, gyms, a good friend etc. For some people, going to a health psychologist proves to be an amazing investment because often underlying emotions, unaddressed needs, and insight into how to advocate for your own health is needed to secure success in maintaining these health habits.

I am Dr. Dashtban. Write to me with your questions about health and habits to drdashtban@medicalpsychologyservice.com