Individuals with heightened AS observe heart rate more correctly due to increased sensitivity and preoccupation with perceived symptoms with heart disease such as faster heart activity while participating in physical activity. Most often, this condition presents itself co-morbidly when there is an existing heart condition. 


AS and Fear of Cardiac Symptoms

AS is associated with Irritable Bowel Movement due to greater vulnerability to symptoms caused by AS. Research shows that people with heightened AS have lower control of abdominal symptoms, but feel insecure over their ability to not control their bowel sensations. The cycle of avoidance and embarrassment increases the effect of the gastrointestinal condition.


AS and Irritable Bowel Syndrome 

Since patients cannot disengage from the attention they receive after an episode of pain, like after a scraped knee, they continue to be vulnerable. This is worsened when the patient suffers from a chronic condition. This is bidirectional because the increased cognition regarding pain leads to increased sensitivity towards pain, and therefore leads to more perceived pain.


AS and Fear of Pain

When patients have AS and chronic health conditions, the former exacerbates the latter since it induces fear, and therefore, vulnerability to symptoms of the physical conditions. 


Santa Clara University

Co-morbid illnesses refer to two or more conditions presenting simultaneously in a person. Co-morbid illnesses can occur as only physical conditions, mental conditions, or a combination of both.

Co-Morbid Illness

- Fear of Chronic Medical Conditions
- Avoidance of Daily Activities
- Engagement in Unhealthy Practices
- Pathophysiological Alterations

Effects of AS

Horenstein, Arielle, et al. “How Does Anxiety Sensitivity Increase Risk of Chronic Medical Conditions?” Clinical Psychology: Science and Practice, vol. 25, no. 3, 2 Apr. 2018, https://doi.org/10.1111/cpsp.12248. 

How does anxiety sensitivity increase risk of chronic conditions?

When chronic illness has a sudden onset, like in the case of a heart attack, it is possible for PTSD or PTSD-adjacent symptoms to occur.  This is due in part to the experience of cumulative trauma during onset or an episode of chronic illness.  

Chronic illness and PTSD

When a person is diagnosed with a physical chronic illness, due to the limitations caused as a result of pain, work absences, activity reduction, and temporary disabilities, there can be a co-morbid presentation of mental illnesses such as Major Depressive Disorder (MDD). 

Chronic Illness and Major Depressive Disorder

AS and Fear of Physical Chronic Conditions

Older adults with a higher rate of untreated depression experienced negative outcomes with overcoming physical ailments like cancer and heart disease. A person’s immunity is also lessened, compromising their ability to fight infections.

Co-Morbid Mental Illness in Geriatric Adults 

Common co-morbid conditions include heart attack, hypertension, diabetes, stroke, high blood cholesterol, asthma, arthritis, osteoporosis, chronic lung disease, cancer or malignant tumor, stomach or duodenal ulcer, Parkinson's, cataract, and hip fracture or femoral fracture. 

Co-Morbid Physical Illness in Geriatric Adults

Himelein, M. J., & Thatcher, S. S. (2006). Polycystic ovary syndrome and mental health: A review. Obstetrical & gynecological survey, 61(11), 723–732. https://doi.org/10.1097/01.ogx.0000243772.33357.84 

Polycystic Ovary Syndrome and Mental Health: A Review

Polycystic ovary syndrome (PCOS) is an endocrine disorder that occurs commonly in women. It is studied that this condition is associated with several mental health conditions, including but not limited to; anxiety, depression, eating disorders, body dysmorphia, sexual dissatisfaction, and an overall lesser quality of life. Among all of these mental health issues/disorders, depression symptoms occur the most in patients with PCOS. 

PCOS and Mental Health

Chaudhari, A. P., Mazumdar, K., &amp; Mehta, P. D. (2018). Anxiety, depression, and quality of life in women with polycystic ovarian syndrome. Indian Journal of Psychological Medicine, 40(3), 239–246. https://doi.org/10.4103/ijpsym.ijpsym_561_17 

Anxiety, Depression, and Quality of Life in Women
with Polycystic Ovarian Syndrome

A research study was conducted in the Department of Psychiatry at Bhabha Atomic Research Centre Hospital to determine the occurrence of anxiety and depression symptoms in women with polycystic ovarian syndrome (PCOS). This study evaluated seventy females (18-45 years old) who reside in India and have been diagnosed with PCOS and had no prior psychiatric diagnoses. The results of this study showed a sample of PCOS patients with symptoms of infertility and alopecia being related to anxiety, symptoms of acne being related to depression, and symptoms of hirsutism being related to a lesser psychological overall quality of life.

PCOS Symptomatology versus Anxiety, Depression, and Quality of Life

A research study was conducted in the Department of Psychiatry at Bhabha Atomic Research Centre Hospital to determine the occurrence of anxiety and depression symptoms in women with polycystic ovarian syndrome (PCOS).

PCOS symptomatology versus Anxiety, Depression, and Quality of Life

Studies have found illnesses that occur along with fibromyalgia may include irritable bowel syndrome (IBS), anxiety and depressive disorders, rheumatic diseases, and many more.

Fibromyalgia and Co-Morbid Illnesses

References for Co-Morbid Illnesses

Research has shown that diagnosed childhood separation anxiety disorder may be associated with a heightened risk for the development of other disorders, such as panic disorder, in adulthood.

Separation Anxiety and Panic Disorder

A syndemic, (also known as a synergistic epidemic) is the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbate the prognosis and burden of disease. 

Syndemic

Depression and panic disorder are significantly more common in individuals with pelvic pain conditions. Anxiety and depression may be more difficult to treat in patients with urological pain syndromes, even with psychotropic medications.

Interstitial Cystitis and Mental Health

Bipolar disorder is frequently accompanied by metabolic disorders, which are conditions that worsen psychiatric symptoms and treatment outcomes but are often overlooked in psychiatric care. Recent research suggests a bidirectional relationship via biological pathways including insulin signaling and energy metabolism. The article calls for a paradigm shift towards personalized, multidisciplinary care models that incorporate metabolic assessments.

The Overlooked Role of Metabolic Disorders in Bipolar Disorder

When patients with AS encounter an unpleasant situation, they reported feeling fear and physiological aroual, which triggers anxiety.

AS and Avoidance of Healthy Activities

The motivation to avoid symptoms of anxiety in AS patients makes them turn to unhealthy practices which are detrimental to their health.

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