Frank, 56, has many of the classic risk factors for heart disease, including hypertension and high cholesterol, so when he suffered severe chest pain, he headed for the ER. He was admitted and kept overnight for cardiac tests and evaluation. The tests, however, found nothing unordinary, and he was discharged.
Michael Munger, M.D.
Unfortunately, Frank's chest pain continued to the point that he couldn't work.
Again, he ended up in the ER.
Again, the tests found nothing wrong.
Finally, Frank came to my office, and we talked about his pain and his ensuing hospital visits. More importantly, we drilled down to all the other things that had been bothering him and found that his heart was not the source of his problems. His pain stemmed from undiagnosed, untreated anxiety.
I prescribed medication for his anxiety and referred him to counseling. The combination is working. Six months later, Frank's pain is gone, his anxiety is under control and his life is back to normal.
It's not uncommon for symptoms such as chest pain, headaches and abdominal pains to have root causes that are related to mental health rather than physical health. Fortunately for patients, we can help them with both. Roughly 20 percent of all visits to primary care physicians include at least one mental health indicator,(www.cdc.gov) and patients may be more likely to discuss mental health with their trusted primary care physician when they have an established relationship.
An Altarum Institute analysis(238 KB PDF) of National Ambulatory Medical Care Survey data from 2006 to 2008 found that more than one-third of mental health visits by patients aged 45-64 years were provided by primary care. Those numbers may be growing. A 2015 CDC report(www.cdc.gov) suggests that the percentage of mental health care provided by primary care physicians is increasing. Specifically, the report showed that although the percentage of people receiving services for mental health held steady from 2012 to 2015, the percentage of those with serious psychological distress who received care from a subspecialist fell from 41.8 percent in 2012 to 34.2 percent in 2015.
May is Mental Health Awareness Month, and the AAFP is reaching out to the public to let people know that despite the stigma attached to mental illness, 20 percent of Americans will experience some form of mental illness in their lifetimes. And when people need help, their family physician is a good place to start.
The Academy's outreach includes resources for patients designed to help them know when to seek help(familydoctor.org) and a guide to help them(familydoctor.org) get the most out of their office visit. The AAFP also has resources for physicians.
Finally, on May 22 the AAFP will have a National Day of Action for mental health. I ask you to join our #MentalHealthMatters Thunderclap campaign(www.thunderclap.it) to share the message that family physicians treat the whole person -- mind and body -- and patients should reach out to us when they need help.