How to know if therapy can help with a physical health problem

Why physical and mental health are more connected than you might think

“Culturally, we still kind of separate mental health and physical health,” Opland says. But in medicine, that model is increasingly antiquated. “Now, we really view the mind and body as being integrated in so many ways,” says David Reid, Ph.D., a clinical psychologist and assistant professor in the department of psychiatry and behavioral sciences at the University of Washington Medical School.

The mind-body connection is a well-documented two-way street. “There’s a huge body of research that shows physical health is correlated with mental health,” Dr. Reid says. “And, importantly, as your mental health improves, your physical health is going to improve.”

Dr. Reid sometimes demonstrates this to patients with a simple visualization: Picture a bright yellow lemon. Imagine slicing it open, feeling the skin, inhaling the citrusy scent, then biting into the sour fruit. Most people start to salivate or pucker—all from imagination alone.

How can what’s happening in your mind influence your body? “The body and brain are in constant communication,” Opland says. One major pathway is the nervous system, which plays a key role in both physical and mental health conditions.

When you experience anxiety or emotional distress, your nervous system shifts into fight-or-flight mode (also called the stress response). Your heart pounds, your breath becomes shallow, and cortisol levels rise. In the short term, this can lead to indigestion, muscle tension, increased pain sensitivity, and energy depletion, Opland says. “Over time, that chronic stress can cause damage to the body,” Dr. Reid adds, like more inflammation, immune system changes, and worsening symptoms.

On the other hand, when our nervous system is in the relaxation response (or “rest-and-digest”), our bodies enter a calm, regulated state more conducive to proper functioning, rest, repair, and symptom relief, Dr. Reid says. But when we’re constantly dysregulated, we spend little time there. “If somebody’s trying to manage chronic pain or an autoimmune condition while also living in a high level of chronic stress, their nervous system is never going to be able to settle down for recovery,” Opland explains. “And their symptoms are going to get harder to manage overall.”

A key nuance here: None of this suggests your symptoms are “all in your head” or that your mental health caused any of these conditions, Opland points out. “It just means that emotional stress, an activated nervous system, and psychological distress can influence symptoms and flare-up frequencies.”

6 health issues often influenced by mental health

Let’s look at some physical conditions and symptoms that have a proven correlation to mental health, plus the mind-body links behind them.

Gut issues

You’ve probably heard about the gut-brain axis—the nerve network that connects your central nervous system with your digestive system. “Stress and anxiety can really show up in GI disorders or symptoms,” Opland says. If you’ve ever had a stomach ache or other tummy troubles when faced with something stressful or nerve-wracking, you know what we mean.

Many studies show that people with irritable bowel syndrome (IBS) or inflammatory bowel disease (including Crohn’s and ulcerative colitis) experience much higher rates of depression and anxiety, and people often report symptom flare-ups correlating with stress or mood. A review published in the journal Cureus in 2023 found that various types of therapy (including CBT and mindfulness therapy) helped improve the severity and frequency of IBS symptoms.

Chronic pain

Chronic pain and stress share the same neural pathways. “The same brain synapses are firing when people are in pain and when people are stressed,” Dr. Reid says, which is part of why stress amplifies pain, and why persistent pain tends to drag mood down with it.

The body’s stress response also plays a role: cortisol surges, muscle tension, inflammation, and fatigue can all worsen chronic pain issues, Opland says. And there’s a behavioral loop: People in chronic pain often structure their lives around avoiding potential triggers, which can keep them from experiencing the mood-boosting benefits of things like movement and social connection, Dr. Reid says.

Cardiovascular disease

The link between mental health and heart health is another well-established one. “People who are having cardiovascular problems are more likely to experience depression,” Dr. Reid says. And the reverse is also true: Stress and depression are known contributors to heart disease. A landmark study of more than 29,000 people across 52 countries identified psychosocial factors like stress and depression to be among the strongest predictors of heart attack—nearly on par with smoking. The American Heart Association even recognizes depression as a risk factor for poor outcomes after acute coronary events.

What’s behind this link? Inflammation (linked to both depression and heart disease) and nervous system dysregulation are two likely pathways, Dr. Reid says. Then there’s the behavioral loop again: “When we’re stressed, we often don’t want to engage in the more difficult things,” Dr. Reid says—exercising, eating well, taking your medication, seeing friends. Skip those long enough, and both your physical and mental health can take a hit.

Autoimmune conditions

Stress can both trigger and worsen autoimmune conditions—including lupus, multiple sclerosis, and Graves’ disease, according to the Global Autoimmune Institute. A large Swedish study published in 2018 found that people with stress-related disorders (like PTSD) were much more likely to develop autoimmune disease, and a growing body of research links stress with symptom flares and increased disease activity. This is likely the result of inflammation and immune system dysfunction from the stress response constantly being activated, Opland says.

Fatigue and poor sleep

Most of us know this one firsthand: fatigue usually tanks your mood, and feeling down or depressed can drain your energy—no matter how much sleep you get.

Once again, inflammation and behavior loops may be at play. “Inflammation can really affect our mood, and it’s also linked to fatigue,” Dr. Reid says. That fatigue often makes you more likely to stay home and become less active and social, which in turn impacts your mental health, Dr. Reid explains.
Then there’s the role of poor sleep in so many physical and mental health conditions. “Sleep is one of these underlying components of fatigue, cardiovascular problems, chronic pain, post-traumatic stress, depression, and anxiety,” Dr. Reid says. The relationship works both ways: symptoms like anxiety, rumination, and pain disrupt sleep, which worsens mood, energy, and chronic symptoms, which makes sleep even harder to come by.

Skin conditions

If you’ve ever experienced breakouts or hives while stressed, you know this one well. In fact, your mind and skin are so closely related that there’s an emerging medical specialty called psychodermatology.

This is another two-way street: Stress can worsen skin conditions (like acne, psoriasis, and hives), through mechanisms like immune system dysregulation, skin barrier weakening, and inflammation, according to a recent research review. Meanwhile, chronic skin conditions can impact your mental health if they tank your self-esteem and cause you to withdraw from social situations. In fact, many dermatology patients also experience psychological concerns like depression and anxiety, according to a 2015 study.

How to know if your symptoms might benefit from therapy

In Opland’s view, most people managing a chronic health condition or ongoing physical symptoms would benefit from working with a therapist—even if they feel like they’re handling things pretty well. “It’s always good to have that additional support system,” she says.

But here are a few clear signs that your physical health concerns are likely influencing or being influenced by your mental health:

• Your symptoms get worse when you’re stressed. If your headaches, GI distress, pain, or fatigue track with tough weeks, your nervous system is part of the story, Opland says.
• Your health concerns tend to bring up big feelings. “Pay attention to whether the appearance or worsening of symptoms triggers heavy feelings, anxiety, fear, or rumination,” Opland says. Same for if other health-related things—like doctor’s appointments or dietary restrictions—send you into a tailspin.
• Your symptoms follow a pattern. Dr. Reid usually asks patients when and where their symptoms appear or worsen, which can often uncover an underlying trigger. For instance, maybe you tend to notice flare-ups at work, at family events, or when you’re finally free of distractions at night and trying to go to sleep. All those details might offer a clue that’s worth talking about with a therapist, Dr. Reid says.
• You’re calling out of work. Whether it’s the physical or emotional toll that’s causing you to miss work, constantly needing to take sick days is a clear sign your condition is interfering with your life in a big way, Opland says.
• You’re not taking care of yourself. “There’s a direct correlation between stress and one’s ability to remember to take care of themselves,” Dr. Reid says. So if you notice that you’re skipping things like taking medication, working out, eating well, or seeing friends, that’s typically a sign that your stress management needs a tune-up.
• Your sleep is suffering. Sleep is crucial for keeping your mood and energy levels stable, so if your physical symptoms are keeping you up at night, that typically means it’s impacting your mental health, Opland says.
• You can’t unwind, even when you have the chance. If you find yourself constantly activated and unable to mentally “turn off,” that could be a sign that you need some help relaxing your nervous system, Dr. Reid says.
• You’re feeling hopeless, isolated, or like a burden. Experiencing a sense of hopelessness, withdrawing from your loved ones, or feeling like people would

What mental health support looks like for physical health concerns

Bringing a physical health issue to therapy might feel counterintuitive, but the goal is the same as it is for mental health: reducing suffering and improving your quality of life. That usually means building practical skills (like improving sleep, setting goals, and pacing yourself), and learning to work more skillfully with your thoughts, feelings, and sensations, Dr. Reid says.

Another major focus is calming the nervous system. “When you’re in that rest-and-digest [state], not only are you allowing your body to relax to where it can function more properly,” Dr. Reid says, “but you also are giving your mind some space.”

Types of therapy that can help with physical health concerns

• Cognitive behavioral therapy (CBT): CBT helps people identify patterns of thinking and behavior that unintentionally amplify distress or symptom-focused fear, Opland says. There are even specialized adaptations for chronic pain (CBT-CP) and insomnia (CBT-I).
• Acceptance and commitment therapy (ACT): ACT helps people with chronic health issues build a greater sense of agency by learning to accept their symptoms, thoughts, and feelings rather than fighting them, and continuing to live in a way that aligns with their values. For example, if you have a thought like “I’m never going to get better,” the ACT approach would be to acknowledge the thought without buying into it—and then do something important to you anyway, like taking a walk, Dr. Reid explains.
• Mindfulness-based therapies: Approaches like mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are great for relaxing the nervous system and training you to observe thoughts and emotions without being swept away by them, Dr. Reid says. A review of 18 studies found MBSR led to improvements for people with chronic conditions including hypertension, diabetes, and chronic pain.
• Somatic modalities: “Somatic therapy has become pretty popular, particularly among individuals who are dealing with traumatic stress,” Dr. Reid says. “It automatically assumes that the mind and body are interrelated.” In practice, instead of only talking about your emotions, you and your therapist might track where and how you feel them physically in your body, then work on releasing that stored tension.

How to find a therapist to help with health concerns

• Ask your doctor for a referral. Doctor’s offices often have a working list of mental health providers who collaborate with their patients on health-related concerns, Dr. Reid says.
• Search by specialty. Dr. Reid recommends looking for a health psychologist, or filtering for therapists who specialize in treating patients with chronic illness, chronic pain, or trauma. Trauma-focused therapists “really have that understanding that individuals who have gone through something physical in their life are affected mentally by it, and vice-versa,” he explains.
• Interview the provider. “You can always screen a therapist by asking them questions before or during the first session,” Opland says—like whether they have experience working with people with chronic health issues, what modalities they use, and how they think about the mind-body relationship.

One final reminder: Seeking mental health support for a physical health concern doesn’t mean that your symptoms aren’t real. It means you understand how deeply physical and mental health are connected, and that you’re ready to address both in order to truly feel better.