Physical factors relate to genetic makeup and how physical health interacts with mental health. They include:
Physical health problems
People with a learning disability are often susceptible to physical health problems. Being physically unwell can have a negative effect on general well-being and may lead to poor mental health.
Physical disabilities (including sensory impairment)
People with a learning disability, especially those with severe and profound learning disabilities, are more likely to have physical disabilities. People with chronic physical disabilities are at increased risk of developing mental health problems, especially depression.
People with sensory impairments are at a greater risk of developing mental health problems, especially those with hearing impairments. A hearing impairment can lead to social isolation and misinterpretation of situations. Mental health problems are more likely when the sensory impairment occurs later in life, i.e. there is an increased sense of loss.
Communication and language problems can have an unfavourable effect on mental health. Some people with a learning disability may not be able to express their feelings, and feel frustrated and angry. Sometimes they may use actions to communicate, but those changes in behaviour may, in turn, be misinterpreted as a phase and not acted upon with appropriate support. Moreover, challenging behaviour can occur in people as a result of difficulties in expression, emotional pain or distress.
The unwanted effects of medication, whether for physical or mental ill health, can lead people to develop mental health problems. For example anti-depressants can sometimes precipitate a period of hypomania. Medication that is given to treat high blood pressure can sometimes contribute to the development of depression. The unwanted effects of medication can sometimes be worse for the person than actually living with the condition they are being treated for and they may decide not to take the medication. People with a learning disability may be taking a number of medicines, and so are at particular risk of unwanted side-effects, particularly if the prescriber does not regularly review these.
Drugs and alcohol
The use of illegal substances, the abuse of alcohol and over-the-counter medicines can increase an individual’s vulnerability to mental health problems.
Syndromes and developmental disorders
Some genetic syndromes are associated with having a learning disability. Conditions such as Down’s syndrome and Fragile X are two of the most common syndromes associated with having a learning disability. Some of these syndromes are also associated with mental health problems, for example, those with Down’s syndrome are at increased risk of Alzheimer’s disease; those with Prader-Willi syndrome are more likely to develop eating disorders; and autism has been associated with an increased risk of anxiety and depression.
(Hardy, S., Kramer, R., Holt, G., Woodward, P., Chaplin, E., Janjua, A (eds.) (2010) Supporting Complex Needs: A practical guide for support staff working with people with a learning disability who have mental health needs)