Feeling anxious, depressed or lonely may boost the risk of early death, a new study found.
The British study of more than 68,000 people found those who reported symptoms of psychological distress were more likely to die from cardiovascular disease, cancer or injuries.
"Even with low levels of psychological distress -- certainly much lower levels than would attract a diagnosis of anxiety or depression -- these people had an increased risk of mortality from all causes," said study author Tom Russ, a clinical research fellow at the University of Edinburgh in Scotland. "The greater the level of distress, the greater the risk."
Russ and colleagues used a survey to probe participants on 12 measures of psychological distress, from lost sleep to lost confidence. After controlling for weight, physical activity and habits such as cigarette smoking and alcohol consumption, they found those who met seven or more of the 12 criteria were nearly twice as likely to die early than those who met none.
The findings, published Tuesday in the journal BMJ, add to mounting evidence that psychological stress can have physical consequences.
"Other studies suggest symptoms of psychological distress can cause physiological changes in the body," said Russ, referring to stress-induced spikes in blood pressure and hormone levels linked to heart disease, stroke and cancer. "The fact that we saw such a clear dose-response relationship adds weight to this possibility."
But stress is difficult, if not impossible, to avoid. And some studies suggest that in small doses, it might even be healthy.
"An attempt to produce a stress-free existence seems utopian and ignores the idea of 'good stress,'" Glyn Lewis, professor of psychiatric epidemiology at the University of Bristol in England wrote in an editorial accompanying the study. "A more useful approach could be to change the psychological interpretation of stressors, because this might reduce their biological impact."
Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University, said people can learn to reduce the effects of psychological distress.
"Cognitive behavioral stress management programs have been shown to reduce measures of distress like blood pressure and stress hormone levels," said Williams, who cofounded the Williams LifeSkills program. "Reducing distress is good for your well-being in general. And it has the extra benefit of potentially increasing your lifespan."
But study author Russ said more work is needed to tease out the link between psychological distress and mortality.
"At the moment, there's no clear evidence that treating these symptoms can reduce the risk we found," he said. "But that's a study that must be done."