News Desk : Feeling dull, tired and irritated all day? It could be your fatty liver playing tricks with you. Turns out excess accumulation of fat in your liver can cause a range of mental health symptoms from poor memory, reduced attention, to disturbed sleep. Liver is responsible for functions like production of bile for digestion, filtration of blood and also breaking down poisonous substances. If this crucial organ does not function well, it can put one at risk of cardiac complications, diabetes, kidney diseases and high blood pressure. People who suffer from fatty liver disease more often than not lead an unhealthy lifestyle or indulge in alcohol abuse which could cause mental health concerns.

"Non-alcoholic fatty liver disease (NAFLD) is a public health problem that is becoming increasingly common over the past few years, affecting over one-third adults in India. It is common in people with diabetes, obesity, and/or high blood cholesterol, but can also develop in their absence. As the name suggests, patients with NAFLD have excessive fat deposition in their liver. It can progress to end-stage liver disease or cirrhosis, and even liver cancer. It is usually asymptomatic, due to which the patients are unaware of the disease until it has progressed to an advanced stage," says

Dr Rohit Mehtani, Assistant Professor, Department of Hepatology, Amrita Hospital, Faridabad.

"Apart from the risk of progressive liver disease, patients with NAFLD are more likely to have mental health problems than the general population. These include depression, anxiety, sleep disturbances, cognitive decline, and poor quality of life. There is around 13% more prevalence of major depressive disorder including suicidal ideation and attempts in patients with NAFLD than those without. They also have difficulty in adhering to treatment recommendations including diet and exercise due to the negative coping mechanism of denial and self-blame associated with the overall health perception. People with NAFLD also tend to have a poor sleep quality due to sleep disturbances such as sleep apnoea and insomnia. This causes feeling of tiredness throughout the day, irritable behaviour, and inability to concentrate. They may also have poor memory, reduced attention span, and difficulty with problem-solving, which worsens as the severity of liver disease increases," adds Dr Mehtani.

Dr Shubham Vatsya, Consultant Gastroenterology, Fortis Escorts Hospital, Faridabad says that growing evidence suggests a positive association between metabolic syndrome and certain mental health problems like depression, anxiety, and chronic stress.

"The association of fatty liver with disorder of mental health is postulated due to unhealthy lifestyle leading to both mental health issues and obesity and in turn fatty liver disease, substance abuse like alcohol abuse leading to both mental health issues as well as fatty liver, gut dysbiosis which can lead to both fatty liver as well as mental health issues, dysfunction of the Hypothalamic Pituitary axis which can cause both fatty liver as well as mental health problems together and obesity which can lead to multiple issues of mental health and metabolic syndrome and in turn fatty liver," says Dr Vatsya.

Dr Chetan Kalal, Program Director, Program Director - Hepatology & Transplant Medicine, Nanavati Max Super Speciality Hospital shares 5 ways fatty liver affects our mental well-being.

1. Hormonal imbalance

Fatty liver can disrupt the normal functioning of the liver, leading to hormonal imbalances. When the liver struggles to regulate hormone levels, it may cause emotional instability and heightened stress responses. These imbalances can result in mood swings, anxiety, and depression, affecting an individual`s overall mental health.

2. Cognitive decline

Studies have shown a link between fatty liver and cognitive decline, including memory loss, reduced attention span, and impaired executive function. The liver maintains brain health by regulating the levels of various chemicals and nutrients and a compromised liver health, negatively impacts cognitive abilities and performance.

3. Sleep disturbances

Fatty liver has been associated with sleep disorders such as sleep apnea and insomnia. As healthy liver helps maintain restorative sleep, poor sleep quality can exacerbate mental health issues, including stress, anxiety, and depression, as well as impair cognitive function.

4. Fatigue

The liver is essential for energy production, and when its function is impaired, it can cause persistent tiredness. Individuals with fatty liver often experience chronic fatigue, which can hinder daily functioning, leading to feelings of helplessness and hopelessness, which can manifest as depression or anxiety.

5. Social isolation

The physical symptoms and emotional stress associated with fatty liver can result in social isolation. As a consequence, individuals may feel disconnected from their support networks, exacerbating feelings of loneliness and worsening existing mental health conditions. Coping with the stigma and misunderstandings surrounding fatty liver can lead to withdrawal from social interactions, further impacting mental well-being.

"In conclusion, fatty liver can have a profound impact on an individual`s mental health through various mechanisms, including hormonal imbalances, cognitive decline, sleep disturbances, fatigue, and social isolation. It is crucial for those suffering from fatty liver to seek medical guidance and adopt lifestyle changes to manage both the physical and psychological aspects of the condition," says Dr Kalal.

Source: Hindustan Times