You already know that keeping your bones strong and healthy means taking care of yourself physically. Now new research has found that your mental health can affect the health of your bones, and in a big way. If you tend to have anxiety, it can even lead to fractures. Here’s why…and what to do about it.


It was already known that certain psychiatric disorders, including depression, were associated with fracture risk. But how anxiety might affect bone health hasn’t been well studied. So researchers at the University Hospital of Messina in Italy led a study that investigated the role of anxiety in postmenopausal women, a group that is already, of course, at increased risk for bone problems because of hormonal changes from menopause. The women studied, about 200 of them, had not been diagnosed with anxiety and were not taking osteoporosis medications at the start of the study. They answered questionnaires that assessed their overall levels of anxiety and were given bone mineral density tests.

Results: Women who had higher anxiety scores had lower bone density in the lower vertebrae and in the femoral neck, the part of the thigh bone just below the ball of the hip joint. In fact, based on their bone-density scores, women who reported the highest levels of anxiety had a 22% greater probability of having a major fracture over the next 10 years (24.94% vs. 20.44%)—and a 34% greater likelihood of a hip fracture (9.26% vs. 6.91%—compared with women with the lowest anxiety scores. (Women with higher anxiety scores were also slightly more likely to have already had a fracture, compared with women with the lowest anxiety scores—but the difference was not considered statistically significant.)

The researchers postulated several ways anxiety could affect bone health…

  • Inflammation. People with high anxiety levels are likely to have high levels of systemic inflammation, which leads to bone loss and is a contributor to osteoporosis.
  • Cortisol. People with anxiety tend to have higher levels of the stress hormone cortisol, which also contributes to bone loss.
  • Oxidative stress. Anxiety may cause more oxidative stress, which means that the body has a harder time fighting free radicals, molecules that can harm cells. Research has found that oxidative stress may be related to osteoporosis in postmenopausal women.
  • Falls. Research links anxiety with an increased likelihood of falls.
  • Medications. While this study did not include women who were taking medications for mental health disorders, antidepressants are known to reduce bone density—and people with anxiety often take antidepressants.

What to do: Understand that anxiety may be one of the factors that can harm your bone health—and besides the smart bone-health measures you already know about, such as getting enough calcium and vitamin D, strength training and aerobic exercise, do whatever you need to do to reduce stress and curtail your anxiety.

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