When you think of someone high in neuroticism, you probably conjure up the image of a person who’s always worried, anxious, fearful, and unhappy. But did you ever stop to imagine what this person’s health may be like?
In the old chicken vs. egg dilemma, also known as “correlation does not equal causation,” such a connection presents a challenge. Is someone’s health bad because of the high neuroticism, or does bad health lead a person to become highly neurotic? Or, is there a third possibility due to some type of unseen factor?
Consider the example of Fredda, who is constantly worrying about future bad possibilities that could befall her. She can rarely enjoy herself because she’s focused on what’s wrong in any given situation. Her physician’s office knows her quite well because she’s always calling in about some new set of bothersome symptoms. As she switches from medication to medication, nothing seems to work; in fact, she seems to be getting worse. In the past week alone, she was more fatigued than ever, and occasionally felt dizzy.
The Problem of Polypharmacy
According to a new study by the University of Montpellier’s Yannick Stephan and colleagues (2025), it’s possible that Fredda is experiencing symptoms associated with “polypharmacy.” Long known to be a concern in the treatment of older adults, polypharmacy occurs when someone’s medications interact with each other to produce unwanted effects, many of them psychological in nature. People who work in the field of mental health and aging are trained to look out for this as a condition that can mimic dementia or impaired cognitive functioning.
Rarely does anyone ever think about the possibility that personality could play a role as a risk factor for polypharmacy. The U. of Montpellier–led research team (who define polypharmacy as the use of 5+ medications) started to wonder about this due to the “consistent evidence” for a connection between health and personality as defined by the Five Factor Model (conscientiousness, agreeableness, neuroticism, extraversion, and openness to experience).
Could the key to this relationship lie in polypharmacy? Previous studies have demonstrated across a number of relationships between neuroticism and heavy usage (e.g., drugs, alcohol) and medications, including painkillers, sedatives, and antidepressants. Relationships to other Five Factor traits are not as consistently shown, nor is neuroticism always a factor either. However, these prior studies varied tremendously in sample size, makeup, length of study, and number of factors included, not to mention variations in health status of participants. That’s where the Stephan et al. study comes in.
Tackling the Personality-Polypharmacy Connection
With data from five large longitudinal studies taking place in the U.S. and England, along with powerful statistical tools, Stephan et al. were able to examine polypharmacy’s role in health and personality. Neuroticism ratings asked participants to answer whether they “get nervous easily” or “worry about things.” Participants reported on their own medication use as well as their health conditions, physical measurements, age, education, and race/ethnicity. All in all, the study included more than 15,000 people, ranging from 16 to 101 years old, and studied them for from 2 to 20 years.
From this very impressive dataset, the French-led research team was able to factor personality and control variables into equations with polypharmacy (yes or no) as the outcome. As the authors predicted, it was those high in neuroticism whose risk of polypharmacy was greatest. The highly conscientious and extraverted had lower risk, and agreeableness played no part. As the authors concluded, “The use of five well-powered longitudinal studies…brings coherence to [the] literature by identifying a replicable association between neuroticism and polypharmacy.”
This conclusion certainly begs the “why?” question. There are several possible answers. In addition to having more conditions that could lead to higher numbers of prescription medications (think about Fredda), the highly neurotic may be constantly stressed by their tendency to worry. But, psychological distress isn’t enough, the authors maintain. Highly neurotic individuals may have objectively worse health due to a greater propensity to engage in unhealthy habits (such as smoking) as well as having a more sedentary lifestyle. Conscientious people, as is well known from prior studies, take better care of their health, and extraverted individuals just seem to have higher rates of physical activity.
What This Means for Your Health
It’s sad, in a way, that higher neuroticism could have this very unfortunate side effect on neurotic people of creating poorer health due to a combination of more chronic conditions and a tendency to seek medical help. Their search for treatment only compounds their problems, leading to further difficulties associated with heightened risk of falling, dementia, fatigue, and frailty—the very conditions that can truly impair their health, if not mortality.
Neuroticism Essential Reads
If you’re a person high in neuroticism, there’s an important takeaway from this very comprehensive study. Look in your medicine cabinet. Don’t just count the number of pills in there, read the labels. Do they indicate side effects such as drowsiness and fatigue? You can also ask yourself whether you’re making full use of the power of your own electronic health records. See if there are potential interactions you’ve been glossing over when you get handed a new prescription. While you’re at it, do the same thing for someone you care about, whether a relative or close friend.
The other important take-home message from this study is the identification of neuroticism as a risk factor for health problems. That medications can accentuate neuroticism’s role only highlights the importance of addressing psychological contributions to chronic health conditions.
To sum up, knowing the medical risks associated with personality doesn’t have to be a completely discouraging exercise. It can be empowering to know that you can take steps to improve your health through very simple actions.
