The most simple and powerful ‘cure’ for mental illness: Looking after ourselves

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Last week I was invited to speak at Vibewire’s FastBREAK event; a monthly breakfast event in which five speakers blitz five-minute presentations on a particular topic, this month’s topic being cure. My background over the last few years having been mental health, I had one or two thoughts on this one. The great thing about these sorts of opportunities, is they force you to consider your own views on the topic, and articulate those thoughts in to something coherent and with a message behind it.

I think modern society’s obsession with fixing things and finding a ‘cure’ is not an altogether healthy one, and in the mental health sector I’ve seen evidence of that. The medical model takes the view that mental illness is a physical malfunction of the brain that needs to be corrected. As a starting point for how we view mental illness, I think this is bullshit and can do more harm than good.

Sure, the evidence is solid that many psychological disorders (to varying extents) have a genetic component, and some people are more predisposed to them than others. I don’t dispute that. But it nonetheless needs a life trigger to happen, and that comes down to personal circumstances. This model in isolation does not explore the life circumstances that triggered the problem in the first place. It’s like giving someone who is obese weight-reduction pills, and ignoring the fact that they spend all day on the couch eating fast food. You’re treating symptoms, not the cause, and as long as that’s the case then the problem will repeat.

The other major gripe I have with this model, is that it waits until there is a problem before looking for a solution. What has become increasingly apparent to me over the years, is that the best solution is ‘prevention’. The smartest investment may not actually be in finding the best drug treatments, but in showing people how they can better look after themselves in the first place.

Now I’m not saying here that the medical model has no value, not at all. Research in to mental health increases our understanding, and helps us to see where the triggers lie and what aspects of our life might have caused the problem. And in some cases, the mental illness is so debilitating (and long-term), that drug treatment is the only way in which to give that person decent quality of life, or to get them to a stage where they can start looking at more holistic techniques to better understand what triggered the problem and the life changes they can make. But I want to use this blog to demonstrate why I think simply taking better of ourselves is the most obvious, and underused, ‘cure’ for mental illness out there. Heck, it’s probably the best ‘cure’ for physical illness too. You’ll see that mental health and physical health are so inexorably linked that when it comes to maintaining them, it’s little use to differentiate.

The positive effects on our bodies and minds of exercise are incredibly profound. Other basics such as our diet and getting enough sleep are also tremendously impactful on our wellbeing. Lack of sleep is correlated with all manner of psychological disorders, and I’m sure we’ve all experienced feeling crap when sleep deprived.

From a more psychological point of view, I think enormous value should be placed on our social relationships with others – family, friends, colleagues. The drive to be accepted, appreciated and part of a community is at the core of humans. We’re fundamentally social creatures. Also having purpose, feeling like we’re contributing something positive, learning are all deeply important to our mental health.

The New Economics Foundation put together a ‘Five Ways to Well-being’ project, which is nicely presented and based on the strength of research. It’s worth a look.

I’ll also jump back to a blog I wrote a while ago on acceptance, and why this is so important. As Seema Duggal explained in her talk, somehow we have developed a culture in which we expect to feel happy – it is deemed the ‘norm’. This is ridiculous and unrealistic. The whole premise behind the evolution of emotion is for the adaptive advantage it gives us. The ability to recognise whether something is good for us or not. Inevitably, there will be some of the latter. It’s healthy to feel sad when we experience loss or disappointment, and there are valuable lessons in the painful emotions too. Accepting our emotions, whatever they may be, is an important aspect of taking care of ourselves.

We all have mental health so let’s take proper care of it; doing so has a huge impact on every day of our lives. I learned this lesson the hard way when I went through depression, however my life has been so much richer since then because of the care I’ve given to acknowledging and building my own mental health. It’s been tough, and I have to be proactive with my mental health. I take time out every day for activities such as meditation, walking, cooking/eating good food, cycling, time with friends and view these as essential parts of my day.

My final thought is on how we might teach people the importance of and techniques that assist us to look after our mental health? Should this be part of public education as we grow up? It has such enormous consequences, and if we could learn these things early…

So a final question. What will you start doing every day to look after your own mental health better? You can’t use the excuse of being short of ideas – there are about ten in this blog alone! Good luck with it, and enjoy the rewards.

Mental illness: A cause or effect of changes in the brain?

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As a graduate of the ever evolving field of Neuroscience, who has since committed their professional life to mental health work, the inevitable link between the two areas has cropped up in discussions more times than I count. It’s a connection I can’t help but think about, given that the potential implications are so far-reaching.

The current drug treatment model is largely based on the assumption that if you remove the associated neurological changes i.e. changes in the level of various chemicals in the brain, then you also remove the problem. Increasingly often this is being paired with more holistic therapeutic techniques such as CBD, and this dual approach is one I certainly see as being more effective.

However, what if the actual underlying problem that has caused someone to become ‘mentally ill’ is far deeper, and by treating the neurological symptoms you’re thereby missing out on areas of their history or lifestyle that, if ignored, will only lead them to return to this unpleasant psychological state. It’s a possibility that would potentially completely undermine the current medical model, and yet this line of thought is continuing to gather momentum.

Based on my experience of mental illness – both personally and of the many people I’ve met, and my time spent studying the brain (somewhat ironically, in between killing my own brain cells with alcohol, like a true student) I’ve come to my own conclusions on it and it’s something I’d like to share, especially in the context of how we approach helping people who are psychologically distressed. At this point I’d like to throw in a couple of key points that will impact upon the context of the rest of this piece.

1. This is not a scientific article, and nor is it intended to be. It’s a blog. There is a great deal of literature and research out there, but I’ve chosen not to reference it here. This is part because I’ve seen how exceptionally competent scientists are at failing to explain their conclusions to the average member of the public, and partly because…well it takes a bloody age. I’m just going to provide an outline and I’ll leave it up to you if you really want to look it up (there’s a ton of stuff out there). Otherwise you’ll just have to take my word on the sciencey-stuff and assume I’m not just making stuff up for kicks.

2. I’m using the term ‘mental illness’ and associated disorders such as ‘depression’ and ‘anxiety disorder’ because they are widely understood. For the record, it’s not language I actively promote because of the negative associations it creates, and I’m also not a fan of grouping such varied symptoms and personal differences in to the narrow categories currently used. The mind is a tad too complex for that. But that’s a whole other topic…

So let me start by saying that there is a well-established link between mental illness and abnormalities in the brain, which has been accepted for several decades. There’s not really any argument about this. Which part of the brain, however, has caused a great deal of dispute. A chemical named dopamine was once thought of as the ‘happy’ or ‘pleasure’ chemical of the brain (what a revelation that would be!), but this theory has since been disproved. Modern research in to depression has brought a lot of attention to a chemical named serotonin, and led to the advent of a popular drug type called ‘selective serotonin reuptake inhibitors’, which is indisputably catchy.

The point I’d like to make here, is that the brain is not so simple that one chemical is assigned to one particular function, such as mood in this context of this blog. Physical and psychological changes are brought about by changes in levels of neurological chemicals in relation to one another, and it also entirely depends on which area of the brain these changes are occurring in. We have a series of chemicals that can either inhibit or stimulate a chemical pathway, and depending on the brain network, an inhibitory chemical could have completely opposite effects on your mood in two differing areas of the brain. Are you beginning to see how damn complex it is? So even if you’re changing serotonin levels, you need to target a very low percentage of those serotonin pathways to have the desired effect. The shotgun effect, which is seen in every drug treatment, produces a whole range of responses to the drug – both good and bad.

What you may also start to realize from this, is that no two brains are identical – quite the opposite. The design of the pathways in your brain and your level of chemicals is completely unique – which is one of the few things I can say with certainty in this commentary. You can imagine the headaches researchers get when trying to draw conclusions about mental health when looking at large samples of people who are all presenting different results.

I’ve spoken with many people who have shared their experiences of drug treatment for a mental illness with me and a few common themes have come out. Firstly, that they may have to try a few different types of medication before they find one that works. Secondly, that they often feel worse to begin with before they start to notice an improvement. Thirdly, the dreaded dependency effect.

What became apparent through my experience of depression, and many others I’ve spoken with who have experienced ‘mental illness’ is that there is a cause, and a trigger. Some of us are genetically more susceptible, but life experience plays a big role. There’s a bigger picture here. And our brains have not evolved to just ‘imbalance’ and cause us to become mentally ill. Doing so is maladaptive.

One of the biggest realizations in the field of neuroscience in the 20th century was that the brain remains plastic for its entire life i.e. it continues to change, develop and adapt. This happens throughout our lives. And these are potentially fairly considerable changes too. And even on a daily basis, there are notable changes. A moment of excitement , of disappointment, a spark of happiness…they all cause a change in the brain. It’s absolutely plausible that events in our life that are too much for us emotionally can have strong, and potentially long-lasting effects on the brain. In fact, it would be completely counterintuitive for someone who is depressed to not demonstrate some notable changes in their brain.

I feel that current attitudes and the medical model fit with our way of western thinking – to find a quick fix and put the cause as being out there somewhere. The fact that we can actually be the biggest drivers of change in our own lives is an intimidating and, often, ignored concept.

I believe we need to depend less on the medical model, accept how different people are and understand that each experience of mental illness is unique so it can’t be treated the same way. Rather, it should be treated holistically, with drug treatment only if so severe they can not manage their everyday life or are very high risk.

What I’d also like to mention, is that sometimes changes we make in terms of what we put in to our bodies could trigger these changes in the brain. A different diet, drug treatment for a physical problem, the contraceptive pill…these can all lead to changes in the our chemical balance and lead to mood or personality disorders.

Where it gets very blurred and unclear for me is in some of the severe cases of mental illness, such as with bipolar disorder or forms of schizophrenia. My conclusions don’t extend to this – partly due to lack of evidence, knowledge or experience. The strike me as being more long-term, with possibly more of an underlying neurological dysfunction and thus drug treatment has more of a role. The brain is so incredibly complex, and we’re learning more all the time.

Whether these changes in the brain are definitively a cause or symptom of emotional and psychological distress, or even a combination of both, remains unclear, and it’s likely that it varies depending on the situation. What is clear given the huge implications, is that like all things related to mental health, we need to talk to get it out in the open and explore it from the point of view of what will be the best for people.