Dr Sarah Waseem, London
As we enter a new year, many of us set targets to improve our health. Usually this takes the form of signing up to gyms, weight loss programmes or giving up unhealthy eating habits; few of us however consider how we could improve our mental health.
Perhaps that’s understandable, given how much we hear about the consequences of poor physical health on our life and diseases that await us if we don’t take action! The list is extensive – diabetes, cancer, heart disease, strokes, arthritis… and so it goes on!
However, how many of us appreciate the relationship between mental health problems and the overall disease burden worldwide? The statistics are quite shocking.
Mental health and behavioural problems (e.g. depression, anxiety and drug use) are reported to be the primary drivers of disability worldwide. In the UK, these mental health problems are responsible for the largest burden of disease – 28% of the burden, compared to 16% each for cancer and heart disease. Major depression is thought to be the second leading cause of disability worldwide and a major contributor to the burden of suicide and ischemic heart disease.
The statistics for young people make grim reading. 20% of adolescents may experience a mental health problem in any given year. 50% of mental health problems are established by age 14 and 75% by age 24. 10% of children and young people (aged 5-16 years) have a clinically diagnosable mental health problem, yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age.
Mental health is thus closely linked to physical health, but what do we mean by the term ‘mental health’ and how do we improve it?
Good mental health can be characterised as having the ability to be able to feel, express and manage a range of emotions in a positive way. That means being able to feel anxious, sad, happy, or even angry, AND to be able to accept the feelings AND be able to speak about them AND deal with them in a healthy manner. So for instance, a healthy anxiety about sitting an exam might mean we study more than usual, talk to professors and friends to get their input on how we could do well, check out past papers , and write practice answers. We may still feel anxious, but we are trying to respond to it in a helpful way. An unhealthy response would be to just worry excessively, to stay up long hours revising, or to avoid talking about the exam. Other unhealthy responses might include self harm, panic attacks or avoidance.
Resilience and coping with uncertaintly are also very important for good mental health. Resilience helps us cope with setbacks. Resilience allows us to get through unpleasant life events such as losing loved ones, or jobs or experiencing changes in our roles, for example changing areas where we live, going to University, getting married, or divorced and starting new jobs.
So how do go about developing good ‘mental health’? Interestingly some of the strategies that work with physical health are also helpful. These include having a good diet and engaging in exercise. There is a lot of evidence demonstrating the positive effects of physical exercise on our brains and how exercise enables the release of ‘feel good’ neuro-transmitters like dopamine. Getting physically active is often an initial treatment for depression and of course we can exercise the brain in other ways such as learning new languages, doing puzzles, reading, crosswords, and problem solving activities.
Relationships with others are important. Social contact helps us to feel connected and this is especially so for young people. Sharing our achievements, our joys and our difficulties means that we get other perspectives on what may seem at the time to be an insurmountable problem. However it is important that we have healthy relationships, with individuals who support us, who care about us and who also have a positive outlook on life. It’s rather like having our own personal football team. We need the players to support and score goals for us not for the other side! Again for younger people, this is especially important. Being part of a social network where one is being bullied or criticised or abused in some way, is very destructive and can have serious consequences for one’s self esteem.
We develop resilience by being able to use positive coping skills to deal with setbacks. These skills can include getting perspective on a difficult event, seeing it for what it is rather than catastrophising about it. So setbacks are just that – they may push us further away from our goals, but they don’t remove the goals. Parents have a huge role here in helping young children develop good mental health, and much of this will come through their own ability to model coping strategies.
Mental health, like physical health, doesn’t always stay the same. It can change as circumstances change and as one moves through different stages of life. However, we need to value it and accord it the same care that we do for physical health.