May the new year bring hope, optimism for new opportunities, and a brighter future to the world. Covid, politics, climate change and instant connectivity have all made the past few years challenging, and unique in the history of humans.
With these challenges, our collective mental health has been pushed to its limit. There is so much stress, anxiety and depression in the world today. It may be time to reformat how we approach health and wellness.
As a physician, I see two broad camps generally used to address mental health. On one hand we have the allopathic approach, which uses psychotropic medications to address disorders like stress, anxiety, and depression. But this in only a Band-aid. It targets the symptoms and does not address (or improve) the underlying precipitating conditions.
Often the side effects of these medications are worse than the symptom itself. This leaves patients blunted, foggy, overweight and with no libido.
Shortcomings of Psychology
The psychological sciences, evolving over the past century, are at their core subjective. We have limited metrics to address the question, “How do you feel?” We are making objective advances with fMRI and neuromodulation. But the assessment of, and therapeutic interventions towards mental health is still steeped in process— less objective content.
Recall the old Reece’s Peanut Butter cup adds from the 1980’s? “You got your peanut butter on my chocolate” and “You got your chocolate on my peanut butter!”
The future of mental health will benefit to learn from the Reece’s model. We need to blend the biochemical contributions with the psychological and emotional ones to create a new platform for mental health.
Literature is replete with data to show that the less-tangible mind, along with objective biochemical metrics both contribute to mental health disorders. We need to be taking both of these factors into play as we move forward to address the upswell in mental health disorders in the year 2022.
Yes, a thought is a product of our minds. It is fleeting or persistent, negative or good, supportive or detracting. And so much of our mental health centers on our thoughts. Shakespeare said it best, “There is nothing either good or bad, but thinking makes it so.”
We know that psychotherapy and practices like CBT can help us to modulate these thoughts. But this is only a part of the equation.
Biology plus Psychology: The Future of Mental Health
In addition to addressing thought-based processes, it is essential that we incorporate a biochemical approach to mental health as well. Inflammation, infection, nutrition, toxins, hormones, environment, stress, and the gut biome all collectively influence the way that a thought—so ethereal but yet so powerful– is produced.
In order to really “move the needle” on mental health, we need to expand our perspectives to include all of the contributing aspects. Failing to address these influences on our biology on mental health is akin to betting on a three-legged horse. It isn’t going to produce the results you want, regardless how hard you flog it.
The old paradigm of try a psychotropic medicine, add another one, and then start escalating dosages is equivalent to flogging the horse. We are not improving our results with this style of practice, and need to begin thinking, in the truest sense of the word, holistically.
And if we were so fortunate to be able to collect, evaluate and refine these relationships with computer learning? This could be the breakthrough that medicine needs to reclaim our collective mental health.