Something is stirring in the world of mental health and for once the news is positive. This month, British scientists began testing a radically new approach to treating schizophrenia based on emerging evidence that it could be a disease of the immune system. Meanwhile, scientists are investigating the possibility that low levels of chronic inflammation may be linked to depression.
Oliver Howes, a professor of molecular psychiatry at the MRC London Institute of Medical Sciences and a consultant psychiatrist at the Maudsley hospital in south London, is leading the schizophrenia research. “In the past, we’ve always thought of the mind and the body being separate, but it’s just not like that,” he says. “The mind and body interact constantly and the immune system is no different. It’s about changing the way we think about mental illnesses.”
Hear, hear to that. For a while, I’ve believed that we need to stop splitting mental and physical health. The mind doesn’t exist outside the body. A body without a mind is a corpse. In a way, this is a return to an old way of thinking: a “healthy mind in a healthy body” was the main component of the ancient Greek Hippocratic philosophy. But since Descartes split mind and body, arguing that the two were distinct, we’ve been living with the consequences.
The NHS distinguishes between mind and body – and can use the division as an excuse not to fund mental health services. And I used to embrace the split, too, until I was afflicted by two severe depressive episodes. I was astonished by how physically unwell I became. I couldn’t sleep. My heart sped up. I felt nauseous. Every bit of me hurt. I was suicidal, because I felt so rotten.
Try this for a moment. Take a deep breath. Let your shoulders drop. Close your eyes. Breathe. Enjoy that moment of physical relaxation. And notice something interesting. When we become physically relaxed, we become mentally relaxed. It’s impossible to be physically relaxed and mentally tense. Equally, if you feel stressed and tense, your body follows.
In repressive cultures where expressions of the thought are not allowed, the mind can manifest itself in symptoms of pain. Those who have suffered intolerable trauma, such as childhood sexual abuse, often have a wide range of physical symptoms. Equally, any doctor will tell you that the physical body breaks down when the mind can’t take any more trauma. Thyroid disorders, psoriasis and arthritis are all autoimmune illnesses that can develop at times of emotional stress.
Once we accept the union of mental and physical health, a few things become clear. First, we should ditch the term “mental health”. From now on, we should talk about someone’s health – all in. We would lose much of the stigma that still surrounds saying we are “mentally” unwell. We’re not. We’re just unwell.
And it follows we should embrace a new way of treating those with mental illnesses once we accept that mental illness can be embodied in this way. The split between mind and body has poorly served us, both in terms of diagnosis and in treatment. First diagnosis. We need to look more to underlying causes for why we often feel so glum, many of them physical.
We don’t exercise enough. We eat junk food. Many of us suffer from chronic high levels of inflammation, with inflammed guts leading to stressed bodies – and low mood. We lead hectic lives. We live in cities. We are divorced from nature, and each other. We are glued to our phones. We are not compassionate to ourselves, or to others.Second, treatment. What promotes good cardiovascular, endocrine and musculoskeletal health also promotes good mental health and vice versa. When I look back at my own battle with the black dog, I wonder if I might have recovered more quickly, or been less ill in the first place, if I had understood more about the connection between my mental and physical health. It seems I’m not alone – and hooray for that.