The Relationship Between Physical Health and Mental Health
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Schools play a vital role in health promotion, with positive impacts on students’ mental and physical health. In order to optimize these impacts, it is beneficial for school professionals to understand the interplay between physical and mental health factors, and to target programs and services to have the maximum positive effect.
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Schools play a vital role in health promotion, with positive impacts on students’ mental and physical health. In order to optimize these impacts, it is beneficial for school professionals to understand the interplay between physical and mental health factors, and to target programs and services to have the maximum positive effect.
Defining Health
The topic of Health begins with the need to clarify its definition. The common dictionary definition: “Noun: the state of being free from illness or injury” is a concept that would be similar to describing “light” as being “an absence of darkness”. The World Health Organizationmore broadly defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. This is preferable to the absence of disease definition, but is not specific, operational or quantifiable. Unfortunately, the field of physical medicine has a vast vocabulary describing the pathological states that range from mild illness to death, but has a limited conceptual framework for defining the spectrum ranging from the absence of disease to optimal health. A similar problem exists within the field of mental health. Nonetheless, it is important to recognize that the concept of “health” does not end at the absence of physical or mental illness, but advances to states of optimal wellness in both arenas.
Mind-Body Dualism
To understand the relationship between physical health and mental health (and the converse, between physical illness and mental illness), it is necessary to understand the historical framework that produced the concepts of mind and body. The Western dualistic concept of the mind being separate from the body can be traced back to the ancient Greek frameworks of Aristotle and Plato, who viewed the “soul” as being separate from the body, where the individual’s intelligence was housed. In the 17th century, the French philosopher, Rene Descartes, described mind/body dualism, with mind and its consciousness as being non-physical and separate from the body. Various religious traditions have also supported this dualism, seeing the mind and soul as spiritual entities that are separate from one’s physical existence.
If one accepts the dualistic view of human nature, then it would follow that health or illness in the physical vs. the mental spheres would significantly differ from each other. However, research indicates that the two are inextricably intertwined, suggesting that a reframing of the dualism concept into a wholistic “mind/body” unity more accurately reflects the reality of the human organism.
Medical Disorders with Mental Health Symptoms
Medical disorders frequently mimic mental health disorders, and often go unidentified by mental health clinicians. Research indicates that at least 10% of patients being treated by mental health professionals do not have mental health disorders at all; they suffer from undiagnosed medical conditions. Vitamin deficiencies, infectious diseases, metabolic abnormalities, tumors, degenerative disorders, endocrine dysfunction, neurological disease, cardiopulmonary disorders, toxins in the environment, medication side effects and alcohol and illicit drugs can mimic clinical depression, anxiety disorders, dementia and psychosis. Complete physical examinations and appropriate laboratory testing is essential to rule out medical causes of psychiatric symptoms in children, adolescents and adults.
Medication Side Effects
When medication is necessary to treat medical or psychiatric disorders, it is important to note that medication side effects can also mimic medical and psychiatric disorders. Examples of psychiatric side effects from medical treatments include steroid treatment causing organic mood disorders such as depression or mania and asthma medications causing hyperactivity and irritability. Psychiatric medications can also cause other psychiatric symptoms, such as antipsychotics causing agitation and stimulants causing irritability. Psychiatric medications can also cause physical disorders, such as antipsychotic medications causing adult onset diabetes.
Psychiatric Disorders with a Physical Basis
In fact, a many of the disorders that we refer to as “psychiatric” have significant evidence of having a physical, medical basis. Abnormalities of steroid metabolism in clinical depression and lactic acid sensitivity in panic disorder are two examples. Significant differences in brain anatomy and brain functioning have been noted for many psychiatric disorders, and genetics plays a significant role in autism, mood disorders, ADHD, anxiety disorders, etc. Many disorders that were previously thought to be “psychiatric” are now correctly diagnosed as medical disorders. As medical diagnostic technology and research advances, many of the disorders now thought of as being “psychiatric” will some day be identified as being “medical”.
Mental Health Problems Affecting One’s Physical Health
Just as abnormalities in medical states can result in disorders of thought and emotion, the reverse is also true. Excessive worrying and repetitive negative thinking can negatively affect one’s physical health. Conversely, research indicates that psychotherapeutic interventions consisting of psychotherapy alone can improve brain functioning in conditions such as Obsessive Compulsive Disorder, and can be effective in treating mental health disorders that have a recognized biological basis such as clinical depression. Clearly, the dualistic distinctions of the separation of mind and body are more a remnant of historical philosophical dogma than reflective of the actual state of affairs.
Thus, in order to understand the relationship between physical health and mental health, it is first necessary to reframe the conception that physical health issues relate to the body, and mental health issues arise in the mind. Rather, it is appropriate to conceptualize an individual as a whole, where mind and body are facets of the integrated individual.
Thus, mental health and physical health are intertwined, and health promotion activities are similar for both.
Lifestyle and Physical/Mental Health Promotion
A breakdown of factors contributing to health indicates that the primary contributing factor is behavioral patterns/lifestyle, followed by genetic predisposition, social circumstances, health care and environmental exposure.
Unfortunately, maximizing positive lifestyle interventions will not necessarily guarantee optimal health. A physically fit individual can develop cancer, suffer a burst aneurysm, experience a heart attack that is due to a congenital malformation, etc. Similarly, although lifestyle factors can affect mental health and mental illness, an individual may have multiple protective lifestyle factors (supportive family, religious faith, optimal diet and exercise, etc.) and still develop severe psychiatric disorders such as schizophrenia, mood disorders, anxiety disorders, etc. Nevertheless, although addressing lifestyle issues will not prevent all health or mental health disorders from arising, it will have a significant impact in preventing many disorders and in reducing the negative impact of others.
Ironically, despite the significant impact that lifestyle has on health, physicians receive minimal training in methods of assisting patients in altering chronic negative lifestyle patterns of inactivity, poor diet, poor sleep habits, tobacco use, excessive alcohol use, etc. School health promotion activities can be an adjunct to physician’s efforts to improve students’ lifestyle choices.
Both the intoxicating effects and the withdrawal symptoms of alcohol and tobacco clearly impact an individual’s mental health, and the effects of these substances on the respiratory, neurological, cardiovascular and immune systems are well documented.
Regular physical exercise is very beneficial. In addition to building muscle tone, reducing fat and optimizing physical stamina and fitness, it also releases catecholamines (e.g., the neurotransmitter, norepinephrine), that have proven antidepressant effects.
Diet can have both significant positive and negative impacts on physical and mental health. The typical American diet is overly abundant in fats, refined carbohydrates, sugar and salt, and lacking in nutrition from fruits, whole grains, vegetables, essential fatty acids, fiber, and vitamins. Obesity rates have skyrocketed for children, adolescents and adults, leading to cardiovascular, endocrine, musculoskeletal, sleep and mental health disabilities. Toxins such as pesticides and mercury in food have been implicated in neuropsychological abnormalities. Sugar and food additives have been found to contribute to hyperactivity and inattention in children. Vitamin deficiencies can lead to psychiatric symptoms.
Eating a well-balanced diet, combined with positive lifestyle behaviors such as regular exercise, is beneficial for physical and mental health. Omega 3 fatty acids, the food supplement SAMe (S-Adenosyl methionine) and the herb St. John’s Wort are useful in the treatment of adult, and possibly of child and adolescent mood disorders.
Schools and Physical/Mental Health Promotion
Recognizing the relationships between physical and mental health, schools can promote both by:
These activities can dovetail with screening, diagnosis and treatment activities, and the combination of interventions will result in overall improvements in students’ physical and mental health.
Defining Health
The topic of Health begins with the need to clarify its definition. The common dictionary definition: “Noun: the state of being free from illness or injury” is a concept that would be similar to describing “light” as being “an absence of darkness”. The World Health Organizationmore broadly defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. This is preferable to the absence of disease definition, but is not specific, operational or quantifiable. Unfortunately, the field of physical medicine has a vast vocabulary describing the pathological states that range from mild illness to death, but has a limited conceptual framework for defining the spectrum ranging from the absence of disease to optimal health. A similar problem exists within the field of mental health. Nonetheless, it is important to recognize that the concept of “health” does not end at the absence of physical or mental illness, but advances to states of optimal wellness in both arenas.
Mind-Body Dualism
To understand the relationship between physical health and mental health (and the converse, between physical illness and mental illness), it is necessary to understand the historical framework that produced the concepts of mind and body. The Western dualistic concept of the mind being separate from the body can be traced back to the ancient Greek frameworks of Aristotle and Plato, who viewed the “soul” as being separate from the body, where the individual’s intelligence was housed. In the 17th century, the French philosopher, Rene Descartes, described mind/body dualism, with mind and its consciousness as being non-physical and separate from the body. Various religious traditions have also supported this dualism, seeing the mind and soul as spiritual entities that are separate from one’s physical existence.
If one accepts the dualistic view of human nature, then it would follow that health or illness in the physical vs. the mental spheres would significantly differ from each other. However, research indicates that the two are inextricably intertwined, suggesting that a reframing of the dualism concept into a wholistic “mind/body” unity more accurately reflects the reality of the human organism.
Medical Disorders with Mental Health Symptoms
Medical disorders frequently mimic mental health disorders, and often go unidentified by mental health clinicians. Research indicates that at least 10% of patients being treated by mental health professionals do not have mental health disorders at all; they suffer from undiagnosed medical conditions. Vitamin deficiencies, infectious diseases, metabolic abnormalities, tumors, degenerative disorders, endocrine dysfunction, neurological disease, cardiopulmonary disorders, toxins in the environment, medication side effects and alcohol and illicit drugs can mimic clinical depression, anxiety disorders, dementia and psychosis. Complete physical examinations and appropriate laboratory testing is essential to rule out medical causes of psychiatric symptoms in children, adolescents and adults.
Medication Side Effects
When medication is necessary to treat medical or psychiatric disorders, it is important to note that medication side effects can also mimic medical and psychiatric disorders. Examples of psychiatric side effects from medical treatments include steroid treatment causing organic mood disorders such as depression or mania and asthma medications causing hyperactivity and irritability. Psychiatric medications can also cause other psychiatric symptoms, such as antipsychotics causing agitation and stimulants causing irritability. Psychiatric medications can also cause physical disorders, such as antipsychotic medications causing adult onset diabetes.
Psychiatric Disorders with a Physical Basis
In fact, a many of the disorders that we refer to as “psychiatric” have significant evidence of having a physical, medical basis. Abnormalities of steroid metabolism in clinical depression and lactic acid sensitivity in panic disorder are two examples. Significant differences in brain anatomy and brain functioning have been noted for many psychiatric disorders, and genetics plays a significant role in autism, mood disorders, ADHD, anxiety disorders, etc. Many disorders that were previously thought to be “psychiatric” are now correctly diagnosed as medical disorders. As medical diagnostic technology and research advances, many of the disorders now thought of as being “psychiatric” will some day be identified as being “medical”.
Mental Health Problems Affecting One’s Physical Health
Just as abnormalities in medical states can result in disorders of thought and emotion, the reverse is also true. Excessive worrying and repetitive negative thinking can negatively affect one’s physical health. Conversely, research indicates that psychotherapeutic interventions consisting of psychotherapy alone can improve brain functioning in conditions such as Obsessive Compulsive Disorder, and can be effective in treating mental health disorders that have a recognized biological basis such as clinical depression. Clearly, the dualistic distinctions of the separation of mind and body are more a remnant of historical philosophical dogma than reflective of the actual state of affairs.
Thus, in order to understand the relationship between physical health and mental health, it is first necessary to reframe the conception that physical health issues relate to the body, and mental health issues arise in the mind. Rather, it is appropriate to conceptualize an individual as a whole, where mind and body are facets of the integrated individual.
Thus, mental health and physical health are intertwined, and health promotion activities are similar for both.
Lifestyle and Physical/Mental Health Promotion
A breakdown of factors contributing to health indicates that the primary contributing factor is behavioral patterns/lifestyle, followed by genetic predisposition, social circumstances, health care and environmental exposure.
Unfortunately, maximizing positive lifestyle interventions will not necessarily guarantee optimal health. A physically fit individual can develop cancer, suffer a burst aneurysm, experience a heart attack that is due to a congenital malformation, etc. Similarly, although lifestyle factors can affect mental health and mental illness, an individual may have multiple protective lifestyle factors (supportive family, religious faith, optimal diet and exercise, etc.) and still develop severe psychiatric disorders such as schizophrenia, mood disorders, anxiety disorders, etc. Nevertheless, although addressing lifestyle issues will not prevent all health or mental health disorders from arising, it will have a significant impact in preventing many disorders and in reducing the negative impact of others.
Ironically, despite the significant impact that lifestyle has on health, physicians receive minimal training in methods of assisting patients in altering chronic negative lifestyle patterns of inactivity, poor diet, poor sleep habits, tobacco use, excessive alcohol use, etc. School health promotion activities can be an adjunct to physician’s efforts to improve students’ lifestyle choices.
Both the intoxicating effects and the withdrawal symptoms of alcohol and tobacco clearly impact an individual’s mental health, and the effects of these substances on the respiratory, neurological, cardiovascular and immune systems are well documented.
Regular physical exercise is very beneficial. In addition to building muscle tone, reducing fat and optimizing physical stamina and fitness, it also releases catecholamines (e.g., the neurotransmitter, norepinephrine), that have proven antidepressant effects.
Diet can have both significant positive and negative impacts on physical and mental health. The typical American diet is overly abundant in fats, refined carbohydrates, sugar and salt, and lacking in nutrition from fruits, whole grains, vegetables, essential fatty acids, fiber, and vitamins. Obesity rates have skyrocketed for children, adolescents and adults, leading to cardiovascular, endocrine, musculoskeletal, sleep and mental health disabilities. Toxins such as pesticides and mercury in food have been implicated in neuropsychological abnormalities. Sugar and food additives have been found to contribute to hyperactivity and inattention in children. Vitamin deficiencies can lead to psychiatric symptoms.
Eating a well-balanced diet, combined with positive lifestyle behaviors such as regular exercise, is beneficial for physical and mental health. Omega 3 fatty acids, the food supplement SAMe (S-Adenosyl methionine) and the herb St. John’s Wort are useful in the treatment of adult, and possibly of child and adolescent mood disorders.
Schools and Physical/Mental Health Promotion
Recognizing the relationships between physical and mental health, schools can promote both by:
- Providing meals, snacks and beverages that are health promoting
- Providing opportunities for physical exercise
- Incorporating programs such as stress reduction, conflict resolution and mindfulness training into school curriculum
- Integrating nursing activities with mental health staff (counselors, social workers and psychologists)
- Monitoring for medical and psychiatric side effects of students’ medications
These activities can dovetail with screening, diagnosis and treatment activities, and the combination of interventions will result in overall improvements in students’ physical and mental health.
Further ReadingsHubbard, J. (1991). Psychiatric side effects associated with the ten most commonly dispensed prescription drugs: a review. J Fam Pract 33(2) 177-86.
Diamond, R. Psychiatric Presentations of Medical Illness: An Introduction for Non-Medical Mental Health Professionals [Online]. Retrieved from http://www.alternativementalhealth.com/articles/diamond.htm The Johns Hopkins Center for Mind-Body Research http://www.jhsph.edu/mindbodyresearch University of Miami Mind-Body Research Consortium http://www.mindbodyresearch.org/index.php |
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