There is no health without mental health.
Dr. Michele Riba, professor of psychiatry, University of Michigan
The World Federation of Mental Health (WFMH) sponsors World Mental Health Day each October. Its mission over the past 62 years has been to increase awareness about mental health issues, and its agenda is summarized in what they call the Great Push for unity, visibility, rights and recovery.
This year they are specifically dedicating the day to mental health and chronic physical illness, and the need to continue to integrate the care of both.
There is good reason. Worldwide, noncommunicable chronic diseases are the leading causes of death. Dr. Gouden Galae, coordinator of health promotions for the World Health Organization, notes that heart disease, diabetes, cancer and lung disease are responsible for 60 percent of deaths worldwide and 80 percent among the world’s poorest people. It is also estimated by 2020 that obesity will be the No. 1 cause of death worldwide.
Prevention and management of these noncommunicable diseases affects both mortality rates and quality of life. The financial burden is enormous — to governments, the health care industry, and families — and sufferers’ ability to cope is affected by these diseases’ emotional impact. Kathryn Powers, director of the Center for Mental Health Service, U.S. Substance Abuse Mental Health Services Administration, declared: “We know that many individuals with chronic medical conditions have untreated, co-morbid mental illnesses or substance use disorders, and this can complicate the recovery from both conditions.”
Between 25 and 33 percent of people with these chronic medical conditions also struggle with depression. Whenever something happens that we feel we do not have control over, depression — a sense of helplessness — is a possibility. A vicious cycle begins as depression weakens the resolve for coping with physical symptoms. In turn, this creates a greater sense of despair. In fact, depression can triple the risk of nonadherence to medical treatment.
What can be done?
Primary care physicians need to screen their patients and provide information for medicine and psychotherapy. A 2007 survey of primary care doctors found that:
- 78 percent believed in a mind-body connection.
- 85 percent thought understanding the mind-body connection helped them in their diagnosis.
- 93 percent thought this understanding helped them manage their patients’ illness.
- 84 percent saw the need to educate primary care doctors on the mind-body connection.
But the most essential piece of information is this: 62 percent of the patients who received a prescription for depression treatment had discussed the possibility of a mind-body connection with their primary care doctor. In other words: They spoke up. If you are coping with a chronic illness, talk to your primary care doctor. There is a good chance he or she will listen and help.
The ultimate key for coping with chronic illness, however, is resilience. Here are some suggestions:
- Stay connected with family, friends and support groups. Our wellbeing is tied to who we spend time with. PsychCentral’s online support community has over 160 forums for support. Your local hospital likely has a list of support groups in your town.
- Consider psychotherapy. Psychotherapists can provide not only personal therapy for coping, but may also be resources for group and family therapy. And, as the Course in Miracles suggests about the importance of psychotherapy “… only the mind can be healed.” Having a psychotherapist to help in the healing process can aid in the mind-body healing process.
- Take care of yourself. Rest, exercise (if your physical limitations allow it), eat a proper diet, and have fun. Don’t let yourself go. A positive outlook is easier to maintain when you are immersed in self-care.
- Practice the principles of positive psychology, particularly those associated with acknowledging gratitude, counting your blessings, and resilience. Here are ten ways to build your resilience from the American Psychological Association.
- Maintain your daily routines. They provide a sense of stability when coping with the demands of illness.
- Nourish your spirituality. Engage in yoga, meditation, prayer or any creative endeavor you are drawn to.
And if you want to nurture those who are ill and are so inclined you may want to pray. While the jury is still out on the efficacy of prayer, there is at least some evidence that prayers can heal. While there are many vehicles and styles of prayer, simply praying for what you would want if you had the illness will do.
What will next year’s World Mental Health Day topic be? I don’t know, but the WHO last month released a report on mental health and development. The CEO of WFMH, Vijay Ganju, said:
“The bottom line is that there is no health without mental health, and there is no development without health and mental health.”
Where will I be this year on World Mental Health Day? In Auckland, New Zealand. Rethink Theatre Challenge has an international competition to raise awareness on mental health issues. They sponsored an international playwriting contest for one-act plays for inclusion in their show. I am attending the event and will report back on their offerings.
The sciences, the arts, medicine, governments, families, friends and patients are on the move.
The Great Push is on.
This blog post is dedicated to my college roommate and life long friend, Roy. His amazingly positive attitude, use of complementary and mainstream healing methods, and sustained positive approach to coping with cancer is an ongoing inspiration. He is my role model for resilience.