The Mind of Health

Cutting Edge Updates for Clinicians and Patients, Bridging the Divide Between Mind and Matter

Author: darylchow

Five Personal Ways to Find Out About Your Mental Health

Five Personal Ways to Find Out How is Your Mental Health

Photo by Annie Spratt 

Search the web, and psychological tools, self-checklist and pseudo-assessments abound. Depression and Anxiety, Stress rating scales, etc.

While these measures that you see in magazines and even non-profit organisations websites helping people in distress are well intended and oftentimes useful, there is also a more PERSONAL way to gauge your mental health.
I propose you to run through these five questions below.

 

#1. Ask yourself how is your inner life like?

Notice the inner-chatter that you hear.

We mistake these voices as us.

You are not the voices. You are the person listening to the voices.

Figuring out your inner life is a highly efficient, though not easy a litmus test on your mental health.

It does require a very important ability to cultivate: Meta-awareness. This means not just the ability to be self-aware, but the ability to notice what, how and why you are thinking a certain way. It requires the ability to PULL yourself out of the inner-chatter and have perspective outside of yourself.

 

#2. Ask your loved one, “What is one thing that you are worried about me?”

There is also a myth permeating in our post-modern culture that “we need to make it on our own.”  (see my other related blog, Full Circles: Reflections on Living on this topic. Click here.)

The truth is “It takes two to know one.”[1] There may actually be a more reliable way to gauge your mental health.

Go ahead, ask someone you trust, “what is the one thing that you are most worried about me?” First, the person might be taken aback. Be open to what they have to say because their responses will be revealing.

Suspend a need to explain yourself and provide a rationale. Instead, listen.

Often, others can see what we fail to see or even admit.

It takes a combination of courage, humility, and intelligence to ask someone what he or she might be worried about you. It’s a powerful conversation starter.

Thank this person that you trust.

 

#3. Measure How You Rest
Are you able to sleep? Can you wind down without the use of substance?
Can your mind switch off when it needs to?

Sleep is often neglected and underrated. Sleep helps not only your mood, but also learning and cognitive ability. Not to mention the impact on your immune system, testosterone levels, and prevention of cancer. (For more, see:
https://blog.bulletproof.com/improve-your-sleep/ )

Sleep is not a waste of time. Don’t waste your life by depriving yourself of sleep (even if it means letting go of that extra episode of Game of Thrones).
#4. Measure How You Function
I’ve intentionally left this as near the bottom of the list. More mental health practitioners focus on a patient’s ability to function as a key metric. I think it’s important, but I think the above three points get left out too easily. Besides, most people who are suffering inside and in silence can function. Sometimes, they pour themselves into work. Sometimes, they overvalue the ability to work very hard as a sign that they are ok. Only to lead to a disastrous burnout and/or symptoms of high irritability and chronic fatigue.

 

#5. If You Are Not Able to Answer Any of the 4 Questions Above…
… Chances are, you’d benefit from connecting with someone, be it a pastor, a counsellor/psychologist, confidante, or someone you can turn to.

Meaningful and personal conversations has the ability to touch, heal, and inspire.

Psychotherapy is not “just talk”. Psychotherapy consists of two Greek words: psyche (soul) and therapy (care). It’s a form of conversation that is caring for your inner life. It’s often a mistake to refer psychotherapy as a talking cure. It’s also not a listening cure. It’s a relational cure.

(For more about the effectiveness of psychotherapy, see Three Surprising Facts About Psychotherapy You and Your Doctor Need to Know).

 

On the Flipside:
There is a paradox in our individual psychological health: By and large, our MENTAL HEALTH IS DETERMINED BY OUR SOCIAL HEALTH.

If we have no idea what our inner-life is like, it is likely we would benefit from having a deep conversation with a trusted friend or a professional.

If you are unable to ask someone the question “what is one thing that you are worried about me?” it means that you might miss an authentic connection with another human being.

If you can’t take notice how you are resting, you are probably overloaded and/or on the brink of burnout (if not already).

If you can’t evaluate how well you are functioning, it might just help to seek advice, and not get lost in the cork wheel of work. After all, there is nothing worse than climbing up a ladder and later realising that, you’ve placed it again the wrong wall.”[2]

What’s your biggest challenge in dealing with your mental health? Love to hear from you in the comments below.

Happy World Mental Health Day!

P/s: Don’t forget to be playful. 

 

Best,

Daryl

 

Footnotes:

[1] Quote is from Gregory Bateson
[2] Actual quote from Joseph Campbell: “Sometimes you climb the ladder to the top, only to discover tt u’ve placed it against the wrong wall.”

It’s Not All in the Mind (So It’s All in the Body?)

 

xin (heart & mind)

The Mandarin word for heart and mind, “Xin”

I was really intrigued when I saw this blog post on chronic fatigue syndrome (CFS) is not all in the mind . It reminded me of the great pianist and improviser Keith Jarrett, who suffered CFS for a whole year. He couldn’t play, he couldn’t get out of his room.

The researchers found that there was abnormal gut bacterial micro biome, leading to gastrointestinal and inflammatory symptoms.

This hints at the potential of uses dietary modifications and pre-biotics and probiotics intervention. (see previous post on Is Your Gut the Second Brain?)

But I worry about people making a wrong conclusion. “If studies are showing physical symptoms, then it is the CAUSE of the problem.” “If brain scans shows abnormality for a depressed person, therefore, it is the CAUSE of major depression.”

Cognitive scientists and social psychologists calls this the attribution error . In other words, we make the mistake of thinking reducing something as a the cause.  Statisticians like to say, “Correlation does not mean Causation.”

Such reductionistic thinking is everywhere. Take the following story:

“A man was lying injured on a couch with his legs in a cast.
He says to wife, “ You know, you were there yesterday when i fell off the roof. 
You were there when i had the car accident…
You were there when I injured my back while lifting the heavy object…
Now that I think of it, you are BAD LUCK.”

The current study about CFS is a useful example. If you dig into the original article, researchers state, “The cause of ME/CFS is unknown, but gut dysbiosis could be contributing to some of the symptoms and their severity.” There were astute enough not to make an attribution error.

Learn to Listen to Our Body

Keith Jarrett came out of the shadows of CFS, and these were the first piece that he played, “I love you porgy.” Take a listen:

It’s mind over matter, only when the matter doesn’t mind.

The thing is, the mind and matter work as one.  I think it’s useful to borrow from my  Chinese culture, as we call mind and heart as “xin” There is no differentiation. (see image above)

Perhaps our minds are there to take care of both mind and heart.

Related article:

The Music of our Emotions: Why it is Important to Listen 

Is Your Gut the Second Brain?

Yours,

Daryl Chow, Ph.D.

 

Three Surprising Facts About Psychotherapy You and Your Doctors Need to Know

 

boy hearing for the first time (w hearing aid)

With the help of a hearing aid, boy hears for the first time.

This is for those who are thinking about seeking help. Maybe you are wondering, unsure of who to go to and what to look out for. Or maybe you just need a reason to give a shot at therapy/counselling before you take a psychotropic drug for your emotional problems.

Here’s what you need to know.

Effectiveness of Psychotherapy

Based on more than 50 years of psychotherapy outcomes research, the average treated person better off than 80% of those who did not receive treatment (Miller, Hubble, Chow, & Seidel, 2013; Wampold & Imel, 2015). This is equivalent to an effect size (i.e., magnitude of change) of 0.8, which is considered as a large effect.

Conventionally used in evidence based medicine, the number need treat refers to the number of patients needed to receive treatment in order to experience a positive outcome relative to untreated patients. To put into context, here are the following NNTs for various treatments (Note: smaller numbers indicate more effective a treatment):

 NNTs

Surprising Fact #1: Psychotherapy is more effective than most medical treatments and has lesser side-effects.

 

Psychotherapy has been shown to reduce the use of medications, consultations with primary-care physicians, length of inpatient stays, and general health care expenditures by 60% to 90% (Chiles, Lambert, & Hatch, 1999; Kraft, Puschner, Lambert, & Kordy, 2006).

More recently, based on a real-world study of over 22,000 clients in a five-year period, the data suggests outpatient psychotherapy has a large reduction of work disability days (41.8%), hospitalisation days (27.4%), and inpatient costs (21.5%). In terms of long-term effects, the researchers found that the year after therapy, the number of work disability days was lower (23.8%) (Altman et al., 2016).

From an investment standpoint, for every dollar spent in terms of care, $2 to $3 are returned! And for every dollar spent in terms of care, it resulted in 3 to 5 times of benefit for health returns (Chisholm et al., 2016). It’s hard to find any other area in healthcare for such returns, with few side-effects.

Are you spinning  by now?

Here’s the gist:  Psychological treatment is an effective treatment, when delivered in a manner that is cogent with the person, by someone with expertise in a given domain (e.g., depression, anxiety, trauma related, relational issues, psychosomatic complaints). Continue reading

Is Your Gut The Second Brain?

 The Unexpected Connection with Our Gut and Mental Health

building-joy-planning-plans

“All disease begins in the gut.” -Hippocrates (450 BCE to 380 BCE)

Leading edge in science is re-discovering that our brain and mental health are influenced by what goes on in the gut (e.g., Kaplan et al. 2015). Yet, if you stop to think about it, the notion that bacteria living in your gastro intentional tract can affect your brain sounds rather odd.

There are two ways to manipulate the microbes in the gut: by consuming live cultures of bacteria called probiotics; or by ingesting certain types of sugar molecules, known as prebiotics, that nurture growth of these bacteria. A recent study indicated that consuming a prebiotic bacteria can have an anti-anxiety effect (Schmidt et al., 2014).

The positive influence of the prebiotic was similar to that obtained by taking existing anti-depressant or anti-anxiety drugs.”

Probiotics seem to lower anxiety and mood issues as well. Probiotics are good bacteria that are friendly and helpful organisms that can live in our gut and help our body function better. You can replenish them with homemade yogurt, miso soup (find it in your next japanese meal), kimchi (go korean dining, or buy it in your Asian supermarkets), sauerkraut, and other fermented foods . Our inflammatory response well to probiotics.  A healthy gut flora reduces inflammation. Introduction of probiotics in our gut can have a significant impact in our gastro intentional function and behavior.

Drugs like prozac and lexapro, belongs to a class of drugs call SSRIs, or selective serotonin reuptake inhibitors, designed to affect the neurochemistry of our brains. Intriguingly, 90% of serotonin is produced from the gut. This means, the level of of gut health, has a significant influence on our mental health.

So, the questions remain:

Q1. Will taking care of our gut make us happy?

Yes. I see it as a necessary, but not sufficient factor to take care of. I know that I did not eat well on a given day, it affects my ability to focus, and makes me more irritable that day. Suffice to say that the sample size of N = 1 (me) is not enough to apply to the rest of the human population. There are good studies to suggest that taking care of what we fill our stomachs with impacts our global wellbeing.

Specifically, as we are now learning and beginning to appreciate,  the presence of helpful organisms in the digestive tract, is vital for keeping inflammation under control in the gut.

Q2. Can probiotics replace antidepressant medications?

I don’t think probiotics can replace sound medical & psychological interventions. There is a place for the use of antidepressants, but it does not replace the need for basic nutritional health as well.

Be careful to resist the urge of simple explanations. Certainly, some make benefit from the consumption of prebiotic foods or probiotic supplements, but at this stage in clinical research, there is no affirmative evidence to suggest which particular strain of probiotics that help with with type of mental health concerns.

On the other hand, even the serotonin hypothesis  (you know, when someone tells you that you are depressed because of a neurochemical imbalance?) has been challenged (see the seminal study by Gardner & Boles, 2011). Lets not forget that our dynamic brains are also affected by what we do.

Be mindful of reductionistic thinking.

When in doubt, be sure to consult with your GP or primary treating physician. Ask them about the impact of your gut health and your mental health. Many are actually willing to explain to you if you ask them the right questions. Don’t be afraid to ask them to point you to the right resources or reading materials if you need them.

In conclusion, mounting cutting edge evidence combined with ancient wisdom, it’s not all in the mind.

gut-infographic

(Infographics from foodmatters.tv)

Links: 

Listen to this insightful podcast: http://www.abc.net.au/radionational/programs/allinthemind/the-second-brain/6926796

Very Useful (and Digestable) information about our gut health:

http://foodmatters.tv/content/everything-you-need-to-know-about-gut-health

10 signs you have an unhealthy gut: http://foodmatters.tv/articles-1/10-signs-you-have-an-unhealthy-gut-how-to-heal-it

 

 

 

References:

Kaplan, B. J., Rucklidge, J. J., Romijn, A., & McLeod, K. (2015). The Emerging Field of Nutritional Mental Health: Inflammation, the Microbiome, Oxidative Stress, and Mitochondrial Function. Clinical Psychological Science, 3(6), 964-980. doi:10.1177/2167702614555413

Schmidt, K., Cowen, P. J., Harmer, C. J., Tzortzis, G., Errington, S., & Burnet, P. W. (2015). Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers. Psychopharmacology (Berl), 232(10), 1793-1801. doi:10.1007/s00213-014-3810-0

Gardner, A., & Boles, R. G. (2011). Beyond the serotonin hypothesis: mitochondria, inflammation and neurodegeneration in major depression and affective spectrum disorders. Prog Neuropsychopharmacol Biol Psychiatry, 35(3), 730-743. doi:10.1016/j.pnpbp.2010.07.030

 

The Age of Anxiety

(coming soon)

The Physical Effects of Depression

(coming soon)

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