What I learned about mental and emotional wellbeing in 3 months at Zinc
Three months ago, I joined Zinc, the London-based company builder for technology businesses solving the world’s greatest problems. The first mission of the programme is improving women and girls’ mental and emotional health, and each business incubated must have the potential to help at least 100 million people in the developed world.
As participants in this impact acceleration programme, we have received extensive training in behavioral health and psychology; learned about the latest technologies, research and scientific discoveries in the field; and connected with tens of world experts that have helped us gain deeper understanding of human psychology and mental health.
I am writing this blog post to share what I learned since joining Zinc, and a few of the most interesting resources, in the hope that this will enhance your understanding of mental and emotional health, and who knows, inspire you to work and innovate in this field.
We all have mental health, so I hope you can read with an open mind and perhaps implement some of the strategies laid out here to maximise your own mental and emotional wellbeing, or support those around in their wellbeing journey.
The following are purely my takeaways from Zinc, and should not be treated as clinical advice.
In case you’re wondering, some of the most common mental disorders are: anxiety, depression, schizophrenia, bipolar disorder, post traumatic stress disorder, eating disorders, attention deficit hyperactivity disorder, obsessive compulsive disorder, borderline personality disorder, addictions, phobias, and self harm. Here we can also include dementia / Alzheimers, which is a neurodegenerative disease (NDD), while Parkinson’s, also an NDD, is not usually regarded as a mental health condition.
Mental conditions are:
- Common — affecting 1 in 5 people
- Disabling — 1 in 20 people have difficulty leading their lives normally due to mental illness eg. working full time
- Have early onset — 75% of mental conditions are triggered by age 24
The magnitude of the problem is both enormous and surprising, and these are some of the most interesting figures and facts:
- Prevalence — 1 in 5 people experience a diagnosable mental condition. Although most of these conditions are not disabling,1 in 25 people (or c. 4%) have severe functional impairment due to a mental illness, such as a psychotic or serious mood or anxiety disorder. Almost 4% of Americans live with schizophrenia or bipolar
- Cost — The global cost of mental health conditions is projected to surge from $2.6 trillion in 2010 to $6 trillion by 2030 (two thirds are indirect costs such as lost productivity and reduced life expectancy). According to Health Affairs, mental disorders were the most expensive disease category in the US in 2013 at c.$200bn (top conditions being anxiety and depression accounting for 43% of spend, and dementia at 19%), 40% of which is for institutionalised patients in prison and military
- Demographics — Most mental health problems develop in childhood or when a person is a young adult. Three-quarters of problems are established by the age of 24, half by 14. Women are now twice as likely as men to be diagnosed with an anxiety disorder. One in five young girls in school are likely to suffer emotional problems, compared to one in fourteen boys. Hormonal and environmental factors (such as public safety) also put women at higher risk of developing mental and emotional health problems
- Disability — Mental illnesses are the leading causes of disability adjusted life years (DALYs) worldwide, accounting for 37% of healthy years lost from NCDs (non communicable diseases). Adults in the U.S. living with serious mental illness such as schizophrenia, bipolar or clinical depression die on average 16–25 years earlier than the general population
- Mortality — Suicide is the one greatest killers today. Germany’s suicide rate in 2015 was more than triple the number of road fatalities in the same year, and suicide is the 10th cause of death in the US. 90% of those who die by suicide have an underlying mental illness
- Risk factors — Childhood trauma is the most obvious culprit, but there are other causes that surprised me. Consuming drugs, especially cannabis, in teenage years can trigger severe mental illnesses like schizophrenia and bipolar disorder, which will leave a person severely affected for the rest of their lives. Social media screen time is an important modern risk factor for depression and suicide, especially in teens and young adults, and especially for females
These figures, while sobering, indicate this is a significant, but under addressed, opportunity to help millions of people in distress with scalable solutions. While we have conquered physical scarcity with products and services within easy reach for most of us - at least in the developed world - we haven’t yet solved for access to reliable and effective mental care, and have not quite figured out how to reliably harness our inner power to ensure lasting happiness (or at least contentment) for the masses.
Pillars of mental health
To build and maintain mental health and wellbeing, I learned that there are several pillars all of us need to nurture (my high level comments here are over generalising and not to be taken as medical advice):
- Sleep — somewhere between 7 and 9 hours a night are a good guideline to regulate mood and cognitive functions; deep sleep is key to rest and recovery, and this happens in hours 5–6 of a sleep session, more tips here
- Nutrition — clean food is a good rule, additionally there is tremendous healing, rebalancing and revitalising power in fruits, vegetables and superfoods (see Medical Medium)
- Exercise — regular exercise can help prevent depression, reduce stress, and strengthen the mind just as much as it strengthens the body; half an hour a day of any kind of physical activity including walking can do wonders for your overall health, and yoga is also great for holistic benefits
- Nourishing social contact — social connectedness is perhaps the most powerful predictor of life outcomes, and anything you can do here to interact with others can help: from talking to the person that sells your milk or newsletters every day, volunteering in your community, or even owning a pet
- Meaningful occupation — work is where we spent most of our waking time, can be a main culprit of stress, and it often directs how and when we do everything else. In the future, we will likely pick roles and jobs that fits us better by matching them with our personality (Ray Dalio explains more on this beautifully in his new book Principles)
- Stress management and entertainment — this can include anything that brings you joy from hobbies, art, play, breathing, yoga, time in nature, meditation
- Purpose — having purpose is linked to a number of positive health outcomes, including better sleep, fewer strokes and heart attacks, and a lower risk of dementia and premature death. Your purpose is not to be understood like a world-saving mission eg. to disrupt education through blockchain technology and help a billion people by creating a unicorn/cryptocorn (though it could well be that!), but whatever gives you meaning and helps you wake up in the morning: religion, taking care of an ill parent, raising your kids, or practicing your favorite sport on the weekends, etc. (this article has a nice overview of purpose)
As you can see, there is no magic pill to mental health, but if one were to prioritise any of these, what I learned is that if you get sleep and social connectedness alone, you are already a long way in maintaining emotional wellbeing. Additionally, given exercise is the highest return investment in your physical health (see ½ hours What is the best thing we can do for our health?), physical activity should also be among your top 3. But in the end all seven are foundational and essential elements of a balanced mental and emotional health.
Strategies and practice
So what are some of the things you can start doing to increase your mental and emotional resilience in a busy world? Besides prioritising the wellbeing pillars listed above, some of the tools and techniques that I found to help are:
- meditation (check out Transcendental meditation, or for the beginners apps like Calm)
- gratitude journaling (check out The 5 minute journal)
- goal and purpose setting (watch this TedX talk)
- seeking meaningful social contact (even by owning a pet or volunteering in your community)
- taking time to disconnect (soon The Thrive app will launch to enable you to have a more healthy relationship with your phone)
- a yoga practice for rebalancing, calm and general health benefits
- doing more of what you love (hobbies, activities, travel, entertainment)
If things get rough, don’t hesitate to talk to a therapist (if you are concerned about cost or convenience, there are more accessible online services like 7cups or Ieso), or someone you trust in your social network.
What not to do can be as or more important as what to do, however. If you know your triggers for depressive or anxious thoughts, such as using alcohol or drugs, or being around certain people or situations, do yourself a favor and avoid these risk factors.
Don’t underestimate how much being intentional and proactive about your mental and emotional wellbeing can achieve for you. The key to a meaningful, healthier life, isn’t necessarily knowing the meaning of life, but building meaning into your life.
After these 3 months of bootcamp in human psychology, here are the key insights that keep me motivated to strive towards my own vibrant mental health, and that of the millions of people we seek to serve with the companies we are building at Zinc.
There is no health without mental health. We all have mental health and need to take care of it to live productive and thriving lives. In the past, people with anxiety were often labeled dramatic, exaggerating or simply too dangerous to not be locked often for life in psychiatric wards. Now we are seen as human beings with legitimate and manageable mental health difficulties. Mental conditions are real diseases that deserve careful diagnosis, care and monitoring — social support, therapy and medication can be life saving here.
Mental health is about everything else. A wide variety of factors affect our mood, affect and mental predispositions: our biology (eg. brain wiring), our past (eg. family history, education, finances), our environment (eg. relationships, occupation, recreation, environmental toxicity), life events (eg. university, job loss, pregnancy), our aspirations for the future, daily activities, internal chemistry (eg. vitamin D deficiency can lead to depression and low moods for example; you can learn more about chemistry, relationships and stress in Beyond Mars and Venus). There is no magic pill to mental wellbeing, which is why one has to develop a practice of mental hygiene and life hygiene. Of course, there are also environmental factors outside our control that can negatively impact us, but here too personal practice and developing your social support network are key to building resilience through life’s challenges.
Mental health is flow. The ups and the downs of mental states and moods will come; life throws a lot of us. By building mental fitness through sustained practice and habits we can build our resilience in the face of challenges. It’s unrealistic to expect vibrant mental states continuously, so don’t be too hard on yourself or others when even when doing your best, it still hurts or you feel down. Even with constant investment in our mental wellbeing we will inevitably have lows, but what is important is to build resilience by practicing the 7 pillars above, and a mindset of strength, recovery, hope, purpose towards better days and your dreams.
Mental illness is not a choice, or an imagination, but a real condition that can be very debilitating. Stigma and discrimination around mental health are pervasive in our social lives and at work. What we need to understand is that the person affected cannot “just get over it”, “feel better” or “change their frame of mind” and the problem will disappear. Nearly nine in 10 people who have had mental health problems report they have suffered stigma and discrimination, and such attitudes are particularly worrisome at work. In a survey on mental health at work, 15% of workers who had experienced a mental health issue because of work said they had faced demotion, disciplinary action or dismissal if they talked to their bosses about the issues they faced. Individuals need to feel comfortable to seek help.
Mental health is tightly regulated by our physiology. The mental state felt by our brains is regulated through hormones, neurotransmitters, and genes. This explains why boosts of dopamine (running outside), oxytocin (hugging a loved one) etc. can suddenly make us feel better, and why often someone with schizophrenia has a parent or more distant family member with the same condition. One interesting case study of a child with suicidal and homicidal intentions turned out to be a case of a tumor that impaired his brain functions. Brains of serial killers and psychopaths show significant differences in their physiology vs. general population, and such brain wiring can make them incapable of feeling compassion and emotion. Constant bouts of daily stress can lead to cortisol overproduction, keeping our bodies in a constant state of alertness, and leading to a spiraling cycle of immuno-suppression, bad sleep and anxiety.
Investing and innovating in mental health supports gender equity. Women are more likely to have a common mental illness, and this effect is particularly striking in adolescents. Therefore developing solutions to alleviate distress will benefit women disproportionately. By 15 years of age, girls are twice as likely to suffer from depression as boys. There are various possible reasons for this, including body image issues, hormonal fluctuations, genetic factors, where girls are more at risk of inheriting depression. In addition, women can be more financially vulnerable (eg. given the gender pay gap), or feel more physically vulnerable and less safe in public spaces. Suicide is the one clear exception to the gender trends in mental health — men are more likely to take their own lives, committing 75% of suicides in a country like the UK.
Our mind is one of the most powerful tools we are gifted with. From miraculously curing ourselves (as seen in the book Cure) to achieving our dreams (see Napoleon Hill’s Think and Grow Rich, the self development bible), our mind is an incredible tool for creation and a beautiful system through which we experience life.
The social challenge of our time is to reverse the growing level of mental ill health. This will also mean solving or improving its structural and individual drivers, no small feat! We’ve cracked the human genome, HIV recently became a chronic illness that one can live with for their entire life, and cancer patients often come out of it cancer-free and live for decades more. Have we done enough to advance the treatment and management of mental health? I would argue we are not even close to addressing the massive needs for effective prevention, treatment and management of mental disorders. In a time of economic and political uncertainty, of automation and climate change, of increasing inequalities and competition, it is high time to equip people with mindsets, tools and treatments to reach their potential, and to get the help they need to thrive in an uncertain world.
Mental illness can be prevented, managed and cured, and now is the time to invest resources in this critical issue of our generation. Now is the time to find cures for dementia and Alzheimers, to increase life expectancy for people with schizophrenia or bipolar disorder, to help people with anxiety and depression live their lives to the fullest. Compared to so many physical conditions, mental health remains drastically under-funded and under-prioritised — it is time that changed.
Many valuable technologies can be leveraged and businesses built to solve the countless and deep pain points in mental health. The areas that I’m most excited about, and where I’d like to see most innovation and disruption in this space, include the following:
- Quantifying mental health — currently diagnosis is largely based on self-reported symptoms, with few objective measurement tools and tests. Neuropsychiatric care is one of the few areas of medicine that does not measure progress with objective tools. We don’t manage that which we don’t measure
- Mental fitness becoming as cool as physical fitness — striving to improve your mental health, whether at work or at home, will be seen just as positive as improving our physical well-being
- Prevention — current paradigm is to give an unwell patient antidepressants or other drugs, or refer them for a six-session course of CBT (cognitive behavioral therapy), which are often reactive band aid solutions, and don’t work for everyone. With a worldwide shortage of therapists and increasing levels of prescription drug addiction, this needs to change, and preventive measures must be developed
- AI and machine learning used to detecting psychosis, depression, or mania from various data such as speech, movement, sleep; I am particularly excited about the power of machine learning to diagnose, gain insights and deliver personalised treatment for mental conditions
- Reducing the negative impact of social media consumption and almost constant connectivity
- Loneliness and dementia as looming health crises, increasingly affecting an ageing and longer living population in the West
- Emerging youth crisis for both teenagers and university students who are inevitably facing significant transitions in their environment, social and support systems, body functions, and are most at risk to develop mental health problems that could affect them for a lifetime
- Severe mental illness like schizophrenia, bipolar, multiple personality disorder, which produce severe distress and very poor life quality, and can devastate entire families of affected patients
- Preventing suicide, the silent killer of our times
- Digital psychotherapy to make up for the significant scarcity, as well as the high cost, of trained human therapists
- Software as a pill — where software applications such as games or VR can improve or cure mental disorders
- Brain-computer technology such as non invasive implants that can reduce or altogether remove the symptoms of depression, psychosis, Parkinson’s
- Mind-body connection, or the ability of the mind to positively influence physical health, especially as it is related to the comorbidity between physical chronic diseases and mental distress
Here are some of the best resources I came about, if you’d like to know more:
- Cure: A Journey Into the Science of Mind over Body
- The Chimp Paradox: The Mind Management Programme to Help You Achieve Success, Confidence and Happiness
- How to Develop Emotional Health (The School of Life)
- Towards a new understanding of mental illness
- There’s more to life than being happy
- The secret to living longer might be your social life
Here’s to your mental, emotional and spiritual health in 2018!