There’s No Such Thing as Mental Health: The Physical Costs of Psychological Distress
Few things brought me greater joy than being the lead scientist on a mental health R&D portfolio while constantly trying to convince my company executives that there is no such thing as mental health. Was it a risky professional maneuver? Yes. But is it true? Also yes. (Good thing you came here for my neuroscience geekery and not my advice on prudence in the workplace!)
Wait, did she just say she doesn’t believe in mental health? On a mental health blog?
Now before I incite a riot, let me explain…
For centuries, western medicine has been founded on the concept of dualism — separation of the mind and the body. I blame René Descartes since he was the one who put forth this school of thought way back in 1641. He claimed that the non-physical mind was the basis of consciousness and self-awareness, while the physical brain was where our intelligence came from.
Over time, medicine grew more and more entrenched in physical, observable phenomena and folks began to assume that anything unobservable was by nature less scientific. Unfortunately, until very recently, we have lacked the technology to observe the dynamics of the mind, which is really more like the movement between structures than a structure in and of itself; as a result, it was deemed to be less medically important than the body. This has led to all sorts of problems in modern healthcare — stigma surrounding psychiatric disorders, insurance imbalances in coverage between psychological and physical therapies, poor patient engagement in their own care, fragmented and misaligned care across multiple providers, and a belief by an alarming number of practitioners on both sides of the aisle that what ails the body is distinctly separate from what ails the mind (and vice versa).
The truth is, our mind is quite physical, and since it is predominantly influenced by the brain, it has bi-directional connections to every inch of our physical body by way of the nervous system. That means our mind doesn’t just rule our body, but it is also ruled by it.
Despite this realization, the mind continues to be short-changed in conventional medicine. Whether it’s the enduring misconception that the blood-brain barrier keeps our mental selves separate from our physical selves, the assumption that psychological function cannot be precisely or consistently measured, or one of the countless other persistent myths about the mind being less scientific than the body, our system neglects mental contributions to bodily function. There is no such thing as mental health because at the end of the day, everything is mental health. And everything is physical health. It’s all just health.
The Neuroscience of Physical Stress and Psychological Distress
When things go awry in our lives, whether they’re social, environmental, psychological, or physical, we tend to assign it all the same name — stress. And it turns out, there’s something to that. While you might think “stress” means something very different when you’re talking about a toxic workplace versus, say, putting too much pressure on your knees, they actually aren’t as different as you might suspect.
Embodied Cognition
Embodied cognition is a fairly recent concept in western neuroscience that has allowed us to better conceptualize the profound interconnection between our minds and bodies. The theory of embodied cognition argues that our cognitive processes are deeply rooted not just in the brain but in the body and its interactions with the environment. Think about the last time you felt nervous. Chances are, your palms weren’t just sweaty because of overactive sweat glands, but because your entire body was participating in the feeling of anxiety. And it can go both ways — most people understand that anxious thoughts create feelings of anxiety in the body, but those same feelings, when triggered by a benign chemical reaction (like when you drink one too many cups of coffee), can actually trick your mind into thinking you’re nervous when everything is actually fine. It’s why caffiene often has a reputation for making people irritable.
Embodied cognition means that our thoughts are not floating on their own in some ethereal space; they are shaped and influenced by the physical experiences of our bodies.
By understanding this, we begin to see that if we want to successfully treat mental health, we can’t just sit around and address abstract thoughts; we have to consider and engage with the whole body.
Allostatic Load
The mind-body argument also works the other way. In many chronic health conditions, our current healthcare system exclusively aims to treat physical symptoms with physical interventions (like surgeries or medications), but the mind is left out of the equation. Allostatic load offers an explanation for how chronic mental distress manifests as physical deterioration. Allostasis is the process by which the body achieves stability through change, a necessary response for a species living in an ever-changing dynamic environment. But when the constant back-and-forth of adjusting to our environment becomes chronic, our sympathetic nervous system (that fight-or-flight part) doesn’t get a chance to rest. This can lead to an overload, often referred to as allostatic load, which wears on the body much like an overused muscle. Heart rate, blood pressure, and inflammation can all spike, and our hormones become dysregulated; particularly cortisol (AKA, the stress hormone). Produced in the adrenal glands, cortisol has a hand in controlling not just stress reactions but also regulating metabolism, inflammation, and even memory formulation. Elevated cortisol from chronic stress can lead to a slew of unpleasant conditions, like weight gain, sleep disturbances, and a weakened immune system. All of these stress-related issues contribute to a cascade of potential health issues — everything from heart disease to diabetes, all stemming from our body’s response to prolonged stress.
How Psychological Stress Manifests as Physical Symptoms
You may already know the story of how stress leads to physical health issues, but you may be surprised at how many symptoms that we usually attribute to physical conditions are actually strongly tied to long-term unresolved mental distress and unpredictable environments.
Cardiovascular System
Long-term stress activates the body’s sympathetic nervous system without a break, leading to increased heart rate and elevated blood pressure. Over time, these conditions strain the heart and blood vessels, potentially leading to hypertension, heart attack, or stroke. Additionally, stress can make us more likely to engage in unhealthy automatic behaviors, such as poor dietary choices, smoking, or being overly sedentary, which further exacerbate cardiovascular risks.
Digestive System
The gut is often called the “second brain” because of its sensitivity to emotions. During intense negative emotion, the strong relationship between the gut and the brain (frequently called the gut-brain connection) disrupts the intricate balance of digestion and gut health. Symptoms can include stomach aches, diarrhea, and constipation. Gastrointestinal conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and gastroesophageal reflux disease (GERD) often have a psychological aspect that triggers symptoms. Stress can also affect the speed at which food moves through the body, can lead to inflammation and impaired nutrient absorption, and make the body more susceptible to infection.
Immune System
Chronic stress impairs the immune system’s ability to fight off antigens, making the body more susceptible to infections. Cortisol can suppress the effectiveness of the immune system by lowering the number of lymphocytes available and dampening other natural immune responses. This weakened state can lead to frequent infections and may increase the duration of illnesses. The brain’s own immune response, called microglial activation, also leads to reduced neuroplasticity and a reduced ability for the brain to clear out dead cells and other neural “debris”, which can increase risk for neurodegenerative disorders.
Musculoskeletal System
Stress can cause the muscles to tense up, which is the body’s natural way of guarding against injury and pain. Prolonged stress can result in the muscles being in a constant state of guardedness, which triggers a threat reaction and pain response that underlies conditions such as tension headaches, migraines, and other musculoskeletal conditions like neck and back pain. Chronic muscle tension and perceived stress can also contribute to the development of long-term chronic pain conditions like fibromyalgia.
Skin Conditions
Conditions such as eczema, psoriasis, and acne can all be exacerbated by stress. Stress can cause outbreaks or worsen the condition of the skin through inflammatory and hormonal pathways. Additionally, stress can lead to behaviors such as scratching or picking at the skin, which can worsen existing skin conditions or lead to infection.
Monitoring the Mind’s Impact on the Body with Wearable Technology
In our digital age, technology offers new avenues for managing health, and wearable devices are at the forefront of this revolution. These devices, which include smartwatches, fitness trackers, and specialized sensors, can continuously monitor physiological indicators such as heart rate, skin temperature, and even electrodermal activity (sweat gland activity related to stress levels). This constant monitoring provides a unique opportunity to manage and mitigate stress-related conditions effectively.
Wearable devices can detect changes in physiological data that may indicate stress. For example, an increase in heart rate or a spike in cortisol levels can signal a stress response. By monitoring these changes, wearables can alert users in real-time, allowing them to activate the PARAsympathetic nervous system (the opposite response to fight-or-flight, sometimes refered to as our “rest-and-digest” response). Once alerted, you can do activities that signal safety to your brain, such as practicing mindfulness, engaging in breathing exercises, or altering your current environment, as a way to “hack” your sympathetic response and reduce physical symptoms related to stress.
For those already experiencing stress-related health issues, wearables can play a crucial role in treatment and management. By providing continuous feedback on the effectiveness of therapeutic interventions, these devices help refine and tailor treatment plans to individual needs. For instance, if a particular medication or therapy is effective, a noticeable change in physiological parameters will confirm its efficacy, allowing for adjustments as needed.
Perhaps most importantly, wearable technology empowers patients by giving them an active role in managing their health. This active engagement can enhance individuals’ control over their stress and anxiety, contributing to better mental and physical health outcomes.
The ability to monitor their own health metrics can motivate individuals to take a more proactive approach to health maintenance, leading to lifestyle changes that promote overall well-being.
Bringing It All Together
Our mental states directly influence our physical health and vice versa. Psychological distress manifests physically across various body systems, from the cardiovascular to the immune system, highlighting the profound impact that mental health has on our overall well-being. And embodied cognition has introduced us to the idea that our thoughts actually have a pretty significant physical component. Chronic psychological stress can leave tangible marks on our bodies, which underscores the need for healthcare approaches that do not separate the mind from the body (let’s get out of the 17th century!). Instead, we need strategies that acknowledge the complexity of human health — strategies that are not just reactive but proactive, leveraging the latest technological advancements in continuous physiological monitoring to preemptively manage health.
Be sure to tune in next week as we expand this conversation into the new world of therapies that DO consider chronic health conditions from the mind and the body, AKA integrative therapies. See you then!
Diving Deeper
For those intrigued by the scientific underpinnings and eager to explore more about the mind-body connection, a wealth of resources is available. Books such as “The Body Keeps the Score” by Bessel van der Kolk provide an in-depth look at how trauma and stress manifest in the body and how healing can occur through integrated, body-oriented therapies. Additionally, research articles and reviews in journals like Psychosomatic Medicine offer ongoing studies and findings that reinforce the need for holistic treatment approaches. Advancements in wearable technology also open new research vistas. Continuous physiological monitoring not only helps in managing stress-related conditions but also provides a real-time feedback loop that can enhance patient care and treatment personalization. And with devices like the Senstream, which collects lab-grade data from a ring-based sensor, the ability to continuously monitor our physical responses without bulky equipment is helping us to explore the relationship between our minds and bodies in more settings than ever before.
Call to Action
It’s more important than ever to advocate for a healthcare paradigm that recognizes the inseparable link between mind and body. I encourage you to engage with this topic further — whether by reading up on the latest research, participating in discussions, or consulting with healthcare professionals who embrace a holistic approach to health.
If you’re a practitioner, consider how integrating continuous monitoring technology might enhance your practice. If you’re someone who experiences stress-related symptoms, explore how wearable devices might not only help manage these symptoms but also improve your overall health.
Let’s use this knowledge to foster a healthcare environment that is more attuned to the true nature of human health — one that treats the individual as a whole rather than a sum of parts. Share this article, join the conversation, and together, let’s push for a future where every aspect of health is recognized and valued.
