Brain Energy and the Implications for Investment in Mental Health
The situation is grim.
We are facing a global mental health crisis with numbers increasing steadily. One in five people are set to develop a mental health condition in their lifetime. The costs for treating mental disorders are likely to increase to USD 6.0 trillion by 2030, up from USD 2.5 trillion in 2010. Depression has overtaken all other illnesses and diseases to become the leading cause of disability globally.
At the same time, the current approach to mental health treatment is not working well. For instance, treatment resistant depression is a reality with studies showing almost two-thirds of patients not experiencing a regression of their illness. Available treatments for other types of mental disorders, such as bipolar disorder, schizophrenia or autism, are equally ineffective, leaving patients to believe that they will have to live with mental disorders for the rest of their lives. This is a reality that is hard to accept.
It is this grim reality and our unwillingness to accept it that inspired us to create Masawa, a social impact fund that catalyses mental health by directing investments into areas that can innovate the way we prevent and treat mental illness and promote mental wellbeing for all. And while a lack of financial resources is certainly part of the problem, there are clearly challenges within our existing health system that money alone cannot address. We are mindful that this requires a deeper shift.
This is where “Brain Energy”, a recently-published book by Dr. Christopher Palmer, comes in. A neuroscientist and psychiatrist with almost three decades of clinical experience, Dr. Palmer offers a bold new theory of what causes mental illness, drawing on decades of research from a wide range of fields, and provides concrete suggestions how treatment can be adapted in light of this new theory.
Today’s mental health treatments are insufficient.
Dr. Palmer begins by outlining the gaps in the current approach to mental illness. Traditionally, Psychiatry treats mental illness as syndromes, a mix of observable signs and symptoms described by the patient. Until now, there was no clear understanding of what causes mental illness. The risk factors likely to influence mental health range from biological (e.g. chemical imbalances in the brain), to psychological (e.g. low self-esteem, unhealthy behaviour patterns) and social (e.g. traumatic experiences, poverty, etc.). Worse, once people are diagnosed with a mental disorder, they have a high chance of developing additional disorders. And yet, there are no risk factors that show up consistently across all disorders. The low success rates of treating mental illness are not surprising. Current treatments focus on the symptoms, not the root cause, which means that most treatments are not solution-oriented. Dr. Palmer urges the medical profession to come to terms with the reality that “for most disorders, treatments don’t work long term for the majority of people”.
Metabolism: the common pathway to all mental illnesses
Dr. Palmer argues that all mental disorders are in fact metabolic disorders of the brain, meaning an imbalance of energy in our brain. In this way, mental disorders share a common pathway with other disorders linked to metabolism, namely diabetes, obesity, and cardiovascular diseases. Specifically, mitochondria, organelles that are attached to the cells, play a major role in their functioning. The analogy with city traffic helpfully demonstrates the impact that mitochondria have on our cells, our metabolism, and the human organism. If the human body is the entire traffic of a large city, then each “car” within that traffic represents a cell and the mitochondria are the “drivers” of those cells. Their under-functioning, over-functioning or absence can lead to disruptions in the energy traffic of the brain. While minor “car accidents” or traffic jams may occur on a regular basis and are addressed locally, too many or severe disruptions can lead to break down of traffic and impact the organism. Drawing on research findings of the past decades, Dr. Palmer concludes that mitochondria and metabolism can explain all the symptoms observed in any mental illnesses.
With this conclusion, he goes on to review all major contributing causes of mental illness and what can be done to address them. These include genetics and epigenetics, chemical imbalances — the biological causes that are widely associated with mental illness today — but also nutrition, drugs and alcohol, inflammation, medication, sleep, light and circadian rhythms as well as love, adversity, and purpose in life. It is this comprehensive analysis of risk factors from a metabolic perspective that makes the reader appreciate the complexity of the problem.
The Solution
Dr. Palmer concludes that by taking a comprehensive metabolic approach we have a greater chance of restoring a person’s mental health. Comprehensive treatment plans that put the patient at the centre require, what Dr. Palmer calls “detective work” at the outset to better understand which contributing factors are playing a major role in a patient’s symptoms and which of these should be addressed. The good news is that “metabolism is malleable”, but the key is to develop a unique treatment plan tailored to the individual needs of a patient but all with the goal to improve mitochondrial functioning. Existing treatment methods have their role to play and certainly in the case of severe mental illness, patients need the support of a competent clinician, especially since finding the right treatment may involve testing out several different approaches that may cause side effects in the short run or make things worse initially.
What is wonderful about this book is that it addresses not only clinicians or those suffering from severe mental disorders. It is written for all people struggling with mental states that are undermining their ability to live life to the fullest. It helps us understand mental health and wellbeing not as a dichotomy, you either are sick or healthy, but as a continuum and depending on the health of our metabolism and the risk factors you are exposed to, you are (or are not) likely to slide into a vulnerable mental state.
Dr. Palmer argues in favour of an interdisciplinary approach, in which not only health professionals but all those professions that work together to help patients address biological, psychological, and social factors, get clearly interconnected.
Implications for Investments in Mental Health
We need to create patient-centred and patient-empowering technological platforms that allow “integrated treatment teams’’ to work together both on the diagnosis, as well as the treatment of mental health patients. We need all hands on deck and this means breaking down professional silos and hierarchies and understanding the contribution that each discipline brings to the table. Wellness or nutrition coaches, for instance, can play an important role in a patient’s treatment, given their focus on specific behavioural change and the skill set required to motivate and inspire people to change. While these professional groups cannot work with patients independently, they may have more frequent contact with a patient than the psychiatrist or therapist and should fill those in on progress that the patient is making.
In terms of patient-empowering technologies, we are already observing a trend in tech innovations towards providing patients with the necessary tools to monitor different indicators of their metabolism: patients can in real time check their blood glucose and hormone levels, observe their sleep patterns and other physiological markers. Companies like YourCoach, Hello Inside or Una Health draw on such technology. At Masawa, we are exploring more of these scientific self-care applications, which provide data-driven, personalised approaches to health and well-being.
When it comes to using such technology to facilitate collaboration across medical and other professions, however, we still have some way to go. Currently, medical treatment is highly siloed between different disciplines to the detriment of patients. And while addressing these silos is primarily a cultural and educational challenge, we believe that technology can play a role in creating an ecosystem that is more connected, more value oriented, and more equitable, and solves the problem of disparate data sources so that patients are able to get better care.
Despite the challenges of data readiness, privacy, and connectivity, we see tremendous potential in providing the patient and the professionals supporting them with a 360 perspective of the patient. With the help of such an integrated platform, the different healthcare and other professionals can draw their data informing their respective assessments from the same but more comprehensive data pool. Any disparities or unmet needs can be detected quicker, diagnoses shared and treatment plans coordinated, thereby increasing the chance of interventions not only tackling the same contributing risk factors but also allowing for adjustments, where required, to be made in unisom.
Implications for Nurturing Capital
At Masawa, we believe that capital investments need to be accompanied by investors’ intentional effort to nurture the humans behind the companies. Early-stage investing is a high-risk endeavour, not only because of the level of innovation and novelty, but also because behind each idea stands a complex individual or team of individuals who are likely to go through high levels of stress and anxiety as they build their venture.
As investors, we know that it is the people and their ability to execute a brilliant idea that makes or breaks a company. And if 65% of startups fail because of “people problems”, then it is likely that their individual and collective wellbeing play a major role in that. We help founders become aware of their brain energy, of what fuels it and of what drains it, and make them feel empowered and enabled to manage it as best as they can.
The trials and tribulations of starting and growing a successful company are here to stay, but how founders experience them can improve.
Huria Ogbamichael is Nurture Capital Partner at Masawa. She is an ICF-certified Leadership Coach with 15 years of international experience in organizational development, change management, and policy and strategy development. For the past five years, she has been coaching managers in global corporations, international organizations as well as tech startups. She is certified as a Conscious Business Coach and as a facilitator of the multi-rater assessment tool Leadership Circle Profile.
Masawa is the mental wellness impact fund. We invest in mental wellness startups with a bespoke nurture capital approach, for a thriving world. Follow us for more posts on leadership performance and wellbeing, organizational health, mental wellness, and impact investing.
