May- Mental Health Awareness Month
“Cogito, ergo sum.” -Renee Descartes
What is mental health? It might be more than you think. Mental Health is the essence of our very existence, for without our mental health, we may not be able to understand ourselves or the world around us. It is from our seat of consciousness- our brains- that we interpret and interact with our environment in the most humanistic of ways. Mental illness can literally make life unbearable or incomprehensible to those who suffer from it, but treatment can help people get better, just like any other medical condition.
The US Department of Health & Human Services defines it as such: Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.[i] Many factors can influence our mental health, including our physical health and wellness as well as our life experiences. This is best understood from the “bio-psycho-social” model of mental health, which emphasizes the fact that no single factor is clearly the cause or contributor to mental health and wellness. This idea was first proposed in the 1970’s by George Engel, a Psychiatrist who realized that previous concepts of mental health failed to encompass the complex interplay between organism and environment. [ii] Much progress is being made in the field of mental health and treatment of mental illness today.
So, Whats New & Where Are We Going from Here?
In 1990, President George H.W. Bush declared the 90’s as the “Decade of the Brain” and founded a project with the Library of Congress and the National Institute of Mental Health (NIMH) to “enhance public awareness of the benefits to be derived from brain research,” and promoted multiple projects involved in furthering our understanding of various topics; these included the science of cognition, the science of emotion, brain development and children’s mental health, and mental health parity, amongst many others.[iii] This research was associated with an explosion in the field of Psychopharmacology, with large numbers of new medications emerging to treat various forms of mental illness that were now better understood. The Decade of the Brain was followed by a proclamation in the 2000’s of a “Decade of Behavior Project,” and in 2010, a proclamation of the Decade of the Mind- the most recent topic to focus research on the concepts of neuroscience and psychology, and much more international effort has evolved.
Part of the Decade of the Mind project came from the United States in the form of the BRAIN (Brain Research through Advanced Innovative Neurotechnologies) Initiative, announced by the Obama administration in 2013 and advanced $110 million USD in annual expenditures for research in the field. Various agencies- including DARPA, NIH, and NSF- received the funding to direct further research into brain mapping, neuroinformatics, and nanobiotechnology. [iv] The European Union founded their own Human Brain Project (HBP) and involves multiple research organizations in various countries across Europe, including academic as well as government organizations. Their total budget for the 10 year plan is estimated to be about $1.5 billion USD with goals of using supercomputers to create a complete map of the human brain and its intricate connections, also known as “whole brain simulation”.
In fact, there is even a local connection to this exciting area of mental health research at the University of Minnesota. The Center for Magnetic Resonance Research (CMRR) houses some of the most advanced magnetic resonance imaging (MRI) instruments in the world, and is conducting several studies on Brain Function and Connectivity using ultra-high strength magnetic fields to look at the function of the brain in various mental states.[v] These scans, called functional MRI (fMRI) and resting-state (rs-fMRI) are helping to elucidate when a mental disorder is present, and has even shown evidence in helping to guide treatment. For example, fMRI scans have been found to be helpful in determining which patients may respond to repetitive Transcranial Magnetic Stimulation (rTMS) for the treatment of Major Depressive Disorder; this facility is also doing research on developing direct visualization of Deep Brain Stimulation electrode placement for conditions like Parkinson’s Disease and others.
The medications available to treat various disorders is also expanding rapidly; more than 2 dozen antidepressants are available for depression, working in many different ways, and new treatments are arriving every year.[vi] Greater understanding of the science behind use of medications is arising as well; an array of companies have developed “pharmacogenomics testing” to evaluate a person’s response to various medications based on their DNA and known mechanism of action of medications, sometimes this is called “personalized medicine.” This is an area of hot research right here at Medica, as a number of different vendors are seeking to become part of our network. [vii]
The science of mental health is taking great leaps forward, but at the same time we are also realizing the profound impact of our daily activities on our mental health, and there is a great number of things that we all can do on a regular basis to improve our own mental health as well as those around us. Moderation in all activities is a cornerstone to our sanity. Self-care, such as a healthy diet and exercise and regular check-ups with health care providers and therapists, have profound impacts on our mental health and wellness. Spirituality and involvement with church or community organizations can be effective antidepressants; and having a healthy relationship with our families and coworkers can be contributors to our well-being, or causes for our illness. Peer supportand sensitivity towards others mental state can be as therapeutic to the giver as well as the receiver; for as our minds interact with the minds of others, we find out what it really means to be human.
[vi] Next Generation Antidepressants: Moving Beyond Monoamines to Discover Novel Treatment Strategies for Mood Disorders Chad E. Beyer, Stephen M. Stahl Cambridge University Press, May 20, 2010
[vii] Principles of Pharmacogenetics and Pharmacogenomics edited by Russ Altman, Russ B. Altman, David Flockhart, David B. Goldstein