Am enjoying a book called Dopamine Nation by Dr Anna Lembke. I also happened to come across a newspaper piece by author Rose Cartwright about mental health having predominantly environmental, rather than chemical causes. It’s fascinating. Since I suffer incurably from the journalists’ affliction of blogging about anything I’ve just discovered, without passing through the efforts required for actual expertise, here are a few things I’m learning:
- You can get excused from quite a lot of things these days by saying ‘it’s not good for my mental health’ (this is my wife’s insight). This is an upgrade on the excuse of Bartleby the scrivener, invented by Herman Melville, who avoided unpleasant tasks at work simply by saying ‘I’d rather not’. (I use Bartleby’s excuse a lot at church.)
- Sadly, perhaps the best way to raise the alarm about your difficulties in life is to use the language of mental health. If you do, at least someone will eventually come along to help.
- Mental ill-health itself, like white light passed through a prism, has a colourful spectrum of differing causes and cures. We need to think prismatically (as Rose Cartwright points out) rather than simplistically.
- The common practice of ascribing mental ill-health to a chemical imbalance in the brain, and then prescribing a drug to fix it, is rather less-well attested in the scientific literature (I think) whereas other causes, like poverty, trauma and deprivation have a rather stronger correlation. Rose Cartwright again: Evidence that exposure to environmental stress is the leading determinant of common mental health problems like anxiety, depression and OCD, seemed to be overwhelming, whereas evidence that organic brain dysfunction or genetics are the leading causes of such conditions seemed to be comparatively scant.
- Addressing one colour in the spectrum (the drug route) is arguably not going to entirely fix things in most cases.
- Academics generally know this. But academics don’t have ten-minute appointments with patients for which they are equipped only with a desperately scant toolbox.
- So doctors are left managing the problem and the result is a feedback loop involving doctors, drug companies, and mildly-sedated patients, few of whom are going anywhere except round and round again.
- I am reminded of a blog I wrote about the magazine Private Eye’s tame(ish) medic, Dr Phil Hammond. He wrote: Friendship and a feeling of belonging; an ability and curiosity to learn and adapt; purposeful physical and mental activity; observation and appreciation of the environment; compassion for others; food that is both delicious and nutritious; an ability to switch off and relax and regular, restorative sleep— collectively these daily joys of health are more powerful than any drug.
- Here’s a dream. Imagine a government that set up a proper study about the causes and cures of mental illness. Imagine it learnt that the issues to tackle are poverty, inequality, childhood trauma, struggling parents, discrimination, bad living conditions, food that isn’t food, the closing of recreational spaces and youth clubs, and (perhaps) the unlicencedness of smartphones, which (perhaps perhaps) are as dangerous and unregulated as cars in the 1920s. Imagine this enlightened government realized that investment and attention in those areas would reverse the tidal rise of ‘mental health problems’.
- Then imagine if they didn’t. Then further imagine what we non-career-politicians could do instead to make our corner of the world more congenial to the wellbeing of many: slow mission; patient revolution. No need to wait for politicians or blame them. Imagine.