The links between mental health and physical health are very deeply intertwined, and there are significant overlaps between these chronic conditions.
By Azran Osman-Rani
As an entrepreneur, CEO and Ironman triathlete, many only see my public persona of strength, resilience and energetic enthusiasm to embrace life’s challenges and opportunities. Hardly anyone knows about the recurring anxiety attacks and chronic stress that can leave me either bed-ridden or feeling disengaged and withdrawn.
Many do not understand that mental health is just like physical health. Some days we feel physically strong, and other days we become sick – either from an infection that may heal in a few days, or when we are struck with a lifelong or life-threatening disease.
This can either be from a genetic or inherited condition, or even from being unhealthy from our own lifestyle choices like getting diabetes or hypertension because of poor diet, lack of exercise, smoking and stress.
Mental health also exists on a spectrum. There’s positive mental wellbeing – when someone is optimistic and curious, focused and resilient, and socially connected. On the other hand, feeling depressed, anxious and stressed is completely normal.
Most of us can self-regulate and feel better after a few days, but others suffer from clinical levels of depression and anxiety because the triggers that lead to these feelings are either prolonged or so intense that the body can no longer return to normal.
It is similar to diabetes where consuming a lot of sugar can cause our blood glucose to spike. If it is only occasionally, for example, having a slice of chocolate cake, the body’s insulin hormones normalise blood glucose.
However, prolonged and excessive sugar consumption impairs the ability of insulin hormones to regulate glucose and that leads to diabetes. Over time as diabetes progresses, it can cause kidney failure, blindness and even death.
Similarly, other hormones control our mental and emotional state, like serotonin and oxytocin. Prolonged stress and pressure, or even intense trauma, can interfere with the functioning of these hormones, causing clinical disorders.
Other mental health conditions can be brought about by genetic and biological factors, leading to illnesses like psychosis, schizophrenia or bipolar disorders, just like auto-immune diseases or cancer which affect our physical heath.
The links between mental and physical health are very deeply intertwined, and there are significant overlaps between these chronic conditions. This can be seen, for example, in the relationship between diabetes and depression, or anxiety and heart diseases.
Addressing only one aspect without the other may be a partial solution, with lower chances of success. We need healthcare that is more holistic with ongoing support, rather than transactional consultations or prescriptions.
So, how do we know if what we are feeling is a regular level of emotional depression or anxiety, or a sign of serious distress?
Again, parallels to physical health are crucial. We can measure our blood sugar levels or blood pressure, but we still need a trained physician to conduct a comprehensive examination and provide a diagnosis of diabetes or hypertension.
Similarly, while there are some symptoms of mental illness, it is important for trained clinical psychologists or psychiatrists to provide a proper diagnosis.
Potential signs or symptoms include feelings of helplessness or hopelessness, loss of interest in daily activities, anger or irritability, insomnia or oversleeping, appetite or weight changes (eating too much or too little), reckless behaviour and unexplained aches and pains.
Professionals would probe to see if these symptoms persist for about two weeks to indicate the body’s inability to self-regulate, and that the person can no longer carry out their usual tasks and responsibilities.
The best way to support someone going through these conditions is to get proper professional help and support. Well-meaning friends and family members can be unhelpful because they can be too judgmental or dismissive, e.g. telling their loved one to snap out of it or to pray hard, or by wanting to help ‘solve’ the problem, they add more pressure.
Unless there is a visible danger where we need to quickly escalate it to medical professionals, the best way to be supportive is to just be there for them in a non-judgmental way, and to validate that what they are feeling is real.
Avoid asking them why they are feeling that way and avoid telling them that you’ve been through what they are going through. It’s about them, not you. Just be present, either by holding their hand, or offering to help them with any tasks to lighten their burden.
When they are ready to talk, they will open up to you. Do not expect them to instantly open up just because you want to help them there and then.
If we are going through these feelings ourselves, there are different actions that we can take. The best is to reach out and get assistance from professionals who are trained to listen attentively and be supportive without judging you.
One of the organisations you can reach out to is Naluri, which provides clients with a 24/7 telephone helpline as a first level of support.
There are various ‘first-aid’ actions for someone going through an anxiety or panic attack, in the form of breathing exercises or grounding exercises. These bouts usually last for about 10-20 minutes.
However, it is important that your mental healthcare professionals help you get to the root issue, define goals and motivations, reframe mindsets and help you focus on the actions that you have control over instead of dwelling on factors beyond your control.
Now more than ever as we go through the pandemic and resulting economic slowdown, financial pressures are overwhelming for many. Through Naluri’s quantitative approach, we have seen a 30% increase in depression and anxiety after the lockdown and movement restrictions.
This is even higher when we narrow it down to young millennials, typically in the 21-30 age group. A traumatic event such loss of employment or even bankruptcy can even escalate to financial post-traumatic stress disorder (FPTSD), which is now its own mental illness classification.
From a preventive perspective, just like going to a gym to get physically fitter, there are various daily exercises that we can perform to sharpen our focus and concentration, and build our optimism, resilience and curiosity mental muscles.
The challenge lies in avoiding over-reliance on specific short-term actions or ‘hacks’ readily available on the web, and to find sustainable support and coaching to embed these as regular habits so that they do not die off after a few days. Prevention, after all, is much better than cure.
Azran Osman-Rani is the Chief Executive Officer of Naluri. Naluri is a Malaysian digital health technology company that provides health coaching and psychological support for chronic conditions such as diabetes and heart diseases, depression and anxiety by combining behavioural science, data science and digital design to help people achieve their healthiest and best selves.