We are the most evolved beings on this planet earth. We cannot evolve further, we can only transcend higher. Still the question of what is mind remains an embarrassing unanswered question.
Mind is part of the human self and the same is true with the body. In medical terms the mind is biological and not something immortal. Mind exists in health and disease. Mental health and physical health cannot be seen separately. Psychiatry resents Cartesian dualism. A healthy mind affects physical well-being and vice versa. Long before Hippocrates, in the pharaonic era of Egypt, mental disorders were treated as physical ones. Treatments were purification, baths, sleep using herbs and dream interpretation using the mystical beliefs of that time. In the Islamic era you find the psyche (ELNAFS) being mentioned 185 times in Koran. The treatments at the first mental hospital in Baghdad (705 AD) and at the one in Cairo (800 AD) were giving emphasis on physical care and environment. The 14th century Kalawoun general hospital in Cairo had four medical branches: Medicine, Ophthalmology, Surgery and Mental disorders, 600 years before Europe had a psychiatry department in a general hospital.
Health came from the word Hal meaning whole which is a state of complete physical, mental and social well-being. Physical inactivity contributes to mental stress and thereby mental exhaustion. When we don’t move our bodies, our muscles become weak, blood circulation slows down and less nutrients and oxygen to our cells. Physical inactivity puts at a greater risk of getting heart attacks, strokes, Type 2 Diabetes mellitus, dementia and cancers of colon and breast. Mental health can be either optimal or poor. At the end of a hectic working day I think we all fall into poor mental health. A functioning, contributing life is optimum mental health. Physical activity contributes to this in health and disease. It is believed that Indus valley civilization created the foundation of Yoga in 3000 BC. Someone with poor mental health dies ten or twenty years earlier.
How can this be managed? First of all, acknowledge that I am having stress and mental exhaustion. Make lifestyle changes such as physical activity (exercise, sport, gym, walking, swimming, jogging, dancing, singing, simple indoor games), healthy weight, adequate rest, sleep, quit smoking and alcohol and medical intervention.
Not all physical activity is equal. Leisure time (recreational) and transport related activity having positive association with mental health whereas occupation related physical activity having negative association and household activity having no relationship. Also whether you like it and enjoy it matters above the type of activity. The physical environment you do the activity (indoor or outdoor) and the social environment (with whom you do with) matters.
Outdoor a bonus
In fact physical exercise helps along with other factors in preventing and treating mental disorders such as ADHD, Anxiety, Depression and psychotic disorders as per study at the University of Manchester. Exercise keeps mild to moderate depression away, keeping the importance of medication. Over 60 minutes of physical activity per week will prevent 12 to 17 % of incidents of depression, thereby reducing the burden of depression. Physical exercise and yoga help in reducing craving for substances along with medications and therapy. Physical activity helps the human body produce opioids and endocannabinoids that are linked to pleasure, anxiolytic effects, sleep, pain reduction, and enhancement of cognitive functions. Keeping physical health in mental illness is very important as it influences the Quality Of Life and length of living. Therefore supervised exercise programmes are a necessity in mental health services.
It's the time of multiple conflicts all over the world. Physical fitness impacts in post conflict settings. The social determinants of living conditions, work, food security, poverty all to be looked into in determining one’s ability to participate in physical activity. So there need to be programmes for the most disadvantaged in the community too.
- Dr Muraleedharan K K
(Consultant, Department of Psychiatry and Behavioural Medicine, KIMSHEALTH Trivandrum)