Despite all the research, when it comes to understanding the brain, the reality is that we are still just scratching at the surface.
What we do know is that the brain is far more powerful than we ever imagined.
We don’t know just how the psyche can affect health, and not everyone in the scientific community even agrees on the idea that there is a direct relationship between your mental and physical health. I argue that there is, and I’m not the first to think this, Freud argued that bodily symptoms may result from chronic or unresolved emotional conflicts, a process which he termed conversion hysteria. With the help of growing fields like neurobiology, neuroscience, and neuroendocrinology our understanding of the interactions between brain function, psychological systems, and molecular mechanisms is expanding.
There is still a lot of stigma towards mental illness even though it is estimated by the World Health Organization (WHO) that one in four people will be affected and about 450 million people worldwide currently have some degree of mental illness. It is estimated that less than half of people suffering from mental illness get treated. With it being so prevalent why aren’t more people treated, and why is it not a part of standard checkups? The majority of people living with mental illness typically have higher rates of poverty, unemployment, lack of stable housing, and social isolation. In addition to the lack of access to affordable health care treatments, makes this a vicious cycle affecting millions.
About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly depression, anxiety, addiction disorders, and psychoses.
The physical consequences of mental illness need to be talked about, technology and conceptual advances in the fields of behavioral, biological, and medical sciences are aiding in our understanding of this complex relationship. Scientists have found that people with depression have biological and chemical changes in several different body systems. These changes are so profound they affect the function of these systems.
People with depression have an increased risk of developing osteoporosis, cardiovascular disease, diabetes, stroke, and Alzheimer’s disease because of the physical effects of depression. Researchers found that patients who had psoriasis and depression were 37% more likely to develop psoriatic arthritis, a complication involving inflammation in and around the joints making them painful to move, than patients without depression. Depressed mood, which includes symptoms like fatigue and anxiety, is as strong a predictor as high cholesterol and obesity are for heart disease. It is estimated that after a major depressive episode your risk of having a heart attack can increase up to 4 times.
Epidemiological studies have shown that chronic stress, depression, and lack of social support may serve as risk factors for cancer development and progression. For example, a woman is twice as likely to develop breast cancer if she had experienced a stressful life event like marital disruptions, for example, divorce, separation, or death of a spouse. Other data indicates that cancer risk increases after the chronic depression that has lasted for 6 or more years. Why do we see these issues so interconnected? To understand this complex relationship, we need to know what happens in the body, more specifically, the nervous system.
Our nervous system is a complex system of nerves and cells that send messages to and from the brain and the body.
The autonomic nervous system is responsible for unconscious bodily functions, for example, heart rate, blood pressure, breathing, and digestive processes. It has control over blood vessels, pupils, stomach, intestines, liver, kidneys, bladder, genitals, lungs, heart, sweat, and salivary glands. The autonomic nervous system receives information from the body and environment and responds accordingly by stimulating either the sympathetic or parasympathetic reaction.
The parasympathetic nervous system is in control when the body is at rest, it is the body’s natural and normal state, sometimes called the “rest and digest” state. It will signal the body to release acetylcholine, a chemical that causes muscles to relax and heart rate to slow down. Stressful or dangerous situations signal the sympathetic nervous system, sometimes known as “fight or flight” response.
The sympathetic nervous system signals the body to release adrenaline and cortisol which increases heart rate, constricts muscles, raises blood pressure, dilates pupils while restricting blood flow to digestive organs. Anything that will help to prepare your body to either fight off or run away from a dangerous situation.
The problem today is that people are constantly exposed to stress because of the many difficulties of modern-day life, making it a chronic issue.
Our bodies rarely, if ever get back to that parasympathetic, relaxed mode, if they do it’s usually for a brief time. Examples of this are when we are resting, after a large meal, and during sexual arousal. The majority of our days consist of stressors.
Chronic stress stimulates the release of cortisol, (the “stress hormone”) catecholamines, and glucocorticoids.
These are very potent substances that help to regulate inflammatory and immune responses. Cortisol is responsible for increasing blood sugar, decreasing bone formation, and suppressing the immune system. Increased blood sugar levels in the body lead to insulin resistance, which can eventually lead to type 2 diabetes. Decreased bone formation leads to fragile and brittle bones and contributes to the development of osteoporosis. Catecholamines, for example, adrenaline, cause increased heart rate and blood pressure.
These two factors add pressure to the heart making it have to work harder, over time the heart can become enlarged leading to a heart attack or heart disease. The stress response also triggers the release of cytokines, which when dysregulated have a powerful effect on the neurotransmitter activities of serotonin and dopamine (our “happy” hormones). This effect produces the physical signs commonly associated with depression or schizophrenia, such as inflammation, hormone abnormalities, headache, and biochemical abnormalities. If these chemicals are being continuously stimulated, which is the situation for most Americans, it will eventually exhaust the body.
Pro-inflammatory cytokines are also released during prolonged sympathetic stimulation, they generate reactive oxygen species that promote tumorigenesis by inducing DNA damage or inhibiting DNA repair. These cytokines can also inactivate tumor-suppressor genes promoting the survival of tumor cells. Other effects of these stress chemicals include the promotion of tumor cell growth and proliferation, stimulation of angiogenesis.
An example of the effects of stress on the immune system can be taken from survivors of natural disasters. A study was done on survivors of Hurricane Andrew that happened in the Bahamas, Florida, and Louisiana in August of 1992 showed that they had lower natural killer cells, suppressor T cells, and helper T cells than the comparison subject.
All of these cells help to strengthen the immune system to fight off infections.
Low immune cell count will weaken the immune system as a whole, meaning you not only become more susceptible to diseases from bacteria, fungus, or virus, but your body is less capable of fighting off these infections. Viral infections contribute to 15% of human cancers worldwide. People with heightened sympathetic stimulation show an increased viral load in their blood and an impaired response to antiviral therapies.
Human papillomavirus (HPV) can cause cervical and retinal carcinomas. Clinical studies have shown that stressful life events only increased the risk of progression of cervical dysplasia in HPV positive women. People with AIDS are more likely to develop lymphomas and up to 19 times more likely to develop anal cancer when confronted with a stressful life event.
85% of cancer patients and 71.4% of oncologists agree with the belief that psychological variables affect cancer progression. The following information is from a review of 25 different studies on the concept, performed by various scientists and researchers over the span of 32 years (from 1966-1998). One study showed that the combination of extreme stress and low social support was related to an increase in breast cancer incidence. In contrast, positive factors such as social support and optimism have increased long term survival chances.
When entering the study, women who reported coping with cancer by expressing their emotions had fewer medical appointments related to cancer, enhanced physical health and vigor, and decreased reported distress compared with women who reported low emotional expression. Other data showed that mortality rates were up to 25% higher in patients that experienced depressive symptoms, and up to 39% higher in patients who were actually diagnosed with major or minor depression.
Another study divided patients into two types, the first was characterized by emotional suppression especially negative emotions and the other type was someone who displayed their emotions.
The first “repressive” type was positively correlated with tumor thickness and unfavorable outcome while the second “expressive” type was negatively correlated with tumor thickness. Questionnaires revealed that cancer patients reported significantly more often to concealing their emotions than benign control patients. One doctor concluded from his research that a stoic response in women and a hopeless response in men were significantly associated with an unfavorable outcome and that a favorable outcome was more frequent in people with fighting spirits.
From this data, we can see a clear correlation between how one deals with their emotions and their attitude on the situation and how it affects their health.
Holding on to negative emotions can weaken your immune response and increase sympathetic stimulation all of which can lead to chronic disease and cancer.
Western medicine falls short because it has a symptom-based approach to healthcare when it is clear that we need to treat a patient’s mind as well as their bodies. Psycho-social interventions like relaxation and cognitive-behavioral techniques that boost negative moods have been shown to help regulate hormonal activity and the autonomic response by stimulating the parasympathetic nervous system.
These interventions can potentially be used in addition to conventional therapies to maximize the efficiency of treatment. One example is writing about your emotions, which is associated with improved mood, fewer health problems, and enhanced immune function.
Other options that can help would be meditation, a good familial support system, or group therapy; anything that will help to keep someone in positive spirits by giving them an outlet to express their emotions. I hope that with continued advances in the field of neurology that we as a society will start to recognize just how important it is to care for a patient’s mental wellbeing. I hope that people who are being treated for chronic illness and cancer begin to realize that without taking the time to care for their mental health, recovery from their disease is virtually impossible.