Guest Editorial: Understanding the Interplay between Mind and Body
Dr. David K. Conn
Network, Spring/Summer 2006
For hundreds of years the relationship between mind and body was considered to be a philosophical issue. Some would contend that Plato was the first “dualist.” Dualism is the view that mind and body are two distinct and separate entities. The 17th-century French philosopher Descartes also emphasized the separation between mind and body, but acknowledged that each could influence the other. We have come a long way from these earlier philosophical views, and although many questions remain, recent advances in the neurosciences have helped us to understand that the relationship between mind and body has a critically important impact on both health and disease.
The Canadian Mental Health Association (CMHA) has emphasized the importance of understanding the mind/body connection through a number of innovative initiatives such as the national awareness campaign “Practice Mind + Body Fitness.” Many branches of CMHA across Ontario have developed their own programs to support this initiative. Mental Health Week (May 1-7, 2006) will also encourage people to take control of their health by focusing on both mind and body.
The relationship between physical illness and mental health is complex. As a geriatric psychiatrist assessing and treating depression in older adults, the vast majority of my patients suffer from some form of medical illness. Depression is often precipitated by a change in physical health, as highlighted by several of the articles in this edition of Network. The article on the interrelationship between heart disease and mental health serves as a perfect example. Important Canadian studies have shown that depression is associated with worse outcomes following a heart attack, including increased mortality. This underlines the importance of screening and early identification of depression in people who have become physically ill.
The list of medical disorders that are associated with depression is very long and includes a variety of neurological disorders (such as stroke, Parkinson’s disease and the dementias such as Alzheimer’s disease), heart and lung diseases, endocrine disorders and cancer. However, there is recent evidence that even if depression is associated with a medical illness, the outcome with treatment is equally favourable.
Many of the common symptoms of depression are actually physical. The fact that depression leads to sleep disturbance, appetite change and loss of energy demonstrates that depression is both a mental and a physical condition. In addition, depression may indirectly cause physical illness when people neglect their health, for example, by not taking their medications regularly or by not eating well. It should also be noted that sometimes physical illnesses can mimic depression.
The psychological impact of physical illness is highlighted by the article on diabetes. It is clear that individuals who suffer from acute or chronic illnesses must learn to adjust and adapt. It is important that healthcare professionals be aware of the need for support and counselling, and indeed self-help groups may be extremely valuable as people learn to cope.
Finally, it is clear that mental health and physical health are intimately connected. The articles in this edition of Network that highlight the importance of exercise and good diet provide critically important messages. There are numerous studies that demonstrate the significant benefits of exercise on mental health, with improvement of both mood and anxiety symptoms. Certainly the importance of a well-balanced diet cannot be over-emphasized, and as the article on obesity suggests, excessive weight gain can complicate both physical and mental illness.
Although we have come a long way since Descartes, there is still much left to understand about the interplay between mind and body. Congratulations to Network magazine and CMHA for highlighting these important issues and for making this information available to all.
Dr. David K. Conn is psychiatrist-in-chief at Baycrest, associate professor in the Deptartment of Psychiatry, University of Toronto, and co-chair of the Canadian Coalition for Seniors’ Mental Health.