The science behind mental health

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Mental health is our psychological well-being. This includes whether or not we have mental health problems such as depression, anorexia, post-traumatic stress disorder and many others. Whilst many dismiss these problems as being insignificant or even exaggerated, they are incredibly common – around 1 in 6 people in the UK experienced a mental health problem over the past week – and detrimental since they are the one and only cause, both indirectly and directly, of suicide. Suicide is an extremely relevant and widespread issue as the greatest killer of men aged between 20-49 years in England and Wales, killing more than heart disease, lung cancer and chronic respiratory diseases. Likewise, it has a truly heartbreaking effect since it ultimately affects those closest to the victim and not the victim themselves. The phrase “taking your own life” could be considered misleading – the victim is not just taking their own life but also the lives of those around them. 

But what is the physical cause of such an issue? Conditions such as heart disease are understood so they can be treated, whereas very little is known about mental health, although a lot of headway has been made in treating it. What we do know is that mental health does, in fact, have a chemical and biological cause. To state the obvious, the brain is responsible for our mental health. The brain is made up of cells called neurons through which electrical impulses are relayed. Between these neurons are gaps called synapses, across which chemical messengers called neurotransmitters are secreted, to propagate electrical impulses from one neuron to the next. In other words, our neurons use neurotransmitters to communicate with each other. These neurotransmitters are linked with mental health problems. For example, lower levels of serotonin, which regulates sleep, appetite, and mood, have been linked to depression, anxiety disorders such as OCD and insomnia. When our serotonin levels are normal, we feel happier, calmer, less anxious, more focused and emotionally stable. Noradrenaline, also known as norepinephrine, is a hormone and neurotransmitter which helps the body recognise and respond to stressful situations, involved in the fight-or-flight response. Abnormal noradrenaline levels are sometimes associated with depression, ADHD, schizophrenia and anxiety. Finally, dopamine is a neurotransmitter which regulates the brain’s reward and pleasure centres along with our emotional responses. Unusual dopamine levels are often linked with depression, tremors in Parkinson’s disease, schizophrenia, ADHD and addiction. There are many other neurotransmitters involved in mental health including glutamate, which helps with learning and memory. There is an association between problems with making or using glutamate and autism, OCD, schizophrenia and depression.

These discoveries have resulted in huge advances in treating mental health. For example, discoveries about serotonin have helped treat 40-60% of those suffering depression through the use of only a single type of drug therapy – selective serotonin reuptake inhibitors (SSRIs). SSRIs work by reducing the brain’s ability to reabsorb serotonin, boosting serotonin levels in the brain. Because of this SSRIs are the most prescribed antidepressants; you might be familiar with SSRIs such as Prozac and Zoloft. SSRIs are also effectively prescribed for anxiety and other problems, proving that neurotransmitters do in fact have an effect on mental health. On the other hand, the remaining 40-60% of people aren’t helped by the treatment perhaps because neurotransmitters are only one of the factors affecting mental health. Likewise, very little is known about the science behind mental health so serotonin may cause some problems but has no influence on others. Equally, as abnormal noradrenaline levels can lead to depression, a sufferer of depression prescribed drugs that increase serotonin levels but do not impact on noradrenaline levels may find these unsatisfactory and depression could loom. But there are antidepressants called NSRIs (norepinephrine and serotonin reuptake inhibitors) which are used in response to this, along with other drugs which stabilise noradrenaline levels, and the same approach is used for other neurotransmitters. There are also many more natural approaches to increasing levels of neurotransmitters in the brain. For example, exercise can increase serotonin levels.

But whilst neurotransmitters are undoubtedly linked to mental health, they are certainly only part of the cause since mental health is an extremely complex phenomenon which very little is known about. Our actual brain structure also has an impact on mental health, due to alterations in the size and activity of specific areas of the brain. The phenomenon known as neuroplasticity – the ability of the brain to reorganise itself as a result of our environment, behaviour, thinking, emotions and genes – is related to mental health along with neurogenesis. For example, studies have shown that depression and anxiety do lead to “negative neuroplasticity” in which the hippocampus (memory centre of the brain) and the amygdala (fear hub of the brain) reduce in size. This is particularly important since these areas themselves have an impact on mental health; for example, the prefrontal cortex, amygdala, anterior cingulate cortex and the hippocampus. Decreased activity in the prefrontal cortex is common with people who have ADHD and post-traumatic stress disorder, and damage or decreased activity in the anterior cingulate cortex has links with schizophrenia, ADHD and depression. Finally, the hippocampus has been reported to shrink as a result of depression, with potential knock-on effects on clinical depression and other problems. In other words, our mental health is having a very physical and worrying effect on our brains, with many of these effects unknown and under-researched.

Much more research needs to take place to discover more about the science behind mental health and effectively treat it since it is such a relevant, severe and widespread issue requiring more support, time and money. Likewise, more awareness should be raised and an emphasis on care for the sufferers will be vital in solving this issue, especially given treatment is still a work in progress and the importance of other unconventional treatments should be considered, such as yoga which has been proven to benefit those with these issues. Finally, the significance of self-care shouldn’t be overlooked: for example, just a few minutes of exercise whilst watching television each day would have a positive effect on mental health.