The relationship between mental health and physical health

Mental health and physical health are a two-way mutually reinforcing symbiotic relationship. There is no clear primary and secondary boundary between the two. Damage in either dimension may trigger a chain reaction in the other dimension. There is no psychological state that is divorced from the physiological basis, and there is no physiological function that is not subject to psychological control.

It may sound a bit abstract, but let me tell you a real thing that I encountered when doing health follow-up visits in the community two years ago. At that time, there was a 62-year-old Aunt Zhang in the district. She had been suffering from high blood pressure for three years. She had been taking three types of antihypertensive drugs, and her indicators kept going up and down. Sometimes the test would be 150/95 in the morning, but it would jump to 170 in the afternoon. Her body was always tight and she had insomnia. After several tests, no organic problems were found. Later, the old doctor who attended the clinic asked a few more questions and found out that her son drove a truck in another province and had a minor accident last year. Since then, she has been holding her cell phone every day waiting for her son to report that he was safe. In the middle of the night, when she couldn't sleep, she would scroll through videos of traffic accidents. The more she scrolled, the more panicked she became. Later, we teamed up with the psychological social worker in the community to give her 8 group counseling sessions, and taught her son to send a two-second voice message at a fixed point every day to say he was safe. Within two months, her blood pressure stabilized at around 130/80, and she didn’t even have the migraines she often suffered before.

At that time, old doctors always said, "You can't just look at the numbers on the movie, but also the person." In the mainstream biomedical framework of a few decades ago, this statement was actually a bit "cross-border" - early medical research generally separated the body and mind into two independent systems. It was not until the rise of psychosomatic medicine in the past 30 years that more and more evidence-based evidence confirmed the connection between the two: a 2022 study in The Lancet Psychiatry showed that people who are chronically anxious have a 32% higher risk of cardiovascular disease than ordinary people, and a higher risk of autoimmune disease. 22% higher. The core reason is that long-term negative emotions will continue to activate the hypothalamus-pituitary-adrenal axis (HPA axis). In human terms, the body is always in a stress state of "preparing to fight/escape". Blood vessels shrink for a long time and immune cell activity is suppressed. Even if you are not sick, you have to get through it.

Oh, by the way, the reverse effect is actually more felt by everyone. When I had influenza A two months ago and my fever reached 39 degrees, I was a person who usually didn’t take anything seriously. During those two days, I even felt annoyed while watching my favorite talk show. I felt aggrieved for a long time when someone quarreled online. After the fever subsided, I thought it was funny. Essentially, when you are feeling unwell, the prefrontal cortex, which controls emotions in the brain, has insufficient energy supply, and the synthesis of happy transmitters such as serotonin and dopamine is affected. No matter how much you persuade yourself to "be happy," it is useless.

Precisely because the connection between the two is becoming more and more known to everyone, two very extreme voices have appeared on the Internet, and the quarrel is quite fierce. One group says that "all chronic diseases are emotional diseases" and advocates that diabetes and hypertension can be cured by mindfulness and meditation alone without taking medicine. Most of these views are supporters of the mind-body-spirit school. They do grasp the regulatory effect of emotions on the body, but completely deny the role of physiological basis. They are obviously going astray - just like if you have bacterial pneumonia, no matter how you adjust your mood, it is not as effective as taking antibiotics. The other group is a typical "materialist warrior" who says that psychological problems are all idle and that just running two more laps and moving more bricks will be fine. Behind this view is the logic of the traditional biomedical school, which emphasizes the basicity of physiological state, but completely ignores the reaction of the psychology on the body, which can also easily delay the solution of the problem.

In fact, there is really no need to have to decide who is the other. The two are more like the battery and circuit of an electric vehicle: if the battery is short of power (physical problem), the circuit will not be able to run no matter how intact it is; if the circuit is short-circuited (psychological problem), the battery will not be able to drive when fully charged. In the past few years of my health intervention career, I have seen too many people who either just stare at the arrows on the physical examination report and stay up late every day worrying about whether they are going to get cancer, which in turn makes their bodies exhausted; or they say they are "in a bad mood" every day and stay up late, drink iced drinks, and eat takeout every now and then. Even their basic circadian rhythms are disrupted, so how can their moods get better?

Oh, there is also a very interesting study. A 2021 review by the American College of Sports Medicine shows that moderate-intensity aerobic exercise, 3 times a week for more than 30 minutes each time, is as effective in improving mild to moderate depression as the commonly used antidepressant sertraline, and has fewer side effects. Look, isn’t this the best example of the synchronization of body and mind?

To put it bluntly, for ordinary people, there is no need to worry about which of the two is more important. Don't check work messages while eating, don't lie down and read the chat history of quarreling with others before going to bed, go out and bask in the sun for half an hour and walk twice when you have time, don't hold back when you encounter bad things, either speak out or do something to vent them. These inconspicuous little habits are much more useful than buying a bunch of health care products or signing up for a bunch of psychological classes. After all, human body and mind are originally one, so how can there be any reason to raise them separately?