However, the factors which influence an individuals mental health are so diverse that media articles and short term courses may only scratch the surface of a complex problem which the World Health Organisation reports will affect 1 in 4 in Europe alone (Source: WHO).
My role as a psychotherapist involves helping individuals and groups work through this complexity to build a complete picture of their lives; to better understand why they are struggling; and find the right therapeutic approach most appropriate to them.
To ensure I get a holistic view of all the factors influencing a person’s health, I often use the Biopsychosocial Model, which was created by American Psychiatrist George L. Engel in the late 70’s. This model was designed to ensure medical intuitions did not focus solely on the physical condition and miss important social influences and/or psychological factors which could be contributing to the condition.
The model is particularly useful in gathering client data, including information which clients may feel are irrelevant, as well as raising awareness of the inter-connected nature of physical health, emotional well being and balanced relationships.
The Biological Factors include
Chronic Stress: With the rise of urbanization, the pressures of societal expectations, slow traffic and fast food, stress levels are constantly on the rise which can contribute to mental health issues.
Genetic Inheritance: It is essential to know your families medical history as your chances of experiencing a mental health issue increases when one or both parents have suffered.
Lifestyle/Diet: Poor nutrition or a lack of exercise could be contributing to higher stress levels.
Gender: Statistically women experience depression more than men (Source: WHO), and in particular Postpartum Depression which is thankfully getting more coverage in the media. However, one theory around the data is that women tend to be more open to sharing their vulnerabilities and will seek professional help quicker than men. With this being International Men’s Health week, hopefully this trend will change as we strive to normalize mental health issues across the globe.
The Psychological Considerations include
Personality: A person’s ego (or pride) may resist change and taking ownership of their health.
Emotional Expression: How we express our inner world is key to maintaining emotional stability. It is OK to be angry, to be sad, to be fearful, etc. however, if we are unable self regulate and communicate in a manner which is understood, we might bottle up, leading to increased physical stress and social tension.
Unhealthy Behaviors: We often appear to be a self-destructive race of people where we unconsciously choose less than helpful behaviors which contribute and exacerbate our problems. These include worrying, shouting, withdrawing and avoiding taking responsibility.
Coping Skills: Resilience is first developed during childhood, where we should be exposed to a “reasonable” amount stress and conflict. If one or both parents are overly protective or overly argumentative, a child may not experience the emotional balance needed to develop the skills of conflict and stress management which are essential to adult life.
The Social Influences include
Home Environment: Crime, anti-social behavior, poor weather, pollution, etc. can take their toil on stress levels.
Family System: Ongoing relationship difficulties, ineffectual communication styles, divorce, separation and bereavement can have a profoundly negative affect on an individual’s sense of self-worth and can lead to trauma and heightened anxiety levels.
Economic Status: Unemployment, the high cost of living and ongoing financial struggles can create a cocktail of stress and worry.Support Network: Without healthy friends and family to ground worries, validate experiences and distract from life challenges, isolation and loneliness can take over leading depression and hopelessness.
Joining the Dots
The above list is far from comprehensive but is a good starting point in reflecting on which aspects of our health we need to work on (whether it is physical, psychological and/or social).
I always start my clients off by encouraging them to journal each day to observe their emotional triggers, thought processes, lifestyle choices, etc. Everything is important…and facts are our friends! Journaling can help provide objectivity and pinpoint problem areas.
Next, we look at reducing stress through establishing stronger boundaries around worry (boxing off 20 mins of worry time can be useful) and relationships (saying No is hard but necessary) as well as correcting breathing patterns to improve their oxygen intake.
Encouraging clients to engage with their social support network is another important step but often they fear being a burden to their inner circle. This is almost never the case as the “right” people will empathize with their struggle as well as motivate them to keep moving forward.
Ultimately, we are all unique and to take control of our mental health, we have to accept that finding the right approach takes awareness, patience and most importantly, self-belief.