Gerry is Chairman of the Oxford-based Global Initiative for Traditional Systems of Health and holds a Professorship of Epidemiology at Columbia University. He will share with us details of his current research that explores the scientific landscape of wellbeing and mental wellness and suggests ways forward for the public and individuals.

KEY TAKE-AWAY

The mental health crisis identified by WHO and UN is already upon us. The full extent of its impact will only be revealed when the tsunami of the viral pandemic has rolled back. Much research is already ongoing, but for this to be meaningful it must dis-aggregate the crisis and acknowledge its complexity.

Neurological metabolic dimension.

  • Some COVID sufferers will be subject to significant and enduring neurological effects (strokes; speech loss; sight loss; persistent stress) as a direct result of the virus’s ability to attack the epithelium and thus cause vascular damage throughout the body. This neurological/vascular dimension to the disease is not being systematically picked up by standard clinical procedures despite its potential to be pervasively damaging.
  • Patients with a pre-existing mental health condition are more likely to die of COVID. The reasons for this are multiple and nuanced. Anxiety and depression compromise the immune system. Pre-existing vascular ill-health might be part of their condition and could result in greater vulnerability to the further vascular onslaught of the virus. Schizophrenia sufferers are statistically more likely to get COVID – we don’t know why.

Psychological dimension.

  • This primarily manifests as a fear of catching the virus and of death (both for oneself and loved ones). So far, there is more fear than depression related to this pandemic.
  • Demographic differences are emerging. Based on a UK study, men and young adults have been identified as the group most vulnerable to psychological health issues related to the pandemic. Women emerge as more resilient thanks to a more holistic approach to handling its fallout.

Social/Economic dimension.

  • Mindfulness and meditation apps are booming – but beware of recommending such a tool to treat a pandemic-related mental health pathology before establishing whether the patient has enough to eat, and a safe and abuse–free place to live.
  • COVID has worsened levels of poverty worldwide (including in the rich world). Poverty brings with it its own swathe of mental health issues. E.g. out of work textile workers turning en masse to prostitution.

A constructive response is to foster the opposite of mental illness that is to say mental wellness. Thanks to its neuroplasticity the brain can self-heal; re-wire; create new connections but this doesn’t happen on its own. Certain activities enhance this cerebral capacity to re-generate:

  • Regular physical exercise and exposure to nature (something as simple as time in the park as opposed to an extra half hour of screen time) are robust and reliable ways of improving mental health in general.
  • In contrast to other physical activities (e.g. rowing) yoga and particularly dance (perhaps thanks to its unique place in the story of human evolution) have a distinctive power to activate new pathways between the motor and meaning areas of the brain.
  • Meditation is proven to generate new grey matter.

This focus on the potential of epigenetics is giving rise to a whole new industry consisting of a plethora of products, activities, and therapies aimed at enabling improved mental wellness.

This is important at the individual level, but the major challenge that should now be facing governments and NGOs is how to roll out widespread public health policies to enable mass access to mental wellness activities and therapies both in the context of mental health care and prevention.