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Defining good mental health

What is good mental health? Some psychologists theorized that before we can focus on improving our mental health, our basic needs must first be met. Abraham Mazlow created his hierarchy of needs, represented below with a pyramid. On the bottom, biggest level, are the purely physiological needs. The next step are the safety needs. These are considered to be basic needs for the human body to survive.

Maslow's hierarchy of needs pyramid. On the bottom are physiological needs like breathing, food, water, sleep. Then is safety, then love and belonging. The next level is esteem - self-esteem, achievement, confidence. On the top is self-actualization - morality, creativity, problem solving, lack of prejudice, acceptance of facts.
From Wikimedia Foundation

After these basic needs, come psychological needs – social health and the feelings of love and belonging, and emotional/intellectual needs like self-esteem, achievement of goals, confidence, and respect of other people. At the very top is self-actualization, which is realizing one’s full potential.

This model is visually shown as a pyramid, but Maslow has written that people do not climb this pyramid by meeting one need at a time. People move between different needs and work on different areas of their needs when needed. Maslow also worked with the Blackfoot Nation, which helped to inform some of his work. Some of the beliefs of the Blackfoot indigenous people is that above meeting individual needs are the needs of the community and that these are all interrelated such that people work for the benefit of community. https://barbarabray.net/2019/03/10/maslows-hierarchy-of-needs-and-blackfoot-nation-beliefs/

A person who is exhibiting positive mental health can get along with others, feels good about herself, is open to new ideas, and is able to cope with stress and negative emotions. Read more here https://www.mentalhealth.gov/basics/what-is-mental-health and here https://www.cdc.gov/mentalhealth/learn/index.htm.

As with other dimensions of wellness, mental health exists on a continuum. On the one side is positive mental health, and on the other side is ill mental health or mental illness.

How do we improve our psychological health?

Psychological or mental health is thought to encompass intellectual, social, emotional and spiritual well-being. These four dimensions of health are highly interrelated, and also have an effect on our physical health.

To review – intellectual health deals with how we think, make decisions, and problem solve. Emotional health is about understanding, expressing and/or controlling your emotions. Social health is concerned with our relationships with others. Spiritual health is about finding your purpose in life and acting in a way that is consistent with your beliefs and values.

What are some things you like to do to improve these dimensions of your health?

Here are some ideas to improve your mental wellness.

Sleep

One important way to help deal with stress is by getting enough sleep. We are all familiar with how our bodies and minds feel when our sleep was interrupted or just too short – we feel clumsy, inattentive, moody, fatigued, unable to focus or remember.

There are several stages of sleep and two types of sleep.

Image showing the four stages of sleep in a sleep cycle: light sleep (when we are just falling asleep), main sleep (body and brain least active), REM sleep (dreaming), and slow-wave sleep (memory consolidation).

Throughout the night, we go through several sleep cycles. At the beginning of the night, we have deeper sleep – more non-REM sleep. Toward the end of the night, the sleep cycles consist mainly of REM sleep.

Image showing 8 hours of sleep with alternating REM and non-REM sleep.

Studies show the many benefits, both physical, mental and emotional, of getting enough sleep.

How can you get good sleep? Avoid eating, exercising or drinking caffeine too close to bedtime. Try to go to sleep and wake up at the same time every day. Have a restful place to sleep – dark, quiet, and cool. Here are more ideas, from NPR – https://www.npr.org/podcasts/510336/sleepbetter .

As with everything, it is possible for sleep to be disordered. Read about sleep disorders here – https://medlineplus.gov/sleepdisorders.html

What are sources of stress?

Every year, the American Psychological Association conducts a survey about stress in the United States. Some of the more common stressors are money, family responsibilities, health-related concerns, and work. To see more sources of stress, and see some generational differences and trends on stress level, see https://www.apa.org/news/press/releases/stress/2021/infographics-march.

A modern type of stress comes from overuse and over-reliance on technology. This has been termed technostress and it can have serious harmful effects. For more on how to deal with this, see
https://www.psychologytoday.com/us/blog/prefrontal-nudity/201708/dealing-technostress .

An important step in considering how to manage your stress level is to first figure out what are your stressors. Think about the top 5 stressors in your life. Are there any changes you can make to help manage your stress when responding to these stressors?

Stress management

It is possible to manage stress – some ideas can be found here https://www.nimh.nih.gov/health/publications/stress/index.shtml and here https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/3-tips-to-manage-stress.

There are certain key ways to help manage the way you think that help with stress.

General Adaptation Syndrome

One way to understand how long-term stress affects your health is through the General Adaptation Syndrome, which describes the three stages of stress – alarm, resistance, and exhaustion – https://www.healthline.com/health/general-adaptation-syndrome.

Before you experience stress, your body is in homeostasis. This is the state where the various body systems are generally in equilibrium. When you first perceive something stressful, the fight or flight response of the alarm phase begins.

Once a stressor is perceived, the body’s resistance to stress is also activated, as the various body systems try to get back to their usual function.

Another explanation of how stressors can impact our bodies is with the concept of allostatic load – the amount and duration of stressors that we are facing (chronic versus acute stress).

Video describing acute and chronic stress and the concept of allostatic load.

What is stress?

When you perceive something as a threat to you, your body activates part of your autonomic nervous system called the sympathetic nervous system which sends hormones through your body. These hormones cause various changes that you can notice – all of these changes are called the fight or flight response.

Image explains the fight or flight response. Brain perceives the threat, in the hypothalamas signals are sent to the pituitary gland, which then communicates with other endocrine glands to release adrenaline (epinephrine) and cortisol. This causes increase in heart rate, dilated pupils, bladder relaxation, flushed face, shaking, dry mouth, slowed digestion.
From Wikimedia Foundation

Stress can be good (known as eustress) or bad (distress). Eustress often comes from events or situations that are challenging, like going to college, getting a new job, or a new baby, but that ultimately lead to growth and success. Distress is caused by things like losing a loved one, losing a job, breaking up with a partner, and other difficult situations. Stress from these events can lead to negative health outcomes.

Read more here:

How-stress-affects-your-health – APADownload

Stress can affect how you feel, physically and emotionally.

Image showing health problems arising from stress. Brain and nerves: headaches, feelings of despair, lack of energy, sadness, nervousness, increased or decreased eating, trouble concentrating, memory problems, trouble sleeping, mental health problems. Skin: acne and other skin problems. Muscles and joints: muscles aches and tension, increased risk of bone density reduction. Heart: faster heart beat, rise in blood pressure, increased cholesterol, increased risk of heart attack. Stomach: nausea, stomach pain, heartburn, weight gain. Pancreas: risk of diabetes. Intestines: diarrhea, constipation, other digestive problems. Reproductive system: in women - irregular or more painful periods and reduced sexual desire, in men - lower sperm production, reduced sexual desire. Immune system: lower ability to fight or recover from illness.
From Wikimedia Foundation

There are different kinds of stress: acute, episodic acute, and chronic – https://www.apa.org/helpcenter/stress-kinds.

Mortality in 1900 vs. 2010

Mortality in 1900 vs. 2010

Over the last 100 years, there have been many advances in public health and medicine. Read about it here https://www.ncdemography.org/2014/06/16/mortality-and-cause-of-death-1900-v-2010/.

Bar graph of top 10 causes of death in the USA in 1900 and 2010. In 1900, people died most from pneumonia and influenza, tuberculosis, gastrointestinal infections. In 2010, most common causes of death were heart disease and cancer.

Consider this question: How have the causes of death changed in the last 100 years?

Consider this question: Why have the causes of death changed in the last 100 years?

Even more recently, we have had a resurgence of infectious diseases and COVID-19 has become the third leading cause of death in the US. What health behaviors can mitigate the spread of infectious illnesses? What policies can help to prevent deaths?

How can we improve our health?

What are some of the most common behaviors that contribute to the leading causes of death? And is there anything we can do to change our likelihood of death from a particular cause?

The behaviors that are responsible for most deaths in the United States are: using tobacco, a sedentary lifestyle, drinking alcohol and an unhealthy diet.

Health behaviors are considered to be modifiable determinants of health – that is, you can change them! But how can people change these common behaviors? The field of health education uses several theories to explain the process of making behavior change.
• Health belief model – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories2.html
• Theory of planned behavior – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories3.html
• Social cognitive theory – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories5.html
• Transtheoretical model or Stages of Change – http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html

Healthy People 2020 and 2030

Our government and many health-related organizations put together a plan every 10 years to improve the health of the nation. This decade’s plan is called HealthyPeople 2030 – https://health.gov/healthypeople/about

Some of the main goals and target areas that Healthy People 2030 focuses on are:

  • Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
  • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
  • Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
  • Promote healthy development, healthy behaviors, and well-being across all life stages.
  • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

From: https://health.gov/healthypeople/about/healthy-people-2030-framework

It is important that we can measure how well the nation is achieving these goals. There are overall health and well-being measures, like life expectancy – https://health.gov/healthypeople/objectives-and-data/overall-health-and-well-being-measures; social determinants of health – https://health.gov/healthypeople/objectives-and-data/social-determinants-health; and leading health indicators – https://health.gov/healthypeople/objectives-and-data/leading-health-indicators.

HealthyPeople 2020 mid-course review shows which of the most important indicators of health are improving, staying the same, or declining – https://www.healthypeople.gov/2020/data-search/midcourse-review/lhi