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Mental HealthWhy mental health is not always in your head

Without exception, we all are guilty to some extent of advocating for the methods and ideologies that we individually have expertise in and consequently believe in.  However, as a mental health practitioner, the burden falls on me to ensure that I am advocating for my patient, remaining vigilantly open-minded and humble enough to consider that the symptoms of my patient’s illnesses or troubles could be caused by things outside of the realm of my specific training....
Parisa SoltaniJuly 5, 20229 min
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Without exception, we all are guilty to some extent of advocating for the methods and ideologies that we individually have expertise in and consequently believe in. 

However, as a mental health practitioner, the burden falls on me to ensure that I am advocating for my patient, remaining vigilantly open-minded and humble enough to consider that the symptoms of my patient’s illnesses or troubles could be caused by things outside of the realm of my specific training.

So, beware of a dedicated salesperson. 

This is the practitioner with a product or method they are comfortable with and are heavily subscribed to and invested in. Unfortunately our reality is that mental health and medical professionals also fall into this bias. They sell what they are comfortable with, not what is best for you. Beware of rigid approaches and uniformity for every patient. 

When it comes to mood issues, your yoga teacher, for example, they may tell you that a chakra is blocked. A Pilates instructor could suggest that your posture is to blame. A general practitioner may prescribe you with painkillers and something to help you sleep. All the while, the culprit is the invisible-to-you black mould in your new apartment. Even with the best of intentions, without impartial investigation, an issue cannot be resolved. 

Another pitfall is that there is still an outdated view on mental health that continues to pervade this field, leading to misguided treatment for patients. That outdated view, as stated on the Mental Health America website, is that “mental illnesses are related to problems that start in the brain”. 

This is simply untrue. There are a range of physical conditions that must be ruled out during treatment for a mental health disruption. So many patients come to me, frustrated with unresolved issues because practitioners have been failing to listen, to keep an open mind for investigation and to admit that the method they have expertise in for treatment may not be what their patient needs.

Let me share an example. I had one patient convinced she had major depression. She suffered extreme fatigue. Some days she was too tired and sad to get out of bed. Feelings of shame and guilt took over her and wrapped her up in a suffocating cloud for days, sometimes weeks. There was a history of depression in her family. But after our initial consultation I sent her for several tests. The results showed that she had hypothyroidism, which is an underactive thyroid – the symptoms of which can include depression and fatigue. No amount of talk therapy or antidepressants would have helped this patient improve her mental health without first addressing her hypothyroidism. It was not in her head at all. I advised her to see an endocrinologist, because I was not the professional she needed for her health in that moment.

Treating the hypothyroidism eliminated the majority of her symptoms and any remnants of depression were able to be treated with practical strategies and  dealing with her past traumas.  

Another client presented with suicide ideation, depression and anxiety. She also had a family history of depression. She kept saying to me “I just don’t feel like myself”. I paid attention, we investigated with a series of blood and stool tests. It turns out that she had a type of parasite in her digestive system, the kind that can change the way the host thinks and feels and influence their behavior.

These examples highlight how patients may waste months talking about their feelings – and still suffering – in traditional therapy, with no relief and no improvement to their mental health. It’s always better to rule out a physical issue: something that can only come with an open mind and a variable approach. 

And in terms of the concept of mental illness as “problems that start in your brain”, here are some of the issues that definitely do not:  

• having a long-term physical health condition

• unemployment or losing your job

• drug and alcohol misuse

• domestic violence, bullying or other abuse as an adult

• significant trauma as an adult, such as military combat, being involved in a serious incident in which you feared for your life

• physical causes for example a head injury or a neurological condition such as epilepsy 

• childhood abuse, trauma, or neglect

• prolonged stress 

• bereavement 

My advice to you is: learn about the human body and in particular your own. Remember that the brain and mind are part of the body and they are in continuous conversation with one another. And please make sure that you see a health care professional who truly listens to you and very thoroughly investigates you as a whole system, before attempting to treat you.  

Parisa Soltani

Parisa has a neuroscience degree and is a counsellor of Integrated Psychotherapy, works in psychological and physical trauma rehabilitation with a speciality in acquired brain injuries and autism and is currently working on her PhD on the therapeutic implications of indoor skydiving on the brain, specifically cerebral palsy and ADHD.. She's also a personal trainer, yoga and barre instructor and lives on a boat in Abu Dhabi.

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