By Professor Marie Reid
Psychology has huge effects on physical health, mental health and wellbeing, which are often inadequately considered. Biomedical science sees health, even mental health, as caused by the physical condition of the body, including the brain. Biomedicine has indeed made huge advances in treating all sorts of diseases, even eradicating some, and prolonging life. Nonetheless, the effective treatment of many diseases requires psychological knowledge as well as medicine, while for mental health problems psychological interventions are more effective than medicines and other biological interventions. Many common health problems need psychological input, usually from clinical and health psychologists. Here are some examples based on our research group’s work at Hull:
In developed countries and affluent parts of developing ones, many people are overweight or obese. The cause is very simple; the food they eat has more energy than the energy that they use up in their lives through work, play and deliberate exercise. But people often struggle to diet, lose weight, and keep the weight off, despite experiencing the many health problems of being overweight or obese. To understand why, psychologists look at entire lifestyle patterns, at how the food industry encourages overeating by how it markets and sells food, and at how the stigma, prejudice and even bullying and abuse directed at obese people makes them despair and lose motivation for weight loss. Often, to lose weight and keep it off, it is necessary to make total lifestyle changes and address the underlying psychological problems that have led the person to neglect weight management.
Life events, challenges and adversities can cause psychological stress, which has adverse effects on mental and physical health because it affects the immune system and other physiological functioning, so people get ill more easily. It is widely recognized that difficult events, like exams, or horrible ones, like a road accident, are stressful. It is less appreciated that positive events and minor difficulties can also be stressful, and all these have cumulative negative effects on wellbeing. Cumulative stress is a very common cause of staff taking long term sick leave, so it is very important to assess stress at work properly in demanding jobs such as policing, to recognize signs of stress and to manage these effectively, rather than seeing them as signs of weakness or vulnerability.
Depression is among the most common mental health problems. Although anti-depressant medication can help, cognitive behavioural therapy (CBT) for depression works even better. Depressed people often have distorted thinking where their memories and feelings are heavily biased towards the negative. Part of CBT is teaching people to recognize this bias and counter it by using techniques for remembering and recognizing the positive aspects of life as well as the negative ones, and being able to count their blessings as well as their problems.
Chronic health problems are challenging to manage and can cause mental health problems such as anxiety and depression. Being anxious or depressed in turn can make it difficult to manage a chronic health problem, so the patient’s condition may deteriorate. For example, someone with diabetes who is depressed may not manage their condition properly by choosing the right foods. A woman with polycystic ovarian syndrome who is depressed may not see the point of losing weight even although she wants to have a baby. Services for metabolic disorders benefit from having psychologists involved to design interventions that consider such issues.
Mental health problems are often stigmatized and those who suffer from them can be seen as dangerous and frightening. For example, drug addicts are often considered to be dangerous and difficult patients, their condition is seen as their own fault, it is thought that they should just stop use, and they may be denied even basic health care, like being vaccinated against hepatitis. Yet, many addicts have terrible life histories of neglect, abuse and suffering and use drugs to block out unbearable feelings they have about the past and about the bad things they have done to get and take illegal drugs. Part of recovering from an addiction is to learn, with the aid of psychology, to live without drugs, which means learning to be able to get over the past and cope with negative feelings. Without being able to cope with horrible thoughts and feelings unintoxicated, it is unlikely that an addict will be able to quit use permanently. Similar issues apply to other mental health problems such as schizophrenia, anxiety, depression, mania and personality disorders, which are often stigmatized, misunderstood and hidden, or treated mainly with medication, when they can actually be treated with psychological therapies.
As people come to live longer, many people are afraid of dementia. It can be difficult to tell the difference between ordinary mental effects of aging, like becoming more forgetful, and more severe effects which may be early signs of dementia. Psychologists can use standard cognitive tests of memory, thinking and reasoning to screen people who worry that they have dementia and give them appropriate information and guidance about their condition.
Eating disorders are frightening and dangerous conditions, especially if the sufferer becomes extremely thin due to anorexia nervosa. Treatment often needs to focus on feeding and weight gain. However, people living with eating disorders often have complex underlying psychological problems, originating in childhood and adolescence, which help to create and sustain the eating disorder. To facilitate recovery in the long term, it is essential to understand and work with these complex problems, which can include perfectionism, difficulties dealing with anger and other negative emotions, and life challenges such as bullying, neglect and abuse. Without addressing these, the person may be of healthy weight but may still be ‘anorexic in their head’ and liable to develop another eating disorder or other psychological problems.
These examples illustrate the broad importance of psychology in understanding and treating physical health and illness, as well as mental health. Other examples include that psychological screening and counselling can improve and speed up recovery from surgery. Many medicines and other interventions are less effective than they could be because patients do not follow the instructions properly. Psychology can understand and improve compliance. Perhaps most importantly, many health problems and illnesses are managed by patients changing their behaviour. Psychology has developed a detailed understanding of how to design effective behaviour change techniques. Indeed, these were applied to the management of Covid-19 lockdowns.
(The author is a Professor of Psychology and Consultant Clinical Psychologist, Department of Psychology, University of Hull. Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)