A healthy mind...

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While I’ve long been interested in mental health issues, and the Beacon has always covered these topics and the latest research, in recent years I’ve gained a deeper sensitivity through some interactions with people close to me.

The combination of new information and a growing awareness are starting to help me understand present — and even past — experiences in a new light.

In that spirit, I want to share some information I learned in a recent presentation by Kim Burton, director of Older Adult Programs at the Mental Health Association of Maryland (MHA).

To start with, let’s look at the term “behavioral health.” If you’ve ever seen it and not been clear what it means, you’re not alone. The term, Burton explained, addresses not only conditions that originate in the brain — what we might conventionally think of as “mental health issues” — but also many originating elsewhere in the body that affect the brain.

For example, while it includes psychological and personality disorders, cognitive impairments and dementias of all types, it also refers to substance abuse and addiction, the effects of brain injury, medication side effects, and even delirium (when common physical conditions like dehydration and urinary tract infections cause confusion and disorientation).

You may wonder why people now lump all these conditions together when they may have very different causes or sources. In part, it’s due to a growing understanding of our mind-body connections.

For example, Burton noted, studies confirm that many physical health problems, including common chronic conditions like diabetes, heart disease and even hearing loss, can increase one’s risk of depression and anxiety. And at the same time, we now know that depression can raise the level of our stress hormones, which impair our body’s ability to fight off disease.

In short, the old adage “a healthy mind in a healthy body” addresses only one aspect of the mind-body connection. At all times, the health (or disease) of our body affects our mind and vice versa.

As a result, the old-fashioned stigma that once attached to those with “mental illness” has become out of date and off the mark. That’s another reason for using the less pejorative, more inclusive, term “behavioral mental health.”

We can all see ourselves as susceptible to behavioral health issues, and therefore as needing to learn how to recognize and treat, or cope with, them — both inside ourselves and in interacting with others. 

A friend recently reminded me that public buses in this area play a recording periodically that says, “Thank you for saving priority seating for older adults and people with disabilities. Remember: not all disabilities are obvious.”

While that last line is meant to refer to less evident physical conditions, my friend noted it’s also true that many of us, “in one way or another, face our own undercover disabilities. Each of us has something that challenges us in a deep way — emotionally, mentally or otherwise.”

Of course he wasn’t saying we can all start vying for those convenient priority seats on the bus. There are disabilities that make it more difficult to walk and to stand, and there are those that affect how we feel about ourselves, and we must respect that different accommodations are required for the former than the latter.  

But he has a point. Behavioral health problems can be debilitating and yet quite hidden for the most part. We can all try to become more attuned to the less obvious, but nonetheless serious, struggles and challenges we, our friends and our family members face.

One reason behavioral health may be on people’s minds more today than in the past is that so many of us are living longer than our forebears.

Burton reported that those with serious mental health issues used to pass away 25 years earlier than they do today. Today there really are more people suffering from these conditions.

Furthermore, despite the good health and medical care that has so extended our physical lives, Burton pointed out that many behavioral conditions that we may have escaped in our youth can develop after a long life.

This applies, for example, to substance abuse, which is a growing issue among older adults. While late-life depression and loneliness may be factors, the aging of our bodies may be even more important.

We simply have more trouble metabolizing alcohol and drugs as we age. Studies also suggest we become much more susceptible to addiction later in life, for reasons that aren’t yet fully understood.

And when we find ourselves changing as we age — developing conditions and facing challenges we thought would never affect us — we can have a particularly difficult time accepting that fact and taking steps to address it.

That may help explain why the highest risk for suicide is found among those 65 and over (particularly among men 80 and over).

I think we can all benefit from gaining a greater awareness of the effects our bodies can have on our minds and vice versa.

For those interested in more information on this topic, as well as practical advice, I refer you to a helpful book published by the MHA: Mental Health in Later Life: A Guidebook for Older Marylanders and the People Who Care for Them. It can be downloaded free of charge in pdf format from www.mdaging.org or ordered in print form (including in bulk) by calling (443) 901-1550, ext. 210.