How A Multidimensional Approach Can Help Improve Mental Well-Being

To date, clinicians follow psychiatric models that were developed in the 20th century which largely rely on prescribing medications to treat “chemical imbalances” that cause mental health conditions. But a group of neuroscientists and psychiatrists argue that this approach is “overly simplistic” and fails to acknowledge the environmental, social, and lifestyle factors that contribute to poor mental health.

“The pharmacological treatment of mental health conditions came to be understood solely to fight a putative ’chemical imbalance’, without a true need to delve into the recesses of the patients’ minds and bodies,” lead author Sidarta Ribeiro at the Federal University of Rio Grande do Norte and colleagues wrote in an opinion piece published in the journal PLOS Mental Health.

“The individual’s environmental and social setting must be understood and improved through integrative practices. It is time to strive towards a more naturalistic and benign approach to promoting mental well-being, by strengthening the connections to one’s own body, nature, and community,” they added.

The researchers emphasized that in the last few decades, the prevalence of mental illnesses has increased significantly even though psychiatric drugs are being widely prescribed and hailed as “effective” treatment. According to the World Health Organization, in 1990, 416 million people were diagnosed with mental illnesses, and in the recent past, that number has shot up to 615 million globally. While the growing number of people getting diagnosed with depression, anxiety, and suicidal ideation can be attributed to better awareness and diagnosis, Ribeiro and colleagues say two factors are often overlooked: harmful side effects and exacerbation of mental illnesses caused by psychotropic medications and over-diagnosis due to financial conflicts of interest.

“Psychiatry must reduce medicalization as a commitment to doing no harm, by engaging in the multidimensional construction of alternatives to the conventional paradigm, which despite being dominant, is ineffective in the face of the complex challenges that involve mental care, such as stigma, social exclusion, and violation of rights,” the authors wrote. “Medicalization reduction works not with the concept of ’disease’, which explains the processes related to health-suffering-care solely in biological, chemical, and physical terms.”

Instead, they further explained that reducing reliance on only prescribing medications could help clinicians broaden their collective understanding of these processes through in-depth dialogue with their patients.

“Psychotherapy has proved itself not just as clinically effective, but also essential for treatment of most psychiatric cases. The quantitative structural analysis of patients’ dreams can offer profound insight into their mental state, as shown to be the case for the early diagnosis of schizophrenia. The analysis of the emotional content of dream reports, in particular nightmares, can provide valuable insight into different neurological conditions,” they wrote. “A deeper engagement with proprioception, interoception, and introspection can greatly catalyze healing processes, broadening self-understanding, and improving well-being.”

The authors highlighted that encouraging activities such as nature exposure, art therapy, and gardening can go a long way in protecting people against mental suffering. “These expressive outlets offer unique, personalized paths towards healing and self-discovery, offering a holistic and integrated approach to psychiatry.”

“The emotional relevance of dreaming and the clinical effectiveness of talk therapy underscores the need for a multidimensional approach to mental health care, capable of listening attentively to the patients. Discourse analysis at the structural and symbolic levels gives introspective access to deeper layers of the psyche, may help to build the sense of meaning in life, and must be more widely integrated into treatment plans,” they added.