The interconnectedness of health

It is the current practice for matters of health to be compartmentalised between mental and physical health. On the surface, this seems like a natural distinction. Most laypeople would say that there is a categorical difference between the mind and the brain. Mental health was also not taken as seriously as matters of physical health up until recently. Furthermore, it is a common view that psychologists seem to ply their trade independently of biological/physical considerations. However, there is a lot of research evidence to suggest that this is not the case. The likelihood of the presence of a mental health disorder seems to increase as the number of physical morbidities/diseases increases (Barnett et al., 2012). Conversely, mental disorders also increase risk of both infectious and non-infectious diseases, and often lead to both unintentional and intentional injury (Prince et al., 2007). Even leaving aside the field of more serious diagnoses, we find that poor mental states can arise from physical factors like stress and tiredness, which in turn also influence our brain’s executive functioning, highlighting the influence of physical health upon mental health (Diamond, 2013).

With that in mind, it is clear that physical and mental health share an irrefutable and mutually influencing relationship. Changes in one will necessarily affect the other. On one hand, these can sometimes lead to vicious cycles. For example, poor physical health can lead to feelings of low mood, which in turn lessens one’s desire to improve physical health through exercise or other methods. Fortunately, this cycle can be harnessed to work in the opposite direction as well. A person in a good mental state is more likely to be motivated to improve their physical health and sustain the necessary changes to their lifestyle, and being able to do so can even in turn help improve their mental state. In other words, there is no mental health without physical health!

Of course, change is difficult. It involves breaking out of established patterns in your life, to do things that may not have any immediate or apparent benefit. To some, this may seem like a herculean act of willpower, and even the idea of it may seem insurmountable. How can I take care of myself if I can’t even get out of bed? This helps illustrate the importance of coaching. Often patients in the early stages of treatment for their mental health issues may find suggestions made by the therapist intimidating or impossible. Health coaches help to break down these tasks and make them seem more manageable, as well as keeping the patient accountable for their own success.

Health coaching is on the rise. Coaching by allied health professionals already has demonstrated health benefits. For example, the COACH program is a proven strategy in reducing total cholesterol and many other coronary risk factors in patients with coronary heart disease (Vale et al., 2003). Health coaching has also been proven to improve the management of other chronic diseases, producing positive effects on patients’ physiological, behavioral and psychological conditions (Kivelä et al., 2014). This is through improving their understanding of their situation as well as motivating them and increasing their willingness to change. Life coaching has also been shown to improve goal attainment, which is in turn associated with enhanced mental health as well as quality of life (Grant, 2003). A health coach helps patients stay accountable and devises plans to improve their overall lifestyle, in domains such as sleep, physical activity, nutrition, stress management, and more. They serve as a third party to help patients make sense of the information that other health professionals provide and create reasonable goals using that information.

Often, what patients need is the motivation and courage to take that first step towards changing their lives. This step is often the hardest, but once it is taken the rest will become gradually and incrementally easier. In the case of depression, withdrawing from daily activities that one might find meaningful or personally rewarding can be a major factor in worsening depressive symptoms. Further work also suggests that physical activity and exercise are often associated with better mood states and functional capacity (Penedo & Dahn, 2005). Therefore, an external agent helping patients to engage in rewarding physical activities can be the catalyst for a great improvement in mood, motivation and general mental functioning. This focus on activities is known as behavioral activation, a therapeutic approach which plays a key role in the efficacy of cognitive behavioral therapy in treating depression (Dimidjian et al., 2006).

The value of mental health is beginning to take hold in Southeast Asia, and with it comes an important reminder not to neglect the role that physical health can play in improving mental health outcomes. It will be good to remember that health as we know it is an interplay of biological, social, and mental factors. Health coaching is thus invaluable in helping us tackle all of those areas to some degree.