Dimensions of Health

The accepted dimensions based on the definition given earlier include physical or biological, mental or psychological, and social. The other dimensions suggested include spiritual.
It is obvious that health is not a unitary concepts. It changes with our social / cultural environment. It is easier to place these dimensions as levels on a hierarchy. The physical / biological will be the most basic one. It is the FINAL COMMON PATHWAY through all the other levels has to be translated into. Phenomena taking place in other levels finally produce changes at this level.
Psychological level includes functions like sensation, perception, thinking, mood and emotions etc.
Social level includes interpersonal and group interactions, cultural variables etc.

Health - an enigma ?

Health is defined as "a state of complete physical, mental and social well being; and not merely the absence of disease or infirmity." This definition is given by the World Health Organization.It looks like a beautiful and self explanatory definition. But in practice this is not a very useful definition. It may be the definition of Ideal Health. But many of us - so called healthy(as per the latter half of the definition - absence of disease) fulfill this ideal criteria.
When it comes to mental health, things become a bit more complex. Is a smoker or a heavy user of alcohol mentally healthy ? Or a person continuing to eat excessively despite having diabetes, high cholesterol ? Or a rash driver ? one who refuses to wear seat belts or helmets (2 wheeler riders). This why I said defining health is a complex process.
Generally we assume that anybody who is not under medical care is healthy. For practical considerations this is enough.

Are they real illnesses ?

This is another common doubt. Most of us agree that bodily illnesses are true illnesses. But as the existence of "mind" itself is dubious, this doubt about veracity of mental illnesses is understandable. Our earlier discussion concluded by locating the mind in the brain. Hence mental disorders can be viewed as disorders of the brain. It is possible to demonstrate some kind of abnormality / malfunction in the brain in majority of mental disorders. Therfore it can be shown that MENTAL ILLNESSS ARE DISORDERS OF THE BRAIN. But obviously many factors including psychological stress, etc can lead to their development.

Who's job is it ?

There are many professionals involved in the care of mentally ill persons. They include Psychiatrist, Clinical Psychologist, Psychiatric Nurse, Psychotherapist, Counsellor, Psychiatric Social worker, Case manager, Community Psychiatric nurse, occupational therapist etc.
Among these the most essential categories are psychiatrist, clinical psychologist, psychiatric social worker and the psychiatric nurse. These professionals are employed in majority of hospitals / clinics. The other categories are employed in centres offering specialised services.
Psychiatrist is a licensed physician trained in basic modern medicine with post graduate qualification and training in Psychiatry. This is a branch of Medicine dealing with diagnosis, management, prevention and research in the area of mental disorders. A psychiatrist is authorized to treat patients using medicines and psychological treatments (in which he is trained / competent)
Clinical Psychologist has a basic degree / PG degree in Psychology plus supervised training and appropriate qualification in Clinical Psychology. S/he is authorized to treat patients using psychological methods in which he is trained / competent. Earlier most of the courses in psychology were in the arts/humanities stream. But now most centers offer courses leading to graduation is science.
A Psychiatric social worker has Degree / PG qualification in Social work. S/he is also trained to offer psychosocial treatments. They offer counseling for alcohol/drug abusers, couples / family therapy etc Also involved in educating families about how to handle a mentally ill member , counseling those in distress, crisis intervention etc.
Psychiatric nurse does the nursing care, administration of medication etc. A community psychiatric nurse offers her service in a community health care setting.
Counselors offer counseling services in their area of expertise For example marital, career guidance, HIV prevention. They are usually qualified in social work, psychology etc. (Note that I have omitted the word Clinical before the the preceding terms. This is because counselors may not have in depth training in clinical work)
Any person who is trained in a specific technique of Psychotherapy an has approval of the licensing authority can practice as a psychotherapist. Usually these persons are psychiatrist, psychologists 9clinical or otherwise0, social workers etc.
Occupational therapists are trained in administering rehabilitation services for the persons with chronic mental disorders.
Case managers undertake liaison work coordinating these various professionals with the patients and their families. They ensure that patient stays in regular treatment.

You can have the cake and eat it too......

By asserting that brain is the seat of all mental activities I do not imply that mind has only a pasive role. This is my position

1) Brain is a necessary condition for any sort of mental activity

2) For every mental activity there has to be corresponding physical activity in the brain; even though present day neuroscience is unable to uncover this link completely.

3) Though dependant on the brain, mind can function with some autonomy. We are able to bring about changes in our mental state with effort !. This can change the brain's function to that extent. For example during meditation one'e altered mental state induces changes in the brain and in the body. Similarly during hypnosis also one is able to change the mental state, and thereby the brain.

Conclusion from the above discussions:
a) The brain is a necessary condition for existence of mind.
b) States of the brain influences our mental actitivty (presence of illnesses, or alcohol, drugs etc)
c) States of mind can influence the brain to some extent.

This basic understanding assumes paramount importance when we try to understand mental health, mental illnesses, their causes, treatments etc.

Without a HEART !!!!

How did the idea that mind is located in the heart originate ? It probably started with the simple observation that our hearts quicken when we feel intense emotions - fear, anger, tension etc. From this it was very logical for earleir thinkers (Aristotle for example) to reason that emotions and consequently the mind is located in the HEART. When the heart of animals were examined they were found to be vibrant, pulsatile, full of life and red blood. This might have convinced every one. But the truth is that when we are emotional hormones like adrenaline (called epinephrine in the USA) are secreted by certain glands, and they act on the heart to make it beat faster and stronger. This is called the 'Fight or Flight respone'. This equips the organism to either fight the threatening enemy or run away for safety (flight).
The BRAIN is the seat of all mental faculties.

But where is the spirit ?

You may ask something like this after reading my last post. If everything is matter, where is the spirit ? Good question, but answer may take a little longer. I do not subscribe to the monistic view that everthing in the wirld can be reduced to a final single entity, whether it is MIND or MATTER, for that matter!!.
It is absurd to think that only mind or only matter exists. Matter has primacy over everything else as without MATTER there is NOTHING.
Mind is the functional output of BRAIN which is matter organized in a very complex manner. One can argue that the human brain is the most complex object on earth. It can think, feel emotions and even be aware of its (and similar others) existence !!!.
How is all this being done ? Well, the complex interrelationship between mind and brain is yet to be fully uncovered. We only have a few fragments of the whole picture. But these fragments are enough to convince us that mental fuctions can largely be reduced to fuctions and activities of, or within the brain.
Neuroscientists have been successful in their attempts to localize the areas of brain responsible for several aspects of mental functioning. Neuraal basis of the ability to understand speech/language and to respond, feel emotions, memories etc have been partly uncovered.

Does it matter ?

Universe is made up of matter. What is matter is for physicists to discuss. We know that our body is composed of matter. Body is made up of cells, which group together to form tissues. Collection of tissues with related functions form an organ (e.g. liver, brain etc). Organs with functional interrelations form an organ system (e.g. gastro intestinal system, cardiac and vascular - haert and blood vessls, nervous system etc).
A living organism is the totality of functions of all these. We breathe, eat, and do various activities with our body.
But where is the mind ? Has it got a specific location in the body ? Is it spread out all over the body ? Or is it within the heart ?
Well, it will take some time to go into this in detail. The current scientific evidence conclusively shows that the MIND is the totality of the brain's functions.
I can see at least a few hands going up after reading the last sentence. It is a bit difficult to believe this. But it is true. Look at the following
1) Children suffering from mental subnormality (mental retardation or learning disability- in the UK) have smaller brains. their brains weigh aroung 200 grams lesser than the normal.
2) A blow on the head can lead to immediate loss of consciousness, whereas if you are punched in the chest or abdomen, this does not happen.
3) Alcohol or other drugs with capacity to alter our MIND do so because they are able to reach the brain. If these drugs cannot act on the brain they lose this ability.
4) When we fall asleep, it is only our brains that are sleeping, Other organs like our heart, kidneys, liver, stomach etc continue to fuction, though they may slow down a bit. It is only the brain that needs this period of enforced rest. Brain cannot work without taking a break (like most of us), but our heart can beat from the time of birth to our last breath without stopping. When we sleep our active mind also disappears, this is because our brain is resting. But some parts of the brain works, though in a slightly different fashion.
In nutshell MIND IS MATTER, THE MIND IS AN OUTPUT OF MATTER.
More on this later.

Mind.....you.......

Well, mind you ! Sounds like a warning at the outset ? NO, never. I was just asking you to mind your and your friend's MIND.
We are sure that every conscious human being has a mind, whatever that means. We seldom bother to go beyond this level. When it comes to questions of this nature, we don't even venture to acknowlege that we have such thoughts.
Such questions can be difficult to answer, may be time consuming and mere mental gymnastics. But still at the back of our minds we know that these questions, or rather their answers, are vital to us, even if we may sideline them due to other more pressing preoccupations.
Some of us ponder over them at our leisure time. Many gloss over them. For some these are of utmost importance.