“It is no measure of health to be well adjusted to a profoundly sick society.”
Juddi Krishnamurti
Depression and anxiety and its link to various lost connections:
From my contextual study:
The 21st century has witnessed a significant rise in mental health issues worldwide.
According to the World Health Organisation (WHO, 2017) depression ranks as the
single largest contributor to global disability. They estimate that more than 75% of
people who suffer from mental disorders in low- and middle-income countries, do not
receive sufficient treatment. This is therefore a significant problem in my country,
South Africa, indicating that my work can potentially benefit a broader audience than
initially anticipated.
Depression and anxiety was mentioned in my contextual study in the previous unit because of my deep concern for the emotional suffering of people. A desire to alleviate suffering has caused me to go on a search for answers surrounding natural and holistic ways to help ourselves and others in order to navigate times that can lead to or are threatened by depression, anxiety or trauma.
Depression and anxiety have 3 causes: biological, psychological and social. It is an insult so assume that these 3 categories and all the complexities they represent can be boiled down to ‘a chemical imbalance’, a phrase we so comfortably tend to accept from the medical world (because they know better, don’t they?). Biological/genetic features, however very real and present, needs to be looked at together with societal factors as often our genetics predispositions won’t even kick in without the influence of society, culture and psychological aspects of perception.
A shift is needed. Away from the pathological view of disease towards a new paradigm that see’s the body as wise and in a state of emotional regulation. To honor the wisdom of the body while integrating the latest findings in neuroscience.
The World health organisation summarised the evidence in 2011, explaining:
Mental health is produced socially. The presence or absence of mental health is above all a social indicator and therefore requires social as well as individual solutions. “In countries around the world, a shift of emphasis is needed towards preventing common mental disorders such as anxiety and depression by action on the social determinants of health, as well as improving treatment of existing conditions. Action is needed as many of the causes and triggers of mental disorders lie in social, economic and political spheres – in the conditions of daily life.”
(Sourced: Allen, Jessica & Balfour, Reuben & Bell, Ruth & Marmot, Michael. (2014). Social Determinants of Mental Health. International Review of Psychiatry. 26. 10.3109/09540261.2014.928270. Accessed on 28/04/2024)
In an article I recently read, that which I have suspected for so long, was confirmed in an official statement. I knew that this was part of what my practice and research stand for in terms of de-stigmatization. On world health day in 2017, Dainius Pūras, a medical doctor and representative for the Office of the United Nations High Commissioner for Human Rights (OHCHR), issued a statement critiquing biomedical conceptions of depression and calling for psychosocial and political interventions.
“Evidence and the experience of rights-holders now tells us that the dominant biomedical narrative of depression as a ‘burden’ on individuals and societies is shortsighted and insufficient for developing appropriate responses in policy and in practice. This is a widespread and systemic public health and human rights issue which demands urgent reconsideration of how we invest in mental health and how we manage conditions such as depression,” he writes.
“Regrettably, recent decades have been marked with excessive medicalization of mental health and the overuse of biomedical interventions, including in the treatment of depression and suicide prevention. The biased and selective use of research outcomes has negatively influenced mental health policies and services. Important stakeholders, including the general public, rights holders using mental health services, policymakers, medical students, and medical doctors have been misinformed. The use of psychotropic medications as the first line treatment for depression and other conditions is, quite simply, unsupported by the evidence. The excessive use of medications and other biomedical interventions, based on a reductive neurobiological paradigm causes more harm than good, undermines the right to health, and must be abandoned.”
Source below (accessed on 27/04/2024):
Impact on my practice and 5 areas for re-connection:
This has a significant impact on my practice. My practice aims to investigate how we have become disconnected from various life sustaining facets of life and how this has in turn affected our mental, physical and spiritual health. Through my art and research, I aim to reduce the ongoing stigma (from self and others) regarding mental health issues. It is our brain, but rather pain that is the problem due to the connections we have lost. These refer to: connection to the natural world, other people, our core values, meaningful creativity and a spiritual awakening. In the light of this, two important things stand out that give a very different perspective and potentially can contribute to a new definition of mental health. When we loose something, we suffer grief. In a story shared by Johann Hari in his book, Lost connections, he tells a story of a woman called Jo-ann who lost her daughter to death. He explains that she found that depression and anxiety and the emotion grief (which is necessary) have identical symptoms for a reason. Is depression perhaps a form of grief? ‘Grief for all the connections we need but don’t have?’ He explains that it is an insult to drug someone who grieves the loss of a loved. Grief is necessary and a normal response. “Just like its an insult to Jo-ann to say that her ongoing grief for her daughter is a mental disfunction, it was an insult to my depressed teenage self to say that his pain is the result of bad brain chemistry. An insult to what he has been through and needed.” Looking at depression and anxiety as pain caused by the connections we’ve lost and needed. A type of grief and symptoms rather than a faulty, weak person, changes everything and encourages the very self-compassion needed for recovery and change.
(Quotes sourced: Harri, J 2018. Lost connections. Audible studios.)
During this MA, so far I have looked at re-connecting with nature, through an intimate material investigation and working in nature and with nature as a theme, I have re-connected with other people, by using people as a theme in figurative work as well as constructing workshop frameworks for future community-work using sensori-motor art processes in a natural setting. I have touched on re-connecting with meaningful creative work by my art-making itself and re-connecting with core values is represented by my concern for the earth’s soil health and my art will hopefully bring awareness to this concern as it re-animates soil and speaks of it’s value both as a life source and as a psychological support (in horticultural and art making therapies). The last connection I would like to emphasise, is the need to re-connect to our spiritual awakened state. A difficult theme to theorise and quantify but in my research I have found valuable Neoroscientific studies that prove its significant health values. I will also turn to Phenomenology used in philosophy and look through its lens to aid the field of psychiatry and shed light on the importance of connecting to a spiritual source in aid of our wellbeing.
Neuroscience and spirituality:
“A thickening of parts of the brain cortex associated with regular meditation or other spiritual or religious practice could be the reason those activities guard against depression – particularly in people who are predisposed to the disease, according to new research. Researchers studied 130 subjects and found that those who highly valued spirituality showed thicker portions of brain cortices that may protect against depression — especially in those at high risk for the disease”
This is an extract from a study done by Lisa Miller. An interview I recently looked at was particularly insightful and useful for my research. Thinning of the cortex is associated with lifelong depression. In this study, a thickening of the cortex resulted from spiritual practice. A remarkable and potentially barrier against the onslaught of depression in those predisposition to it.
(Sourced: Miller L, Bansal R, Wickramaratne P, et al. Neuroanatomical Correlates of Religiosity and Spirituality: A Study in Adults at High and low familial risk for Depression. JAMA Psychiatry. 2014;71(2):128-135.doi:10.1001/jamapsychiatry.2013.3067 (accessed: 25/04/2024)
Interview:
An interview I listened to between Lisa Miller and Rich Roll helped push me into a conclusion that I felt was another important (and perhaps conclusive) part of the holistic approach to wellbeing that my practice has been researching.
From this interview (source can be found below):
When it comes to despair and suffering, right now the number one killer of young adults in the US is suicide. According to Miller (a professor and researcher in clinical psychology and writer of the Awakened brain) in an interview on The Rich Roll podcast in 2022, there is a meta analysis that was conducted by Wuhan University colleagues over 2000 tragically completed suicides and 5000 matched controls match for demographic diagnosis. There was a 62% decrease in relative risk of completed suicide when there’s a strong personal spirituality and that goes up to 82%. And four-firths less likely to complete suicide when spiritual life is shared for the young adult and adolescent.
According to a Miller we can use Mindfulness to become present but she continues to explain: “what then is potentiated is that we are at a threshold to cross from being present into a state of awakened awareness. The bonding network is engaged and we feel that ‘life itself’ is holding us (front temporal network). The Parietal lobe puts in and out hard boundaries that we can toggle between a sense of difference and common felt love. A reduced activity in the Parietal lobe allows an influx of this sense of commonality among all (connected). We move from a narrow top down dorsal attention network to situational awareness and see in perspective.
We have in our western culture overemphasized the head telling our heart what to do, a form of disaggregation of our true being. And this is why our young people are suffering so much right now – we have deauthorised the knowing of the heart.
At around the age of 15-18 (middle to late adolescence) we start to ask profound existential questions. With biological puberty this time is also marked by augmented spiritual awareness (with or without religion). They long for connections and meaning. If they are left, they will find transcendence through addictions (but really is a spiritual seeker). With puberty comes spiritual hunger and adults need to be available to guide them. A hunger for the deep questions of life and a depression in not knowing the answer.
(Source: https://youtu.be/BuBDmIRThtk?si=C9ICLlIUvuUX6F_x OR: https://www.armyresilience.army.mil/ard/videos/Transcript-ARDWebinarSep21.pdf opened on 17 April)
Phenomenology:
According to the Stanford encyclopedia of Philosophy, Phenomenology is the study of structures of consciousness as experienced from the first person point of view. The central structure of an experience is its intentionality , its being directed towards something, as it is an experience of or about some object. An experience is directed towards an object by virtue of its content or meaning (representing the object) together with appropriate enabling conditions. The study of things as they appear in our experience. , thus meanings things have in our experience. It studies this experience as experienced from the subjective or first person point of view.
(Sourced from: https://plato.stanford.edu/entries/phenomenology/ Accessed 27/04/2024)
Through my practice, I am interested in how phenomenology related to psychiatry and psychology and how it can potentially aid in diagnosis. As my practice advocated for de-stigmatization of mental health related issues, I find it valuable to discover research and articles stating that a change is needed in Psychiatry due to over-medicalization in the field of psychiatry.
How does this impact my art practice? Firstly, my art is made from a first person experience of my mental health state and my interaction and re-connection with nature, others, my values my creativity and spiritual connection. This is a visual representation/ visually communicated phenomenology. Secondly, I advocate for re-connection to various aspects of life as an holistic alternative to over-medicalization or as an aid to recovery from stress or mental health challenges. In terms of this, the bias of my practice resonates with the need to bring phenomenology into psychiatric diagnosis and alternative participatory interventions to re-connect. I consider a person centered, subjective experience that link with this research that seek to bring in phenomenology into psychiatric diagnosis. My practice aims to bring alternative answers and value the subjective experience of each individual. Empowering them to participate in their own healing and offering an alternative definition to their depression and anxiety which states that their pain is valid, has merit and is a necessary guide and teacher towards wellbeing. This will foster better self-compassion. A vital quality that often lack in those with mental health issues. A quality that is further suppressed by the medical approach towards depression and anxiety. Having a ‘chemical imbalance’ as prognosis, makes you faulty, in need of medication to “fix’ you. This will partially benefit the patient but ultimately benefit the pharmaceutical companies and perhaps even doctors. There is a need for medication in certain and many scenarios, but it is the over medicalization and stigmatization of self that I am concerned about.
The following extract from a journal article by ANNA DROŻDŻOWICZ (PhD University of Oslo, Oslo, Norway), discusses the action needed and explains how phenomenology (as I feel is visually represented in my art) has a role to play:
“Recent editions of diagnostic manuals in psychiatry have focused on providing quick and efficient operationalized criteria. Notwithstanding the genuine value of these classifications, many psychiatrists have ar- gued that the operationalization approach does not sufficiently accom- modate the rich and complex domain of patients’ experiences that is crucial for clinical reasoning in psychiatry. How can we increase the role of phenomenology in the process of diagnostic reasoning in psych- iatry? I argue that this could be done by adopting a clinical staging approach in diagnostic reasoning in psychiatry. The approach has the resources to include the progressive nature of patients’ experiences to a much greater degree than is currently practiced. It can address the recent plea for increasing the role of phenomenology in psychiatric diagnosis by offering a model for clinical reasoning that goes beyond the operationalized, static criteria of diagnostic manuals, without depriving us of their benefits.”
(Sourced: The Journal of Medicine and Philosophy, 45: 683–702, 2020 doi:10.1093/jmp/jhaa022
Advance Access publicaton on October 23, 2020
Downloaded from https://academic.oup.com/jmp/article/45/6/683/5936225 by guest on 29 April 2024)