The following is adapted from an essay submitted to the World Psychiatry Forum Essay Prize

The boundary between mental and physical health separates a false dichotomy. Rather, physical and mental health exist on a continuum where the former represents gross aspects of health, and the latter represents subtle aspects.

When we are talking about the ‘mental’ side of the coin, what we are encapsulating are the subtler realms of experience such as thoughts, emotions, and self-perceptions. The ‘physical’ side includes our physical bodies and things we can objectively measure.

1. Origins of mind-body duality

The mind-body duality has long been a cornerstone of Western medicine. This duality matured from the initial premise most poignantly articulated by the French philosopher Renee Descartes (from whom the ‘cartesian plane’ is derived – the x and y axes we use often in mathematics).

Just like the orthogonal axes, Descartes created a distinction between body and soul, which philosophically, created a language to separate mind and matter. This substance dualism was the first time in Modern Philosophy where the physical reality and the mental/spiritual reality were signified as different entities.

This articulation of mind-matter duality created a distinction between aspects of reality that are rationally observable (matter) and therefore empirical and that which is not (mind). This distinction aided scientific empiricism to investigate the reducibility of the physical world while neatly relegating the spiritual (or what we may call now the mental) world to that of material mystery.

An alternative view articulated by Aristotle and Plato before Descartes (in their discussion of teleology), and one that is clear in Buddhist psychology, is that ‘mind’ and ‘body’ is part of a spectrum. This view embraces the mystery of our reality and does not relegate it as unobservable. In fact, subjective reality (the mind side of the coin) is in some ways the only observable reality from which empirical analysis may arise.

2. Interface of mental and physical health in cardiovascular disease

Collapsing the duality between mind and body has important implications in health. Take, for example, cardiovascular health. Interventions within cardiovascular medicine have excelled through a longitudinal understanding of the biomarkers that correlate with disease. The Framingham Heart Study is a cornerstone example. As a result, cardiovascular disease has largely been addressed as a physical ailment whether through life-style interventions or pharmaceutical intervention targeting lipid-profiles, insulin sensitivity and blood pressure.

The mental health underpinnings of cardiovascular disease, on the other hand, is equally as meaningful; albeit underemphasised in Western medicine. It is no accident that the symbol of the heart throughout cultures and languages, represents love, compassion, and connection. One may hypothesise that a disease of love, compassion and connection are the roots of cardiovascular disease.

While mental and emotional health may correlate with physical health, these two spheres need not be confined to a causal relationship. Indeed, they may exist on a spectrum as the boundary of physical and mental health is a thin veil that disappears when we consider an individual as both a physical being and a collection of experiences. In these terms, an interface is revealed that may empower the individual to develop a self-awareness of thoughts, emotions and personalities that are amenable to their well-being.

3. Mental health, chronic stress and the cardiovascular system

The modern health crisis of chronic stress is a potent link to cardiovascular disease. Chronic stress cannot be purely distilled into physical causes. Overwhelmingly it is the psychological factors rather than physiological that activate the stress response long enough to create disease.

Interventions for chronic stress such as psychological therapy, CBT, mindfulness-based exercises and even physical exercise, all require engaging the subtle aspects of experience including a close analysis of one’s relationships, meaning-making, emotional states and self-perception. While these aspects can be hard to measure, on the chronic scale of illness, it is these aspects that amplify and potently mediate disease.

Chronic stress is never purely a physical or mental health phenomenon. It depends what lens we choose to view the situation. Our modern relationship to our jobs, selves and others mean invovle complex interactions that can promulgate a chronic activation of our glucocorticoid (primarily cortisol) system.

We are entering an increasingly atomised age. Our reducible instinct that has motivated tremendous technological advancement has also led to a fundamental separation from the totality of our mind-body experience. Collapsing the duality of mind-body is a philosophical necessity to re-embody our mental/spiritual experience in the interest of health, and generally in the interest of being human.

Those habitually without desires

Perceive [the Way] as ‘subtlety.’

Those habitually with desires

Perceive it as ‘action.’

These two have the same source,

But different names.

Together they’re called ‘darkness’ –

Darkness of increasing darkness,

All mystery’s gateway.

Lao-tse, Tao Te Ching [translation obtained from The Te of Piglet by Benjamin Hoff]