HealthyGamerGG - Boomers Don't Understand Mental Health

Episode Date: June 16, 2022

Today Dr. K talks about how different cultures deal with mental health, and how it interacts with religion as well Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

Some data that shows that generally speaking, depression is more common in North America and Europe, but there are caveats to that, which is that the interpretation of mental illness seems to be different in different cultures. Analysis of the difference in mental health levels between Western and more traditional cultures, role of religions slash the lack of greater life purpose. It's a great question. So, what's the relationship? between mental health problems in the West and in more, I don't know what traditional culture means, but let's assume East. And what is the influence of religion and the lack of like, what's the role of religion

in this stuff? So this is a really interesting question. What's the relationship between mental health and culture and mental health and religion? So there's a lot of evidence that shows that exporting Western culture leads to, an increase in body dysmorphic disorder in cultures that receive exported Western culture. So it looks like eating disorders especially seem to flow with like the exportation of Western culture. And at this point, eating disorders may have taken root in other places like Japan or South Korea or places like that. So then they've started to propagate as well on their own there.

There's some data of that, okay? there's also some data that shows that generally speaking, depression is more common in North America and Europe, but there are caveats to that, which is that the interpretation of mental illness seems to be different in different cultures. So if you go, if you take a standardized instrument for depression, let's say the Beck Depression inventory or the PHQ9, and I travel. to like Sudan, what I may discover is that the rate of depression in Sudan is far lower than the rate in the United States. But that's because the instrument that we use to detect depression was developed in a particular cultural context and doesn't really capture sort of the cultural manifestation of depression in different cultures. So the phenotype of depression, what depression looks like will be different depending on what culture you're in.

So, for example, like in Indian culture, feelings of depression are generally speaking like will manifest as like odd physical complaints. So people will complain about upset stomach. They'll complain about cognitive fogginess because in the east, the sort of the concept of a mental illness doesn't exist in the same way that it does in Western conception. So conceptions of psychology are different. So there does seem to be a cultural sort of like specificity there. But this is where if you do more advanced research, what you tend to find is that if we sort of say that depression looks different in different cultures, but then if you tunnel down further, okay, if it looks this way over here, and it looks this way over here, is the percentage of people who suffer from these two things basically comparable?

And the answer is like generally speaking, yes. So it looks like in the most nuanced and advanced research on things like mental illness, that they tend to be pretty consistent worldwide. Now, that's got a bunch of caveats that we've already gone over. So one is, for example, the exportation of culture and the correlation with mental illness. So that could be a factor there. That also begs the question if I have vague physical symptoms versus mental symptoms, and we're saying that both of those are about, let's say, 10% of the population, are those different illnesses, or are they the same illness? Is that depression manifesting this way in culture, manifesting physically in one culture and manifesting mentally in another culture, or is it like two

different illnesses? It's a good question. We have no blood test or no genetic test or no final test for depression, so we don't really know. We also know that, for example, the instruments are culturally sensitive. So if you move it to a different culture, if I take the back depression in Vintory and then I go administer it to people in like Russia, who knows how well it'll translate? their experience of depression may be different. So the short answer is we're not really sure, but chances are, my sort of conclusion, which is highly disputable, by the way, is that generally speaking, if we look at the neurochemical processes that lead to mental illness, they tend to be pretty conserved across humanity.

So we know that schizophrenia exists everywhere. But there's also other kinds of very interesting data, like the likelihood of developing schizophrenia is greater if you're an immigrant. So schizophrenia is greater in immigrant populations than it is in local native populations, which is just weird findings. There's a lot of stuff that we don't quite understand. But generally speaking, my take is that mental illness is pretty common throughout the whole world. It just looks differently in other places, but it has a root core problem. I mean, the core problem is the same, but it manifests in different ways.

So next thing is what about religion? So this is where I think for a long time, religion was used to a... address mental health. Right? So I'm not necessarily talking about mental illness, but if we look at the ways in which people made sense of the world. So if you look at research on psychotherapy, for example, there are different types of psychotherapy. But what we've discovered is that psychotherapy type A may not be better than psychotherapy type B or C. What leads to good treatment outcomes is not which kind of psychotherapy that you do, but the adeptness of your therapist in a particular type of psychotherapy. So if therapist, one, understands this kind of

psychotherapy really, really well, and therapist two understands this kind of psychotherapy really, really well, and therapist three understands this kind of psychotherapy just a little bit, A and B will be about equal and will outperform C. So it's comfort within a particular system that seems to correlate to the best treatment response. And I think we sort of see that in religion as well. So before we had psychotherapy, religion sort of handled this kind of stuff, right? So if you lost a loved one, who consoled you, who helped you get past it, who helped you with mourning, it was oftentimes a religious figure. So there isn't a therapist, so you don't go to a therapist, you'll go talk to a priest or someone who will help you make sense of things, just like we talked about earlier,

we'll help you, like, integrate and understand the loss, we'll help you cope, oh, they're in heaven, or they'll be reborn, or whatever, you know, whatever kinds of soothing things they'll say. And as long as there's an internally consistent system that the person who's consoling you is confident in and competent in, that leads to positive outcomes. Now, the other thing is that religion was also a very good, by good, I mean like it was comprehensive and seemed to meet people's needs in terms of finding purposes and direction. So religion would tell people what to believe and tell people, generally speaking, what to do. actually, I don't even know if I agree with that. That's more Judeo-Christian religions. That tend to be more commanding in nature, right?

So they'll say, like, here's the 10 commandments. Do these things and don't do these things. Whereas the karmic religions are even different in that way. The karmic religions say there's karma. You can do whatever you want to, but there's cause and effect, so your causes will have particular effects. And the value judgment actually comes from us. It doesn't come from the religion,

which is sort of a foreign concept. But there isn't like an intrinsic morality, which is also debatable. So there's a lot of new ones. ones and caveats here. So I do think that what's happened is that as we've seen the decline of religion, we've had to grapple with these questions more. Now, that doesn't necessarily mean that the decline of religion is bad for humanity. It just means that if we're not trusting religion to give us the answers, we've got to figure that stuff out on our own. But the jury's still out,

whether listening to religion or figuring it out on our own is better over time. Right. So religion, I think, made things simpler for us and sort of simply dealt with things like mental health and mental illness. But as we've learned about psychotherapy and stuff, it seems like we can sort of target particular problems and develop interventions more specifically for them as opposed to religion, which is like an amalgamation of all kinds of stuff. Right. There's morality baked in. There's some amount of like psychotherapeutic kind of interactions kind of baked in going to church churches have like support groups and social capital and like talking to the priest and like you know developing acceptance so for example we know that that just developing acceptance is uh is good for your mental

health like it leads to less suffering over time right that's that's what acceptance and commitment therapy is based on and religion offers easy avenues to accept and surrender to god and things like that. But it turns out that if you look at the science, it's not the God that seems to be important. It's the fact that you accept a God or surrender to a God that leads to the therapeutic value. Now, people who are very religious will dispute that and they will say, no, no, no, surrendering to a false God is bad for you. The God that you should surrender to is my God because my God is the real God. So that's, I'm not going to comment on that. If you believe that, that's totally fine. What I'm talking about is,

science. So we know that the concept of acceptance, which is something that religion is taught, acceptance and surrender and stuff like that, it's the will of God, right? That's sort of where acceptance kind of comes in. We can take that concept, we can remove it from religion and we can apply it, and it seems to have therapeutic benefit. The last thing that I'll sort of say is that there are some religions that really do consider mental health and mental illness very, very centrally. So this is where my personal bias may come in. But I think if you look at the karmic religions, there'll be, this is where I think religion really isn't even the right term, but it's sort of like a Western construct. But if you look at things like Patanjali's Yoga

Sutras, it talks about how the mind works. Right? So like, I'll give you guys an example. So let's grab just the top book on my shelf. So this is the Geranda Samita. Okay. So this is commentary on the yoga teachings of Maharishi Maharishi Geranda. So this is like, this is presumably a religious leader, right? But if you look at like what he actually says, I'm just going to like flip it open to a random page. So let's go to page 371. Okay. The process of controlling the mind through the medium of the senses is called Bratihara. In this chapter, the knowledge of Pratya Haraz imparted in brief by Sage Geranda to his disciple, King Janda Kapali. He begins with the description of patience by combining it with the senses.

His analysis is based on the understanding that patience is impeded by negative or positive feelings in the mind which arise due to the various experiences of the senses. In his opinion, if the mind is separated from those sensory feelings and experiences, their effects will automatically stop. in this way an internalized state of mind will be achieved. So that doesn't sound like a religious text, right? But if you look at a Western conception, this person would be viewed as a religious figure in the East. But I think that the yogic perspective and like this karmic tradition is like very, very into how the mind actually works.

The nature of suffering, the nature of happiness, the nature of thoughts and where they come from. And so religion sort of taught that, right? It was sort of viewed in the province of religion. But even if you look at like sort of the evidence-based effects of mindfulness, that is a religious practice, quote unquote, right? It's not really a religious practice because anyone can do it. It has nothing to do with belief. But if you look at like the origins of meditation, they were in the West what we would categorize as a part of a religious tradition. So Buddhism is like, we classified it as a religion. And Buddha was teaching people out to meditate and how to understand their minds. So I do think that this is what we're also seeing is that as we're understanding

kind of like the value of some of these quote-unquote religious traditions, we're removing the religious piece from them and we're teaching them separately. There's a certain loss there because I think that when we do that, we tend to discard anything that we don't like as opposed to, yeah, so like we'll discard things for like based on our own biases and political beliefs. Whereas I think we're losing a lot of therapeutic value there because we're like, yeah, that sounds kind of shady, right? So we'll believe sentences six, seven, eight, nine, and ten, but we'll just sort of say like, okay, 11 is ridiculous. So we're not going to do that. And then what's happening over time is the science on meditation is advancing, right? So remember,

like 50 years ago, if you said that meditation could be used as a treatment for mental illness, people would have called you a religious quack, right? They're like, oh, this guy's like, he's like a religious nut. That's crazy. There's no way that meditation can help with mental illness. Right? So that's what people used to say.

And now we'll say certain things about meditation, like, yeah, I can help with mental illness, but there'll be other things that will say, oh, that's absolutely ridiculous. So we've just moved the line, and we're moving it slowly as we sort of scientifically test things and stuff like that.

So I do think that religion has traditionally had a role in mental health and having people make sense of the world. Although a lot of people will connect the dots and will jump to, thus it is a tragedy that people are more agnostic or more atheistic today. I wouldn't quite jump there. Like, it's had a role and now our, you know, as religion sort of declines, or people generally speaking become less religious, I don't think that that's necessarily a loss. It just means that we have to figure out the answers for ourselves.