Other approaches to mental and physical illness

S. Jayasinghe

Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka

EDITED BY MATTHEW HOTOPF

Kendell's (2001) editorial on the distinction between mental and physical illness was illuminating of the present predicament of modern psychiatry and medicine. However, he did not do justice to other systems of knowledge and medicine, loosely known as ‘complementary’ medicines, which are widely used around the world. For example, the Ayurvedic tradition (with its lineage to the early Vedic civilisation and systems of thought in India, around 1700 BC), as described in the classical texts of Susrutha and Caraka (200 BC—400 AD), avoid a strict body—mind dualism and instead emphasise their interaction in the causation of the human condition (in health and disease) (Ramachandra Rao, 1990). Clinical features of ‘insanity’, depression and epilepsy are described, with aetiological roles for both mental and physical processes and interactions. The Buddhist traditions (600 BC) take a similar position and state that ‘the mind and body are neither separate nor identical, not even alternatives, but inseparable... like two bundles of reeds supporting each other’ (Goonatilake, 1998).

These systems therefore preserve the unitary nature of body and mind, and approach problems in a more holistic manner, without Cartesian dualism. Meditation, ‘noble’ living and ‘good’ emotions are often included in their therapies. Interestingly, these ideas are being confirmed in certain fields of molecular biology and immunology. Contemporary research has shown the impact of emotions on the immune system and the effect of disease on the mind (Dantzer et al, 1999). The intermediary appears to be cytokines, which are able to modulate the functioning of several organ systems (Licinio & Wong, 1999). Similarly, meditation has led to the search for new psychologies to reduce stress and in the treatment of other disorders (Goonatilake, 1998). Delving into these systems of knowledge and moving away from dualism may reveal novel therapeutic modalities (e.g. meditation) and areas for further research.

REFERENCES

Dantzer, R., Wollman, E. & Vitkovic, L., et al (1999) Cytokines and depression: fortuitous or causative association? Molecular Psychiatry, 4, 328-332.[CrossRef][Medline]

Goonatilake, S. (1998) Toward a Global Science. New Delhi: Vistar Publications.

Kendell, R. E. (2001) The distinction between mental and physical illness. British Journal of Psychiatry, 178, 490-493.[Free Full Text]

Licinio, J. & Wong, M.-L. (1999) The role of inflammatory mediators in the biology of major depression: central nervous system cytokines modulate the biological substrate of depressive symptoms, regulate stress-responsive systems, and contribute to neurotoxicity and neuroprotection. Molecular Psychiatry, 4, 317-327.[CrossRef][Medline]

Ramachandra Rao, S. K. (1990) Mental Health in Ayurveda: Source Book of Charaka & Sushruta Samhita. National Institute of Mental Health and Neuro Sciences, Bangalore: Nimhans Publications.





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