Mental health is much more than just mental health.

By Neel Burton M.D.

On October 30, 1938, Orson Welles broadcast an episode of the radio drama Mercury Theatre on the Air. This episode, entitled The War of the Worlds and based on a novel by HG Wells, suggested to listeners that a Martian invasion was taking place. In the charged atmosphere of the days leading up to World War II, many people missed or ignored the opening credits and mistook the radio drama for a news broadcast. Panic ensued and people began to flee, with some even reporting flashes of light and a smell of poison gas. This panic, a form of mass hysteria, is one of the many forms that anxiety can take.

Mass hysteria can befall us at almost any time. In 1989, 150 children took part in a summer programme at a youth centre in Florida. Each day at noon, the children gathered in the dining hall to be served pre-packed lunches. One day, a girl complained that her sandwich did not taste right. She felt nauseated, went to the toilet, and returned saying that she had vomited. Almost immediately, other children began experiencing symptoms such as nausea, abdominal cramps, and tingling in the hands and feet. With that, the supervisor announced that the food may be poisoned and that the children should stop eating. Within 40 minutes, 63 children were sick and more than 25 had vomited.

The children were promptly dispatched to one of three hospitals, but every test performed on them was negative. Meal samples were analyzed but no bacteria or poisons could be found. Food processing and storage standards had been scrupulously maintained and no illness had been reported from any of the other 68 sites at which the pre-packed lunches had been served.

However, there had been in the group an atmosphere of tension, created by the release two days earlier of a newspaper article reporting on management and financial problems at the youth centre. The children had no doubt picked up on the staff’s anxiety, and this had made them particularly suggestible to the first girl’s complaints. Once the figure of authority had announced that the food may be poisoned, the situation simply spiralled out of control.

Mass hysteria is relatively uncommon, but it does provide an alarming insight into the human mind and the ease with which it might be influenced and even manipulated. It also points to our propensity to somatize, that is, to convert anxiety and distress into more concrete physical symptoms. Somatization, which can be thought of as an ego defence, is an unconscious process, and people who somatize are, almost by definition, unaware of the psychological origins of their physical symptoms.

As I discuss in The Meaning of Madness, psychological stressors can lead to physical symptoms not only by somatization, which is a psychic process, but also by physical processes involving the nervous, endocrine, and immune systems. For example, one study found that the first 24 hours of bereavement are associated with a staggering 21-fold increased risk of heart attack. Since Robert Ader’s early experiments in the 1970s, the field of psychoneuroimmunology has blossomed, uncovering a large body of evidence that has gradually led to the mainstream recognition of the adverse effects of psychological stressors on health, recovery, and ageing, and, inversely, of the protective effects of positive emotions such as happiness, belonging, and a sense of purpose or meaning.

Here, again, modern science has barely caught up with the wisdom of the Ancients, who were well aware of the close relationship between psychological and physical well-being. In Plato’s Charmides, Socrates tells the young Charmides, who has been suffering from headaches, about a charm for headaches that he learnt from one of the mystical physicians to the King of Thrace. However, this great physician cautioned that it is best to cure the soul before curing the body, since health and happiness ultimately depend on the state of the soul:

He said all things, both good and bad, in the body and in the whole man, originated in the soul and spread from there… One ought, then, to treat the soul first and foremost, if the head and the rest of the body were to be be well. He said the soul was treated with certain charms, my dear Charmides, and that these charms were beautiful words. As a result of such words self-control came into being in souls. When it came into being and was present in them, it was then easy to secure health both for the head and for the rest of the body.

Mental health is not just mental health. It is also physical health.

Originally published at Psychology Today