It is normal to think about issues, but when does what we think, spill over into our emotions, and cause us to have health problems.
In 1947 the World Health Organisation defined health as “a state of complete physical, mental and social wellbeing.” Until now governments and healthcare practitioners have given precedence to promoting physical wellbeing, but a recent paper, ‘Our Healthier Nation’ concludes this may need to change.
The paper emphasises the importance of emotional wellbeing for health. Interestingly, the paper defines health as ‘being confident and positive and able to cope with the ups and downs of life.’ This definition is supported by more and more research suggesting that promoting just physical wellbeing may well be inadequate.
It is wholly inadequate. The concept of mental and social wellbeing is less well defined than that of physical wellbeing, but the link between our emotional health and wellbeing is emerging as an important part of illness.
Emotional distress can create susceptibility to physical illness. For example, it is well accepted that exam stress increases susceptibility to viral infection and stress from a lack of control in the workplace, or from life events creates susceptibility to heart disease.
Animal studies provide supporting evidence that emotional distress can lead to physical illness by affecting the immune response. Health related lifestyles, provide the basis for an alternative, potentially complementary link. For example, smoking, drinking, and the consumption of high fat foods are all valued by the public for their ability to relieve emotional distress and this behaviour is providing the link that physical disease may be the consequence of emotional distress.
Several studies have shown that social and emotional support can protect against premature mortality, prevent illness, and aid recovery. It is plausible that these could act by reducing emotional distress. Various studies also suggest that as important for health as our income is, our social links and organisation (civic participation, social trust) is of emotional benefit.
Solutions to public health problems like inequalities in health and unhealthy lifestyles may therefore contribute to a problem with emotional and physical health. A further body of research shows that unresolved emotional distress in childhood is an important cause of emotional distress in adulthood.
Two successful programmes to address this are parenting programmes and mental health promotion programmes in schools. The evidence shows that parenting programmes can both reverse emotional and behavioural problems and prevent their emergence.
Several school mental health promotion programmes have been subject to controlled trials which show a positive impact on emotional wellbeing through developing empathy and respect, leading to improved self-esteem in children and parents and increases in their ability to give and receive social and emotional support.
For this to continue into mainstream daily care, doctors’ and other healthcare professionals and including politicians will need to believe that emotional and social wellbeing are as important for health as physical wellbeing.