Mental Health: A Biopsychosocial Approach

By: Josiah Igono, Ph.D., CSCS

Mental health has become a buzz word in modern-day vernacular. We are now seeing more vulnerability in this area than any point in history, particularly with athletes. Mental health exists on a continuum, and it must be treated as such. Although mental health may deal with things such as depression, anxiety, suicide, substance abuse disorders, eating disorders and psychosis, this will not be the emphasis of this article. Instead, the biopsychosocial model will be presented as a means of mitigating problematic areas that athletes may face and encourage the formation of new behaviors that may augment one’s mental health. This article will address what mental health is, why it is important and how to maintain a healthy mindset.

One of the common definitions of health is the state of being free from illness or injury. Furthermore, mental health is defined as a continuum ranging from having good mental health to having a mental disorder (National Council for Behavioral Health, 2015). In theory, an individual who is mentally healthy is someone whose mind is somewhat free from anything that would cause it harm or danger. It is important to understand these definitions on a granular level, because mental health is widely viewed as a negative construct. Viewing mental health as simply a negative construct is both an injustice and inhibits people from getting the help they may need (Robinson et al., 2019). Moreover, it prevents individuals from improving their current position regardless of where they are on the continuum. Barring mental disorder, there are many things that may affect one’s mental health. Among these include psychological stress, lack of sleep, hyper-interaction with information and social media, and environment.

For many athletes, prolonged bouts of psychological stress may affect overall mental health. There are various forms of stress (eustress, chronic stress, acute stress, distress, etc.). Whereas the appropriate application of stress causes growth, an overload of stress can cause damage, brokenness or worse. It is important for athletes to be able to think clearly, and to manage mood, emotions and feelings. Stress is closely related to psychological well-being (Xiang et al., 2019), and when compromised, can be a detriment to one’s mental health.

It is well known that the lack of sleep can compromise one’s physical well-being (Patrick et al., 2017). Sleep has been found to be a predictor of depression, with individuals who are sleep deprived being at more risk of depression than their counterparts (Myers & DeWall, 2015). The lack of sleep also compromises one’s psychological and cognitive functioning. Sleep deprivation also inhibits reaction times, and increases errors on visual attention tasks (Myers & DeWall, 2015) which is of high consequence to athletes. When an individual is not well rested, these preceding areas inhibit higher levels of performance. Ultimately, a chronic lack of sleep eventually compromises one’s mental health.

In our technologically advanced society, research indicates that we are dealing with information overload, and are spending an average of 20-30% of our computing and mobile time on social media, respectively (Nielsen, 2012; Scheinbaum, 2018). These numbers have the potential of becoming even more magnified for athletes, as they are entrenched in a proverbial glass bowl of performance and undergo constant scrutiny. With voluminous information being readily available, and potential interactions with thousands (sometimes millions) of followers which the athlete may never physically meet, having frameworks in place to manage information uptake and social media consumption is imperative.

A healthy environment is critical in the maintenance and growth of a healthy mindset. There are several factors that go into creating a healthy environment. An athlete’s support system, home life, nutrition, hydration, relationships, medication if necessary, spirituality and his or her ability to healthily recover from the rigors of professional and personal responsibilities are vital. Some models in literature, such as the biopsychosocial model, first developed by George Engel, suggest that when these disparate areas are addressed, it will yield an individual who is mentally healthy (Kusnanto et al., 2018). It is important for an athlete’s environment to edify, encourage and facilitate the rejuvenation of both body and mind.

For athletes who are experiencing stress, activities such as meditation, prayer, mindfulness, diaphragmatic breathing, yoga, reading, laughter and activities involving music may be beneficial for overall mental health. For athletes who struggle with sleep, forming a sleeping routine with the aid of professionals, which includes eliminating substances that affect sleep, and organizing/rearranging the sleeping environment may be beneficial. Well-rested athletes typically have more energy, sustained endurance, faster reaction times and improved performance (Myers & DeWall, 2015). Sie and colleagues (2013) suggest that when it comes to online networks, individuals should keep a balance between an appropriate amount of information sharing and interaction in their respective networks, along with a trustworthy and supportive following. Athletes who adhere to this advice may see improved balance in the handling of information and their social media interactions.

Mental health is a complex phenomenon, and a complex model such as the biopsychosocial model may be beneficial in addressing mental health issues that many athletes face. This model may add value in restoring balance for athletes, as it incorporates elements that positively influence one’s biology, psychology and environment. Are you achieving peak levels of mental health? Ask yourself the following:

• Are you typically free from long bouts of psychological stress consisting of both duration and intensity?
• Are you getting quality sleep on a regular basis?
• Do you have a healthy balance in mediating interactions involving social media and information consumption?
• Do you have an environment that healthily addresses your home life, nutrition, hydration, relationships, medication if necessary, spirituality and your ability to recover from the rigors of life?

If you answered “no” to one or more of these, please consider some of the solutions presented here. There is also an array of health professionals who can be of assistance regardless of where you are on the mental health continuum (i.e., doctors, performance coaches, nutritionists, social workers, counselors, psychiatrists, psychologists and other mental health professionals). Mental health is no longer a stigmatized subject with minimal answers. It is a multifaceted construct with multiple solutions.

References

1. Kusnanto, H., Agustian, D., & Hilmanto, D. (2018). Biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of Family Medicine & Primary Care, 7(3), 497–500. https:// doi-org.lopesalum.idm.oclc.org/10.4103/jfmpc.jfmpc_145_17.
2. Myers, D., DeWall, C. N. (2015). Psychology (11th ed.). New York, NY: Worth Publishers.
3. National Council for Behavioral Health. (2015). Mental Health First Aid USA. Washington, DC: National Council for Behavioral Health.
4. Nielsen (2012), State of the Media: The Social Media Report. Retrieved from: https://www.nielsen. com/us/en/insights/article/2012/social-media-report-2012-social-media-comes-of-age/
5. Patrick, Y., Lee, A., Raha, O., Pillai, K., Gupta, S., Sethi, S., … Moss, J. (2017). Effects of sleep deprivation on cognitive and physical performance in university students. Sleep & Biological Rhythms, 15(3), 217–225.
6. Robinson, P., Turk, D., Jilka, S., & Cella, M. (2019). Measuring attitudes towards mental health using social media: investigating stigma and trivialisation. Social Psychiatry & Psychiatric Epidemiology, 54(1), 51–58.
7. Scheinbaum, Angeline Close, editor. (2018). The Dark Side of Social Media. New York, NY: Routledge.
8. Sie, R. L. L., Pataraia, N., Boursinou, E., Rajagopal, K., Margaryan, A., Falconer, I., … Sloep, P. B. (2013). Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm. Journal of Educational Technology & Society, 16(3), 59–75.
9. Xiang, Z., Tan, S., Kang, Q., Zhang, B., & Zhu, L. (2019). Longitudinal Effects of Examination Stress on Psychological Well-Being and a Possible Mediating Role of Self-Esteem in Chinese High School Students. Journal of Happiness Studies, 20(1), 283–305.