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Rethinking Mental Health: A Community Approach

by Ashlynn Krieger

July 2023

Public health experts point out these North Dakota death numbers: Drinking and driving kills one North Dakotan about every 10 days; 80 North Dakotans die every year from a drug overdose; and in 2020, 135 North Dakotans died by suicide. Taking note of those numbers, North Dakota healthcare providers make a link: these deaths from alcohol misuse, drug misuse, and suicide are often related to the mental health of the state's residents. Making a difference in those numbers might just start with thinking about mental health as health in general, or specifically brain health.

The brain gets many of the problems other organs do, like infections, cancers, and blood flow conditions, like those that cause heart attacks and strokes. These conditions are also treated much the same way as they are treated in other organs. However, the brain tends to carry more mystery about it than other organs because some of its malfunctions can't be picked up by scans or blood work. Those malfunctions are often triggered by the chemical reactions within the brain.

Understanding brain chemistry might start with considering what happens if someone takes a candy mint that dissolves in the mouth and instead puts it in a soda pop can. When those two ingredients are mixed, an explosive chemical reaction happens spreading sweetness everywhere it's not wanted. Chemical reactions in the brain can act in the same way. Instead of candy and pop, the causes can be what some people might put in their mouths, like too much pain medication used past the time it's needed. Other troublesome brain chemistry is inherited from parents. Sometimes life circumstances can disrupt the brain's chemical balance. For example, a crop failure, being diagnosed with a serious health condition, or losing a parent, a spouse, and a child all in a short period of time can trigger deep sadness and excessive worry that makes life not so good.

When the brain is not functioning as well as it could, there are treatments depending on the cause. If there is an infection, antibiotics can be used. If there's a problem with brain chemistry, treatments that either work from the "inside out" or the "outside in" are available. An example of "outside in" is talk therapy and for "inside out", medications can help. Some people get better quicker with a combination of both. Like many other medical conditions, the earlier the diagnosis of a brain chemistry problem, the earlier treatment can be started and the quicker someone's brain health can get back to normal.

"Mental health" is a label providers use to talk about the chemical machinery in the brain that triggers emotions like sadness and excess worry. However, mental health conditions still often have "stigma" – stigma, referring to disgrace or that someone has a "weak character." Research shows over and over that stigma prevents people from getting treatment. Communities that think about mental health as part of overall brain health can help lessen stigma and make it more comfortable for their members to get brain treatment. With the right combination of support, communities can be at the forefront of confronting brain health for all those in need.

This article also appeared in the July 20, 2023 issue of the Wahpeton Daily News.

About the Author

Ashlynn Krieger is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. As a participant in patient care experiences offered in the Wahpeton area, she chose to participate in the Targeted Rural Health Education program, or TRHE. The program focuses on teaching student doctors the importance of rural newspapers as a way to share health information with rural community members. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.