ONCE UPON A time, in Ancient Greece, doctors explained the human body with reference to the ‘four humours’. Every health complaint could be assessed as an excess or deficiency of one of four distinct bodily fluids: black bile, yellow bile, phlegm and blood.

In Roman times, the four humours evolved to correspond with four temperaments. For instance, if you had anger issues, you would be told you had too much yellow bile, the fire humour. Which means when you tell someone to ‘chill’ you are echoing official health advice from Ancient Rome.

If you were feeling depressed, or melancholic, that was down to an overload of black bile. In fact, the very word ‘melancholia’ stems via Latin from the ancient Greek words melas and kholé, which literally meant ‘black bile’.

This system seems ludicrously unscientific. But in one way, at least, it was advanced. Namely, it did not make a division between physical and mental health.

The philosopher René Descartes is largely to blame for this distinction. He believed minds and bodies were entirely separate. Back in the 1640s he suggested that the body works like an unthinking machine and that the mind, in contrast, is non-material.

People liked the idea. It was a hit. And it still impacts society.

But this split makes little sense.

Mental health is intricately related to the whole body. And the whole body is intricately related to mental health. You can’t draw a line between a body and a mind any more than you can draw a line between oceans.

They are entwined.

Physical exercise is known to have a positive impact on all kinds of mental things, from depression to ADHD. And physical illnesses have mental effects. We can hallucinate with flu. A cancer diagnosis can make us depressed. Asthma can cause us to panic. A heart attack can cause mental trauma. If you have a bad lower back – or tinnitus, or chest pain, or a lowered immune system, or a painful stomach – because of stress, is that a mental or a physical problem?

I feel we need to stop seeing mental and physical health as either/or and more as a both/and situation. There is no difference. We are mental. We are physical. We are not split up into unrelated sections. We are not an existential department store. We are everything at once.

Guts

BRAINS ARE PHYSICAL.

And besides, thoughts aren’t just the products of brains. As cognitive scientist Guy Claxton writes in Intelligence in the Flesh, ‘the body, the gut, the senses, the immune system, the lymphatic system, are so instantaneously and so complicatedly interacting with the brain that we can’t draw a line across the neck and say, “above the line it’s smart and below the line it’s menial”. We do not have bodies. We are bodies.’ Then there is the issue of the ‘little brain’ – a network of 100 million neurons (nerve cells) in our stomach and gut. Okay, so it is nowhere near the 85 billion neurons that our ‘first brain’ has, but it is not to be sniffed at. One hundred million neurons are the amount a cat has in her head.

When we get ‘butterflies’ in the stomach before a job interview, or when we get hungry before a late lunch, that is our ‘second brain’ talking to our first brain.

So, in other words, this suggests that the idea of ‘mental health’ being separate to our physical self is as outdated as Descartes’ dodgy wig.

And yet we still suffer from the divide. We separate the world of work into mind jobs and body jobs. ‘Skilled’ jobs, which need what we generally see as intelligence and a ‘good education’, and lower-valued ‘unskilled’ jobs which often tend to be manual labour. White collar and blue collar.

There is an intelligence to movement. An intelligence to dance. An intelligence to playing sport. And yet we casually section people off, from school age, deciding if someone is sporty or academic or – in Breakfast Club speak – a ‘jock’ or a ‘brain’. This then determines their career path, whether it will result in a lower-paid manual job or a higher-paid job staring at an Excel spreadsheet. And we divide culture into high and low. Books that make us laugh or give us heart palpitations are seen as less worthy than books that make you ‘think’.

The line we draw between minds and bodies makes no sense the more we stare at it, and yet we base our entire system of healthcare on that line. And not just healthcare. Our selves and societies, too. It’s time to change this. It’s time to rejoin the two parts. It’s time to accept our whole human self.

A side note on stigma

WE AREN’T ENCOURAGED to talk about our mental health until we are mentally ill, as if we have to fake being in 100 per cent full health. Stress simply isn’t taken seriously enough. Or it is taken so seriously that people are ashamed of talking about their bad mental health days. Either way, this leads to more people becoming not just stressed, but ill.

And when we become ill, and might talk about it, we encounter a new stigma.

Too often, we view mental illness as a product of the person in a way we don’t with other illnesses. Because mental illness is seen as intrinsically different, we talk of it in different, more scandalised terms. Think of the words used about mental illness.

Newspapers and magazines sometimes talk about celebrities ‘confessing’ to depression and anxiety and eating disorders and addictions, as if those things are crimes. And actual crimes are too often explained as the product of an illness – mass shootings and sexual abuse are often given the media context of ‘mental health problems’ or ‘addiction’ rather than terrorism and sex crimes. In reality, people with mental illness are far more likely to be victims of crimes.

We also don’t really know how to talk about suicide. When we do talk about it we tend to use that verb – commit – which carries connotations of taboo and criminality, an echo of the days when it was criminal. (I have recently been trying to say ‘death by suicide’ but it still feels a bit forced and false on my tongue.) Many people struggle to deal with the very idea of taking your own life, as it seems a kind of insult to us all, if you see suicide as a choice, because someone has chosen to give up on living, this sacred precious thing, as fragile as a bird’s egg. But personally I know that suicide isn’t such a clear-cut choice. It can be something you dread and fear but feel compelled towards because of the new pain of living. So, it’s uncomfortable, talking about it. But talk we must, because an atmosphere of shame and silence prevents people getting the right help and can make them feel more freakishly lonely. It can, in short, be fatal.

Suicide is the biggest killer of women and men between the ages of 20 and 34. It is also the biggest killer of men under the age of 50 (at least in the country where I live, the UK. Other European countries have similarly bleak statistics. In the US, where firearms contribute to the depressing statistics, suicide is the tenth leading cause of death overall, across all ages and genders, though as with Europe, Canada and Australia, men are over three times more likely to kill themselves than women). These deaths are so often preventable. This is why we must ignore the pleas to ‘man up’ and find true strength instead. The strength for men and women to speak out.

The echoes of historical shame are everywhere in our words. For another example, when we talk about someone ‘battling their demons’ we are conjuring up those Dark Age superstitious ideas of madness as the work of the devil.

And all this talk, over and over, of bravery: it would be nice one day if a public figure could talk about having depression without the media using words like ‘incredible courage’ and ‘coming out’. Sure, it is well intentioned. But you shouldn’t need to confess to having, say, anxiety. You should just be able to tell people. It’s an illness. Like asthma or measles or meningitis. It’s not a guilty secret. The shame people feel exacerbates symptoms. Yes, absolutely, people are often brave. But the bravery is in living with it, it shouldn’t be in talking about it. Every time someone tells me I am brave I feel like I should be scared.

Imagine if you were heading for a quiet walk in the forest and someone came up to you.

‘Where are you going?’ she asks.

‘I’m going to the forest,’ you tell her.

‘Wow,’ she gasps, stepping back.

‘Wow what?’

And then a tear forms in her eye. She places a hand on your shoulder. ‘You’re so brave.’

‘Am I?’

‘So incredibly brave. An inspiration, in fact.’

And you would gulp, and go pale, and be permanently put off going into the forest.

Additionally, there is still a lingering toxic idea that people share mental health issues for ‘attention’.

That attention people seek can save lives.