By – Dr. Ashutosh Pradhan

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               In the earlier article Health – Basic Concepts (Click Here to read it first if you have read it) we have dealt with the definition of health and its meaning as elaborated in various dictionaries. In this article we will elaborate in depth about what is health, what parameters tell us that we are in good health. These parameters in medical terminology are labelled as Determinants of Health.

Physical Well-Being

What are the parameters of physical well-being? We breathe in and out 12 to 18 times every minute. However, are you aware? Till I tell you the rate at which you are breathing per minute, do you know it? No! You can be aware of your breathing only when you are consciously focusing on your breathing. The same logic applies to each and every part / cell, organ within our body. Till the time you are not conscious / you are not aware of the part or process within our body in normal living you are enjoying health. Unless otherwise you deliberately become aware of these organs, functions such as in case of Yoga, when you deliberately focus your attention on breathing. Some parts and processes are even beyond our awareness. For example: movements of vocal cords. You are not aware how the movements are. The only time you are aware of your voice is when one loose one’s voice in acute laryngitis, yet the way vocal chords move, we are not aware of it. All the parts, cells, processes of the body are harmoniously functioning at it’s own normal pace with ease. When we loose the ease of action of a bodily part at which the part or the process is functioning we become aware of the part and process and then we are diseased. We are dis-eased! We are not at ease. We are diagnosed as diseased (dis-eased). The disease process makes you aware of the ailing part or of the ailing process. For example, when we suffer from common cold, breathing in air is difficult due to nasal obstruction and we experience nasal blockage. It is a well experienced fact that we are aware of our bodily parts and processes only when we are sick. Then how can one differentiate and become aware of healthy functions to label oneself as being in a complete state of physical health? Let’s consider the parameters that tell us whether the part or the functioning is normal or abnormal.

Park’s Textbook of Preventive and Social Medicine¹ describes physical health as having “a good complexion, a clean skin, bright eyes, lustrous hair with a body well clothed with firm flesh, not too fat, sweet breath, a good appetite, sound sleep, regular activity of bowels and bladder and smooth, easy, coordinated bodily movements. All organs of the body are of unexceptional size and function normally; all special senses are intact; the resting pulse rate, blood pressure and exercise tolerance are all within the range of normality for the individual’s age and sex.”

Complexion, clean skin, bright eyes, lustrous hair, and firm flesh reflect good nutrition. If the person is eating appropriate quantities and taking a balanced diet, there are no deficiencies seen. A state without any deficiencies reflects these signs good complexion, clean skin, bright eyes, lustrous hair, etc. Sweet breath reflects good oral health. Good appetite rules out many diseases. In diseases such as hepatitis, tuberculosis one tends to loose appetite. However, these are pathological states. A person suffering from indigestion or worm infestation may have poor appetite and bad breath. Seven to nine hours of sound sleep in adults indicate sound mind. Seven to nine hours of sleep rejuvenate cells which have been working round the clock for maintaining the bodily functions. (Do refer my earlier article on Optimum Sleep) Regular activity of bowels means passage of stools on regular intervals with sense of satisfaction. Regular bladder movements indicate absence of diseases such as diabetes or in case of males, diseases related to prostate. In females, diseases related to uterine or bladder prolapse. Coordinated body movements indicate normal functioning of brain in medical terminology normal function of central as well as peripheral nervous system. The other important parameters which need to be normal are: Temperature, Pulse, Respiratory Rate, Blood Pressure. Abnormal temperature, pulse, respiratory rate and blood pressure values are seen in many grievous diseases. Normal temperature, resting pulse, respiratory rate, blood pressure within normal range pertaining to age and sex are signs of physical well-being.

Mental Well-Being

If one thinks retrospectively there is definite difference between lower animals and higher animals. Lower animals the only goal of living is survival. They simply need to eat, drink, reproduce and survive. As against that human beings are higher animals and need to have a definite higher purpose of living. One of the important aspect of differentiation amongst lower animals is that we can smile / laugh. Human beings can think beyond survival. A mentally healthy person will search for objectives of higher purposes of living and will align it to the goals of living. 

Park’s Textbook of Preventive and Social Medicine¹ states mental well-being as “a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between realities of the self and that of other people of the environment.” 

Park’s Textbook¹ further describes that a mentally healthy person is:

1. Free from Internal Conflicts and is not at “war” with himself or herself
2. Is well adjusted means he / she can get well along with others and can accept criticism and is not easily upset
3. Searches for identity
4. Has strong sense of self esteem
5. Knows himself / herself – his needs, problems, and goals (self-actualization)
6. Has good self-control-balances rationality and emotionality
7. Faces problems and tries to solve them intelligently, and can cope with anxiety and stress successfully

Free from Internal Conflicts and is not at “War” with self

Dilemma about making decisions is a stressor commonly experienced by individuals and it act as an indecisive force compelling one to change his / her decisions often and stay away from productive execution of ideas. The self-conflict can be between the conscience whether whatever steps am taking are right or wrong. Self-conflict can arise out of disproportionate perception of reality that whatever I do I will be criticized by the people around and in order to “avoid” the criticism no steps are taken. This state is also indication of low self-confidence.

Well-adjusted and can accept criticism

Ability to receive criticism positively indicates balanced state of mind. The moment one overcomes the sensitivity of receiving criticism he / she can get well along with everyone around. Till the time there is intense sensitivity towards criticism often it is seen such individuals isolates themselves from others for a distorted perception of “I am targeted and am an object of laughter”.

Searches for Identity

Your sense of identity has to do with who you think you are and how you perceive yourself. It’s about how you define yourself. Both affect your mental health, your behavior and how you relate to other people.

It’s important to understand how we develop sense of identity because low or a poor sense of self can contribute to so many problems in our lives. It’s also important to understand what steps we can take if we need help in these areas.

People who don’t have a strong sense of their own identity may be easily influenced by others. They may have trouble in making decisions and may get involved in unhealthy relationships.

The parents must shape identity of their kids. One needs to support them while they try and wipe off negative self-talk. Often peers inculcate a negative thought in the child which kills self-identity. One need to be observant and replace precisely the negative thought with positive one in order to formulate a positive identity. If the child fails to understand his / her own value, one needs to subtly help the child to identify their own values with which they will grow positively in their identity. Such a treatment in Clinical Psychology is referred to as positive re-enforcement.

Case

We had a male child coming to us whose elder sister was a great performer and he use to get subdued in light of her performance. During his upbringing his parents could not focus much on the second child due to their professional commitments. Due to which the male child was poor performer in the school and the peers inculcated a negative identity in his mind that he is not so intelligent as compared to his sister. The fact of the child developing negative identity was brought to notice by us to his parents who subtly as per our instructions “wiped” away the negative self-talk and inculcated confidence with a thought that you are equally intelligent, however, your efforts are falling short. The moment you will increase the efforts you will achieve similar or more than what your sister achieved. The Positive Re-enforcement ‘therapy’ helped the male child to come over negative self-talk and he could build a positive identity and over a period of time his performance at school excelled equivalent to or more than his elder sibling’s performance.     

Strong Sense of Self Esteem

Self-esteem is how you value yourself. It has to do with your sense of self-worth. It’s important to understand how we develop self-esteem because low self-esteem can contribute to so many problems in our lives.

People that have poor self-esteem may be susceptible to a number of psychological problems like depression, anxiety and eating disorders. They may be more likely to become addicted to stimulants such as alcohol or other drugs. Low self-esteem is not the only cause of these problems, but it is often a contributing factor. Children and adolescents with poor self-esteem are more likely than other children to have behavior problems and have trouble getting along with authoritative figures.

The World Health Organization² defines mental well-being as, “Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

The WHO’s narration about mental well-being matches with the definitions or aspects of mental well-being considered till now based on Park’s Textbook of Preventive and Social Medicine.

Disease or Infirmity

We have seen earlier what dis-ease is. Whenever we are sick, we loose the sense of well-being and develop a feeling that something is not well or one does not experience fresh and energetic sense of being. Such a sense is many-a-times accompanied with body ache. In medical terminology we call it as malaise. Malaise as per dictionary is a noun and it means a general feeling of discomfort, illness, or unease whose exact cause is difficult to identify. That clearly indicates the first symptom experienced by us is on mental / emotional level. If it is not treated or if it is not feasible to take rest when we experience the sick sense the disease progresses further to evolve. In reality, an individual experiences stress in day-to-day living which lowers the immunity and consequently lowered immunity level attracts diseases.

Whenever one suffers from a sudden onset of disease which lasts for a shorter period of time it is labeled as an acute disease. Whenever a disease has slow onset and lasts for longer period of time it is labeled as chronic disease. Flue, diarrhea, pneumonia are few examples of acute diseases. On the other hand, diabetes, hypertension, thyroid disorders, asthma, PCOD / PCOS are examples of chronic disease.

Whenever an individual is suffering from a chronic disease few of the signs reflected on the physical level affect the bowel, bladder movement, disturbs sleep. If the early signs of physical disturbances along with disturbances on the mental level are not identified and addressed to, then the disease evolves further to the next level.

Research has proved time and again that there is a clear relation between stress and health. Thus, till we do not effectively manage stress achieving the health goal is too far away to be achieved to.

If at all you have any questions, feel free to get in touch with me.

References:

1. Park. Park’s Textbook of Preventive and Social Medicine. 23^rd Edition. January 2015. P 14 – 15.
2. World Health Organization. Fact Files accessed at: http://www.who.int/features/factfiles/mental_health/en/ on September 11, 2016.
3. Ashutosh Pradhan’s Clinical Experience since January 1993

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© April 2020, Dr. Ashutosh Pradhan – Consulting Homoeopath – Wellbiance Quality of Living Clinic