*This is an earlier draft of a published article under the same name in Mentor Magazine (Autumn 2023, edition titled 'Psyche'.) While the final version was edited by the Mentor Magazine team, this version was planned, drafted and written entirely by me.
Imagine that you’re at the beginning of a large hedge maze. It's difficult to reach the end at first, and will be difficult the next few times too. However, after a period of time and practice, you remember the route so vividly that it's easy to pass through. Equally, if you don't return to the maze for a while or simply walk out of the entrance, you begin to forget how to complete it - until one day it's just as hard as when you first took that journey. This analogy describes the concept of neuroplasticity, the ability for our body and brain's neural pathways (made up of nerve cells called neurons) to change! This is done by a process called synaptic pruning - in which pathways can strengthen or weaken or die depending on how much we use them. Our bodies contain millions of neural pathways for specific thoughts, behaviours, and actions.
For this reason, neuroplasticity is useful for a range of things, including learning motor skills like riding a bike, increasing navigational skills by playing video games - even for recovering from brain damage. At the root of it all, neuroplasticity facilitates our ability to learn. Learn, through repetition and practice: essentially, habit-forming.
This idea of habit-forming can be used as part of our mental health treatment, as a sort of preventative form of healthcare. Going forward, new ideas will be based around paediatric healthcare given that the brain is established to be more plastic at younger ages (though it has been proven to still be plastic when older, for example, through Bezzola et.al. 's golf study)(1).
Let’s use depression as an example. With one in six children aged 5 to 16 identified as having a probable mental health problem as of July 2021, there is no doubt that common mental disorders like depression (experienced by around 1 in 6 UK adults) are on the rise (2)(3). But how does depression occur? One explanation involves a physical, more biological view of psychology - regarding depression's onset as a result of physical processes of the brain. For example, some psychiatrists, like Albert, believe that depression is due to 'maladaptive neuroplasticity' (4). This means that, in line with previous explanations, the same thought processes that tend to characterise depression (for example, anhedonia - the inability to experience pleasure) have their neural pathways strengthened over time - attenuating other regions of the brain as a result. More specifically, Rădulescu cites that depression correlates with neuronal atrophy in parts of the brain controlling mood and emotion, such as the cortical and limbic regions (5).
Studies like Albert's have reviewed the effects of brain stimulation on the induction of corrective neuroplasticity - with Albert finding that brain stimulation techniques such as deep brain stimulation (DBS) increased areas of neuronal connections using neuroplastic mechanisms like axonal sprouting. Although Albert drew the conclusion that these methods may be used to enhance neuroplasticity to be used in recovery from major depressive disorders, it must be recognised that the psychiatric field is still unsure as to conclusive links between the concept of neuroplasticity and psychiatric disorders - as this is a developing field.
Another explanation is less concrete and more abstract - Beck’s model of depression (an explanation from the cognitive discipline of psychology)(6). This describes the experience as a disorder of thought.
His negative triad (next page) demonstrates that those with depression frequently respond to situations with negative views of the self, world, and future. These flawed responses/ interpretations of everyday stresses and events occur due to a concept called schema. Schema is a sort of mental framework; it holds our beliefs and expectations of new things according to lived experience, and it allows us to process new information and make sense of the world. Although they help us quite a lot in this sense, negative schemas as a result of negative experiences, Beck theorised, lead to the negative triad. Most pertinently, schemas are created as we
have new experiences - meaning that they are often rooted in childhood.
However, with the repetition of positive practices, we can equip children with a positive view of the self, world and future to counteract negative lived experiences - developing positive schemas as a result. The first example is for a negative view of the self: a slightly more complex approach can be used to introduce this idea, such as printing out the faces of all the children in a class and sticking them around the room on blank posters. Then, when the children enter, they can find a face, have one minute to write one good quality of the classmate on the poster, then move along one. Continuing to do this (including points where the schoolchildren must write a good quality about themselves) ensures each child has around 30 recognised good qualities on their poster. Domestic situations can vary, so allowing these posters to stay up in the classroom at school ensures that not only the posters are a permanent fixture in the children’s lives, but they recognise the classroom is a positive space away from home which maybe where negative schemas would develop otherwise. Going forward, compliments between classmates and encouraging strengths during lesson starters for example, would be one way to maintain this experience and develop this schema.
Next, negative views of the world and the future can often go hand in hand - especially as the influence of the media is on the rise, and has been found to correlate with negative behaviours in children (7). Ensuring children have a positive view of the world is difficult, and assuring them of their place in the future - even harder. However, this idea can be approached in a child-friendly manner with exposure to positive news and opportunities. As an example, during registration at the beginning of the day, a teacher could hand out child-friendly news articles (like First News) and ask the students to summarise the article in 100 words or less (8). This would allow exposure to real news of the world without withholding information about any of the contents, or depressing them with an onslaught of upsetting truths while their schemas are still being developed.
Ensuring positive views of the future could come from, perhaps, educating about ways that global issues can and are being tackled in addition to simply relaying the facts about the issue, leaving behind a sense of doom and gloom (like climate change). Ideally, active participation in combating the issue (such as educating about environmental pollution and then participating in a town clean-up) would allow them to feel like there are ways in which they can help, and more importantly, adults are helping, to ensure they have a stable and positive future to grow up in. Other ideas may revolve around exploring career paths together and giving the class time to research ways into the careers of their choice.
These are only a few ideas, for one mental illness only (albeit among the most common) - but there are so many more potential avenues of activities that could be explored. However, the key is that the same message is conveyed repetitively - through daily news articles, through weekly career exploration, through monthly self-love activities - regardless of the practice, it has to be maintained to work. This way, the class develops positive schemas towards the self, world, and future - so as they age and meet the stresses and challenges of adulthood, they are equipped with a positive outlook, thereby not triggering depression.
On the other hand, there are limitations that come with this approach. Biopsychologists such as Nestadt et.al. have found biological bases to many mental disorders - from a genetic basis of obsessive-compulsive disorder (OCD), to abnormal neurochemistry resulting in depression (9) (10). This cannot be single-handedly prevented with primary school activities that most probably will not counteract its onset.
In a world where there’s more access to the media from a much younger age than ever before, there are an increased amount of environmental stressors that can lead to the triggering of mental illnesses, like depression. This is why we need to focus on doing our best to form these healthy habits in children before they grow older and are met with these and more life challenges; this way, we may see a decline in rates of mental disorders in young people since they are better equipped to deal with modern society.
Bibliography
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2. Thandi S. Mental Health of Children and Young People in England 2021 - wave 2 follow up to the 2017 survey [Internet]. NHS; 2021 [cited 2023 Jul 15]. Available from:
https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-you ng-people-in-england/2021-follow-up-to-the-2017-survey
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