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Viewing Mental Health Through the Lens of Complexity Science

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The Value of Systems and Complexity Sciences for Healthcare

Abstract

A non-linear perspective may be relevant to understanding mental disorders, particularly in primary care settings. There is growing evidence that variability in heart rate and mood over time, that non-linearity of a variety of parameters (from heart rate to mood), and that the degree of co-variability of anxiety and depression may be relevant to our understanding of what constitutes mental health and illness as well as their outcomes. In a small study (n = 15) of adult primary care patients with major depressive disorder, panic disorder, or neither disorder, patients recorded hourly levels of anxiety and depression while awake for 4 weeks. Analysis of data employed measures of non-linearity as well as state space grid analysis. Eleven subjects completing the mood diary had missing data rates of 0–2.4 %. Results showed that all three groups differed in their patterns of mood variability and anxiety–depression co-variability. These results suggest that healthy mood variability includes both linear and non-linear components, and that mental illness may represent a disturbance in either of these components or in the coupling between different moods. Such a proposed model is based upon the linear–non-linear relationships between symptoms of anxiety and depression, and how these dynamics change as illness severity increases. If true, then non-linear dynamics may have important clinical implications for classification of mental disorders (necessitating revision in diagnostic approaches and the classification of mental disorders), identification of novel treatments (small but well-timed, pulse interventions or multifaceted, whole patient approaches), and monitoring of dynamics (i.e., cardiac monitoring) and response. For this reason, a dynamical systems approach has been advocated for psychiatrists and psychologists alike, but such advice may be of particular importance to primary care physicians. However, these implications are based upon preliminary evidence that a non-linear, dynamical basis for classification and treatment of mental disorders is more parsimonious than the current linear, symptom level model. Further investigations are needed to assess whether a non-linear, dynamical framework may provide us with a new, yet rewarding, perspective for understanding the emergence and evolution of mental illness.

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Authors and Affiliations

  1. Family & Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, USA

    David A. Katerndahl

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  1. David A. Katerndahl
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Correspondence to David A. Katerndahl .

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  1. Department of General Practice, Newcastle University, Newcastle, New South Wales, Australia

    Joachim P. Sturmberg

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Katerndahl, D.A. (2016). Viewing Mental Health Through the Lens of Complexity Science. In: Sturmberg, J. (eds) The Value of Systems and Complexity Sciences for Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-319-26221-5_11

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  • DOI: https://doi.org/10.1007/978-3-319-26221-5_11

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