Full transcript of philanthropist and public health specialist Khaliya Aga Khan’s TEDx Talk: What if Most of What We Knew About Mental Health Was Wrong? at TEDxBeaconStreet conference. Khaliya Aga Khan is a philanthropist, venture capitalist, public health specialist and active advocate for social change.
Notable quote from the talk:
“What we need in this case, as in the case of more mental injuries, is to harness the power of neuroplasticity. Psychiatric medications, for the most part, shackle the brain and control the level of neurotransmitters but don’t necessarily create a change in behavior and don’t necessarily create a change in the person.”
Khaliya Aga Khan – Philanthropist & public health specialist
My name is Khaliya, and as they said, I am a Columbia University-trained public health specialist focusing on mental health.
What is mental health?
In a nutshell, mental health is the absence of mental illness, just as being healthy is the opposite of being sick.
But in physical health, there is not just sick and not sick. You can be injured. You can be healing. There aren’t really words like that in mental health.
So today, I would like to introduce a new term, and that term is “mental injury“. To explain what mental injury is, I would like you to think of a woman in your life, someone you love: a mother, a daughter, a child. Picture this person.
Next, think of somebody that you know is a veteran of war, maybe you don’t know them, maybe imagine your friend’s friend. Picture them in your mind.
Now picture this: One out of every three to five women will be the victim of violence or sexual assault in their lifetime. We are talking about more than one woman per minute.
And in the U.S. alone, one out of four veterans of war suffer from post-traumatic stress syndrome. And every new day 22 of them commit suicide.
Now I ask you: Are these people mentally ill? Were they before, or did they become so? And if they became so, is there a way that we can fix it? I think the answer to that question is “Yes.”
By calling mental distress “mental illness,” we imply that these people are broken, and it is partially because many of the tools that we are using simply didn’t work.
What if most of what we knew about mental health was wrong?
When I think of mental health, I think about three things that I think are going to change the face of public health: blindspots, neuroplasticity and psychedelic science.
Many years ago, I read a story that stuck with me. One particular story was a woman called Mrs S, who was in her 60s and suffered a massive stroke, which impacted the functioning of her right cerebral hemisphere. She could only see things that happen to be on her left field of vision. But Mrs S didn’t know.
She continued on happily, unaware that she was seeing really only 50% of the world. Her mind protected her from what she did not know by pretending to know. This is what I call blindspots.
And the truth is that we all, to varying degrees, have these blindspots. And science does too.
What if we are all stuck with working with 50% of the facts, and we’re told that that was the whole picture?
Well, statistically mental injury affects one in four people over the courses of their lives, and is projected to account for more than half of the global burden of disease. And these numbers are growing rapidly, particularly among youth.
Because mental injury is not just PTSD. It is also depression, anxiety. Most people when they think of mental health and the “tools” that the psychiatric industry has made available, think of SSRIs; they think of Prozac, Zoloft, Paxil, selective serotonin reuptake inhibitors that are often re-used in these instances.
But while these drugs all work on changing the levels of neurotransmitters, none of them impact neuroplasticity. And this is key.
Neuroplasticity is in the brain’s ability to reorganize itself to compensate for injury or loss. An easy example to yourself of neuroplasticity is to try to brush your teeth with your non-dominant hand for a week. In the beginning it will be hard, but then suddenly it will get easy because neurons that fire together, wire together.
Or the more you encourage axonal sprouting around an activity, the more your brain will create pathways that make that activity faster and easier.
Neural pathways are there as learned patterns to help us get through life more easily and also to help us with survival. For example, in PTSD neural pathways are also altered. Your survival mechanism is triggered and it goes into fight-or-flight, bypassing the prefrontal cortex and going straight into the primitive zone of the brain where the amygdala is. This is the limbic system.
And the problem with this is that it’s very hard to undo. It is, after all, the mechanism that was put in place to keep you alive and one of the ones that gets the most hard-wired the most quickly. Attempts through the years to address this have been largely unsuccessful: cognitive behavioral therapy, exposure therapy and SSRIs.
But these tools are woefully inadequate to their task. What we need in this case, as in the case of more mental injuries, is to harness the power of neuroplasticity. Psychiatric medications, for the most part, shackle the brain and control the level of neurotransmitters but don’t necessarily create a change in behavior and don’t necessarily create a change in the person.
Neuroplasticity changes that. Which takes me to my third point: psychedelic science. No, “psychedelic science” is not a misnomer. It is a real science with real tools.
And think about the idea that perhaps we’ve spent the last 50 years solving for only half of the equation, keeping the mentally ill alive, but not healing them.
So when I ask the question: What if most of what we understand about mental health is not true? I was also inferring: what if we are not admitting to what we don’t know? What if we have been forced to wear blinders? To not see the other half of the mental health equation?
Now, just to be clear, I am not promoting the use of psychedelics. I am, however, promoting the use of science. For example, if I told you that there was a drug currently in trials that in severely depressed treatment-resistant patients healed the patients in three to four sessions with a 72% success rate, you would say, “That’s crazy; that can’t possibly be true.” But it is true.
And this is just one of the psychedelic drugs that is currently in trials, and it is one of the many that show real promise, specifically in treating depression and PTSD but for a number of other things involving the element of neuroplasticity.
Major institutions such as Johns Hopkins, NYU and Imperial College London have persisted in the face of huge obstacles to progress this science. And groups such as the Multidisciplinary Association for Psychedelic Studies, The Berkeley Foundation and the Heffter Institute are, in my opinion, heroes for keeping the flame of this research alive.
Together, we can solve the mental health crisis. Together, we can push to bring this science back into the mainstream. Mental health is a human right and these people – the mentally injured – they deserve to heal too.