It was the 4th century BC in that Greece of wise men and gods, when Athens was devastated by the plague. Today it is believed that the cause was a plague of bacteria that even killed Pericles himself. The damage was immense and possibly changed the course of the city’s history, as its weakening favored its subsequent Roman invasion. How important is, after all, health!
So valuable that, centuries after that plague, the oracle of Delphi elevated a discreet and forgotten lady to the category of goddess. It was Hygieia, the goddess of health. His father, Asclepius, god of medicine and healing according to Greek mythology and son of Apollo, was educated by Chiron, who instructed him in the clinical arts. As a result of his love with Epíone, who represents relief, five daughters were born, the eldest of them Hygía. The legacy of Asclepius in our medicine is such that the Hippocratic oath to which health workers are entrusted includes him and two of his daughters, Hygieia and Panacea. However, the development of scientific medicine has placed more emphasis on Panacea, goddess of healing, than on Hygieia, goddess of health. We have learned to heal more than to stay healthy. The remedy against hygiene. We have preferred to cure rather than prevent. But things are changing. For some years now, a new term has been circulating in biomedical research: salutogenesis. That is, studying the origin of health. Can we help people move towards better health? Dr. Antonovsky asked himself before coining the term. Three decades after their work, science has been able to put a new vision of medicine on track: that of lifestyle or preventive medicine.
Take as an example the pioneering Finnish project in Karelia. This region had an exaggerated rate of heart disease until authorities established a comprehensive lifestyle education program that reduced deaths from heart disease by 68%. The world is echoing the need to promote health. In 2005, countries such as Germany and France spent the equivalent of almost 30% of gross domestic product on public programs to promote well-being. It is the responsibility of the State, but also ours. Before assuming our duties it is necessary to understand the importance of our task. We are called to take care of ourselves, and the first interested parties are ourselves. It becomes necessary, or rather urgent, to include in the faculties of Medicine a new look at Hygieia, accompanied by Panacea of course, but not hidden behind it. The two fundamental pillars of medicine, surgery and pharmacy, do not always arrive on time in those diseases resulting from unhealthy lifestyles, which represent a significant and growing percentage of conditions.
Just as we have already eradicated some of the diseases that frightened our ancestors, and we remain tireless in trying to eradicate current ones, attempts to alleviate diseases that affect mental health are still timid. Anxiety, stress and a decrease in well-being and satisfaction affect the general population, from adolescents to adults, with its incidence in the child and adolescent population being especially worrying. Globally, 25% of the population will suffer from a mental disorder at least once in their lives. 70% will live a potentially traumatic experience. The number of people with depression has increased by 18.4% between 2005 and 2015. In Spain alone, 6.7% of the population suffers from anxiety and/or depression, with the prevalence being higher in women (9.2%) than in men (4%). Nearly 90% of patients with mental health problems receive informal support, that is, from family or friends, but not from professionals, which is a possible cause of relapses, inaccuracies in diagnosis and a lower probability of recovery. We have begun to act against mental illness, but prevention must be promoted. Scientific research is currently developing several programs to prevent mental and brain health disorders. There seems to be a strong consensus that the three pillars that support a mentally healthy lifestyle are diet, physical exercise and emotional regulation. The balance between the populations of microorganisms that inhabit the intestine, the microbiota, is essential for mood. Regular physical exercise, about two hours a week, acts as a powerful antidepressant. The knowledge and regulation of emotions moderates stress, a great physical and mental enemy. Raising awareness among the population of the importance of identifying one’s own and others’ mental illnesses and the need to resort to professional assistance, as well as educating about the responsibility of protecting health, is one of the great challenges for governments, educational centers and the media. It is about literacy in mental hygiene. As the Orphic hymn dedicated to Hygieia, goddess of health, sings, “without you everything is of no use to humans. Come queen, Hygieia, because if you are not here everything is unnecessary. The world longs for you, sovereign.”
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