In the future, we will include mental vacation days

Loneliness and stress: many people are under pressure. The corona period, too, continues to affect people's mental health to this day, according to new research. In this column, I sketch a future in which we say goodbye to the attitude of “don't be silly and pull yourself together.” A future in which mental days off are a given.

Sometimes we are struck down by the flu. Other times we are just in a really bad mood. Sometimes it goes further and we suffer from mental complaints such as anxiety. Recently a friend came to me. She told me that she had been arguing with her partner all evening. Her head was filled with negative thoughts the next day. “I couldn't get anything done at the office. But I also thought it was pretty stupid to call in sick just because of a bad mental state,” she said.

“Just” because of a bad mental state. That got me thinking. A construction worker who breaks his leg. ‘Ouch, that's painful,’ one immediately thinks. ‘He won't be able to work for a while.’ But my friend also couldn't concentrate on her work. Maybe she can't do her job as well as that poor man with a broken leg.

I see it happening all too often around me. When it comes to mental illnesses such as depression, anxiety disorders or dissociative symptoms, there is a certain degree of skepticism. Because these conditions are not always immediately visible, they are sometimes underestimated or questioned. People with psychological problems are too often told that they “just need to pull themselves together”.

That could change in the future. With advanced neuroimaging techniques, such as functional MRI and advanced EEG scans, it is becoming increasingly possible to map the neurological and biological markers of mental illness. This makes it possible to clearly measure a person's inner state.

What if, in roughly 2100, our diagnostic techniques are so advanced that our inner state becomes visible in real time and with great accuracy? And depression is just as measurable as a broken bone on an X-ray.

The brain scan as a mirror for the mind

In the near future, the diagnosis of mental illness will no longer depend on interviews and questionnaires, but on ultra-advanced brain scans that map a person's inner world with pinpoint accuracy. With quantum MRI, neural spectroscopy and real-time connectome mapping, we can record exactly how neurons fire and which brain areas are out of balance. With the help of AI, a single scan can detect within seconds whether someone suffers from a depressive disorder, an anxiety syndrome or a complex dissociative disorder.

For example, it becomes clear that increased activity in the hypothalamus, together with overactivity in the amygdala, indicates anxiety symptoms. When the prefrontal cortex is underactive, this can be an indication of depression because this area is involved in regulating emotions and decisions. Mental complaints are measurable. They are as clear as day.

Personal care

With the ability to objectively detect psychological disorders at an early stage, the healthcare system can act much faster and in a more targeted manner. Instead of generic trial-and-error approaches to treatment, we will have personalized therapies. For example, an anxiety disorder will be given precisely the right dose of sertraline, which is often prescribed for anxiety disorders, that matches a person's specific brain activity and body composition.

No taboo

This technology also has a major impact on the rest of society. The taboo surrounding psychological complaints disappears completely. Employers and organizations can no longer trivialize what is now scientifically proven. It will become the norm to provide a brain scan in the case of long-term absence due to psychological complaints, just like a doctor's note.

Perhaps even more interesting is the introduction of 'mental days' in the Netherlands: times when employees can take leave three times a year because their brain is temporarily not functioning optimally. My girlfriend will be happy with that, especially after an evening full of arguing with her partner.

And to be honest, I too sometimes have days when absolutely nothing gets done. Days when I have been staring at a blank page for half an hour, even though I could have finished my article in that time. On days like that, a mental time-off day would be a relief!