THERE can be few things more debilitating than going to bed, after a long and tiring day, and being unable to drift off. The harder you try to fall asleep, the more difficult it becomes 鈥� a vicious cycle of unwanted wakefulness that takes a significant toll on the lives of millions.
But it doesn鈥檛 have to be this way, because a new, more nuanced understanding of insomnia has made it a solvable problem, as we report in our cover story. Underlying this improved understanding is the recognition that there isn鈥檛 one type of insomnia but many 鈥� a departure from the standard 鈥渙ne-size-fits-all鈥� approach to the diagnosis and treatment of mental health problems, which is failing.
Advertisement
This recent progress on insomnia, built on identifying the different types and treating them accordingly, should be a flag-bearer for a new way to think about mental health problems more broadly.
Take depression. For decades, the go-to treatment strategy has been to prescribe drugs that boost levels of serotonin in the brain and yet, as a recent study found, low levels of this chemical messenger don鈥檛 appear to be the primary cause of the condition for most people. One person鈥檚 depression isn鈥檛 the same as another鈥檚. Instead, we should identify the different types of depression, and the different causes, before considering treatments.
This approach 鈥� sometimes called precision psychiatry 鈥� isn鈥檛 entirely new, and it is fair to say that progress has been slower than many would have hoped. Studies performed to-date indicate there may be . And in the UK at least, there is a shortage of specialist mental health practitioners.
But that isn鈥檛 to say we should give up on the idea. In other areas of medicine, such as cancer, personalised treatments are beginning to be made available, and some of those taking them have seen spectacular improvements in their health. With mental health problems continuing to rise across the world, even limited success would be transformative.
