Every day we read that athletes, managers, workers, celebrities and even politicians are leaving their roles to ‘focus on their mental health’.

Simone Biles is the latest of many. She pulled out of the Olympic gymnastics events. Biles noted what she called ‘twisties’ – sudden losses of concentration that could be devastating for her mid-performance.

So, what’s it all about?

Our brains are complex organs. Our brain controls our physiology – our physical activities. But our brains also allow us to think and to direct action.

A physical malady of sufficient severity causes us debilitation. It precludes or impairs bodily function. Simple examples are muscle strain and heart disease. Muscle strain perhaps precludes running, allowing walking but with pain. Heart disease perhaps causes breathlessness and precludes walking any distance.

A psychological (thought-related) impairment can also cause debilitation. Anxiety is typically where someone worries about possible events. Often those events are not real or have low probability of occurrence but present themselves in our brains as real and immediate. Such worry can impair activity. Extreme anxiety can render sufferers incapable of any function. Depression, another mental ailment, is where someone can see nothing good. Everything is terrible and terrible things will inevitably occur daily, with no end in sight. Again, extreme depression can incapacitate sufferers.

And then there’s spill-over. Sufferers of physiological maladies often experience psychological effects, and vice versa. Worriers, for example, often experience physical malady. As an example of this, stress can cause kidney disease. And conversely, a cancer sufferer will very possibly be depressed.

So, Simone Biles seems to have been experiencing such spill-over. She’s under huge pressure to perform. Yes, she has trained for this, but the stress is there. Her set point will be high. She will ordinarily cope. But she saw a risk. She foresaw those ‘twisties’- spill-over from stress to physical error – occurring as a result of stressors.

One could argue that if her ‘head was in a better place’, she would have been able to better focus and mentally banish the ‘twisties’. But that’s likely over-simplifying her problem. She saw too big a risk to her safety and to her team’s medal chances. And so she did the right thing and withdrew.

So how do we sum up ‘mental health’?

Physical health is where the body can do what the brain wants. We can get up, walk, and run. We can work on tasks requiring high dexterity. And we can get out and work in our gardens.

Mental health is where the brain can keep up with the body and support the body in doing what’s needed. If we’re trying to run a marathon, the brain needs to be ready and able to support the body. The body might be able to get past the ‘wall’ at 20 miles, but if the brain wants the body to give up, we won’t finish.

Every physical activity needs mental support – even everyday activity like doing a day’s work needs brain power. One of the key mental concepts, for example, is motivation – what we use to decide what to do, how much effort to put in and in what direction. It’s what we use to decide when to stop doing one thing and start another. If the brain is cluttered and debilitated, motivation will be impaired and action will stop.

A person can have high mental health and low physiological health. Or they can have high physiological health and low mental or psychological health. When someone says they need to concentrate on their mental health, they are saying that their psychological health is down - below that which is needed to perform.

And how do we gain and sustain ‘mental health’?

Well, its simple. We need to train to ensure that our normal or set-point mental health is high enough. That starts in childhood and it’s well beyond this article to cover the huge subject of child and adolescent development. In adulthood our set-point needs to be sustained through challenge and success, but also by rest and recuperation. High-quality rest and recuperation strengthen. Sustained stress weakens.

Just as normal physical health can take a knock, so our set point or normal state of mental health can take a knock from time to time. And just as rest and recuperation is needed in physical health, so we need take time out to recover our psychological wellbeing. Both physical and mental health need management and sometimes we need physiological or psychological help from specialists.

Simone Biles describes the stress of this year’s competition amidst a worldwide pandemic. Perhaps she just didn’t manage her mental health well enough, or perhaps she simply suffered a mental health ‘accident’ just at the wrong time. Her body was willing, but her psychological wellbeing took a knock. Hopefully she’ll soon be back fully recovered on both counts.

Mental health is health of the brain and its thoughts. The brain needs looking after with food, exercise and rest, just like the body.