You are currently browsing the daily archive for March 4th, 2008.
People like simple explanations to clarify life’s matters. A caused B. This is appealing – it is thoughtless, ‘clean’, and easy to grasp. The desire for simplicity is more when there is a tragedy:
Why did this man shoot those people?
Why did the housing market crash so?
Why did the plane crash?
Why did I get (fill in whatever illness you have)?
We knew this could happen so why did nobody do anything about it?
The wish for simple explanations is even more coveted in Medicine.
Patients want to know why they have depression or anxiety or panic attacks; and why they have cancer or diabetes etc. On rare occasion the answer is simple – your lung cancer or emphysema is from the many years of smoking cigarettes. Alas, it is hardly ever that simple.
I remember a medical cartoon; there are numerous balloons in a graph all pointing towards each other in a chaos of web-links. They have such labels as ‘your parents’, “genetics”, “what you ate last night’, “childhood”, and “lack of exercise” – they all accumulate to a balloon labeled ‘Depression”. Somebody wrote on this balloon ‘YOU ARE HERE’.
When addressing the question “why am I depressed?” I frequently use the metaphor of “The Perfect Storm”. Genetics, your upbringing, you lifestyle(s), choices, life’s circumstances, bad habits, and sometimes bad luck all come together to create disease. Like a hurricane, enough ingredients were present to result in the storm called mental illness. Nearly always most of the contributing elements have to be addressed to calm the storm.
Harder to accept is the notion we may not be able to find all the ingredients that caused an illness, or the plane crash, or the public shooting.
A bad belief from Freudian psychology: the discovery of “the hidden cause” will alleviate of the condition. An ‘aha!” realization = symptom relief. I rarely see this happen. This cures ignorance, not illness.
Some times people accept there is no simple ‘cause’.
Often they still yearn for it.
