So many times we say it. Even more often, we think it. But like the old adage, “Just because i’m paranoid doesn’t mean they aren’t out to get me, ” just because something is all in your head doesn’t mean it isn’t real.
When we say, “It’s all in your head, ” what we really mean is that is where the problem begins. Medicine has proven that brain disorders can cause true health problems. Frustration can cause ulcers. Anger can cause strokes. Fear and anxiety can cause tachycardia. Depression can cause insomnia and anorexia. And pretty much everything can cause digestive problems. And the reverse is true as well. Vitamin D deficiency and lack of exercise can cause depression. Insomnia can cause memory loss. Hypoglycemia can cause attention deficit. Hormonal imbalance can cause psychosis. Body and brain are inexorably linked. So why do we consider brain causes to be inferior to body causes? If your heart races from fear instead of an intrinsic dysrhythmia, is it any less of a problem? After all, 180 beats per minute is 180 beats per minute. If you have irritable bowel from anxiety instead of irritable bowel from low serum ferritin, is your poo any less stinky? After all, shit is still shit.
The only real issue i see is in the treatment. If your high blood pressure is caused by genetics, and we treat it with anti-hypertensives, then you stand a chance of getting a good result. You can’t change your DNA (at least not yet), so you change the conditions it operates under: Specifically, you change the chemical cascade. But if your hypertension is due to the fact that you are forced to live in the basement of your chain-smoking, verbally abusive, peri-menopausal great aunt… Well, then, Metoprolol is really only masking the problem, now isn’t it? Even tho your blood pressure problems are caused from your stress and not your parentage, it can give you a heart attack or stroke just the same, so you have to deal with it. But the mechanism that causes the mercury to rise, when the mercury is taken away, is sure to find another outlet. In other words, if all you do is fix your blood pressure, the Aunt Gladys still remains, and who knows what that stress will cause next? You have to move out of the basement to really solve the problem.
Yet, we would never accept our physician telling us that the answer to our health issue is to move out of the basement. We want a prescription. A treatment. Something simple and easy, like twice daily shots in the bum with a magic serum. Somehow that seems better and more important than doing something about our sanity. A medicine chest full of pills is far more glamorous than taking charge of our lives. A prescription is far more socially acceptable than a Tai Chi class and an appointment with a therapist. An outpatient hospital procedure is far less problematic than standing up to Gladys. Give us the easy route, doc. We have enough complications in our lives already.
That is not to say that pharmaceutical mediation isn’t necessary for emotional conditions. Nothing mental is cured overnight. Gotta keep the stroke at bay while we learn to deal with the basement thing. The best long-term solution is to attack it from both sides: the mental and the physical. Take your Nexium AND your meditation. Take your Prozac AND get sunlight and exercise. Take your Beta Blocker AND move out of the basement. And don’t feel squirrelly about doing the “non-medical” things. I promise, using thunderstorm sounds to help you with your insomnia won’t cause you to wear bellbottoms and patchouli. Talking things out with a therapist or minister won’t make you social outcast, and it will probably lessen your need for the antacids. But remember, just like no magic pill cures depression, no magic herbal tea cures heart disease either. Both fronts, physical and mental, must be fought to win the battle.
I have made no secret of the fact that i hate society’s expectations and subjugation of the human brain. We concentrate so much on other parts of the body and their overall health, and yet neglect the most important organ of all, the one that makes us human. The issues in our heads that cause our bodies to be “off”, and the issues in our bodies that cause our minds to be “off” – these things should be one and the same. Part and parcel of this discipline we call medicine. Rather than a hierarchy of treatments, there should be an evolving cloud of health: Take your medicine, get your testing, sleep, eat, exercise, play, read, talk, think, laugh… All these things contributing equally to the overall well-being of the patient. Whether the problem starts or finishes in your head, the head requires treatment. For some, that treatment requires medication. For others, it requires peace.
I look forward to the day when a doctor can look at his patient and say without reserve, “Take your pill, get some exercise, and do a little fishing, ” and have each part of that statement be equally important. Indeed, it is already true, but we are just afraid to admit it.