Symptoms or Causes?

By Dr. Ken Larsen

Imagine a situation where a man, wounded and in pain, staggers into your local emergency room.

The ER doc begins the intake workup.

“Are you in pain?” the doc asks.

“Yes, it hurts a lot” the patient replies.

“When did it begin?” the doc asks

“When I got shot with the arrow in my back–that really hurt.” the patient replies

ER doc strokes his chin, “Hmmm”

“So you’re in pain because of that arrow in your back?” The doc proclaims with great insight.arrowinback

“Yeah, that’s what I said” The patient looks a bit puzzled as he replies.

Doc says, “I’ll be right back.”

The doctor returns in a short while, gives the patient a prescription for Motrin and has the nurse give him instructions for how to put on his shirt over the arrow.

Admittedly this scenario is a bit preposterous but I use it to illustrate a point.

Your immediate reaction is to recognize that the cause of the patient’s distress was not effectively dealt with.  He left with the problem that he came in with.  The arrow in his back.  What’s wrong with this picture?

There is a growing concern that this sort of event is happening far too frequently with the diagnosis and treatment of mental health issues.

I’ll tell you of a personal experience.  About 20 years ago I was unhappy.  I talked to my personal physician who asked me some questions.  I met the criteria for a diagnosis of depression.  I was given a psychiatric referral.  When I met with the psychiatrist he asked me some questions and gave me a prescription for Prozac.  This meeting took 20min.  The fee was $250 plus the cost of the prescription.

What was I to conclude from that experience?  Was I suffering from a Prozac deficiency?  Was that the cause of what had been labeled “depression”?  I didn’t have enough Prozac in me?

Dr. Wm. Glasser, author of “Choice Theory” and “Reality Therapy” has stated that “many people are diagnosed with a disease they don’t have and given brain drugs they don’t need.”

Unhappiness is the most common presenting complaint for depression.  That unhappiness usually has a cause and that cause is most often associated with a close relationship that is not working right.  I have to ask if giving drugs that allow the accumulation of serotonin in the brain changes the circumstances that caused the unhappiness.

There is growing concern that this is not the answer.  In fact there is growing concern that some of these brain drugs that have been so freely administered have made the problem worse or have caused more serious problems.  And most importantly, they leave the person with the arrow in his back.

The issue of mental health looms ever more urgently in our culture, reinforced every time we read about another senseless act of violence.   One report suggested that some of these guys are not necessarily loners but failed joiners.   This is one possible explanation.   All too often these are people who want to be connected in caring relationships but somehow have not been successful.

helpinghandsAs a civilized society we are at a crisis point.  Do we continue to dispense drugs that are non-solutions to lonely, isolated people in distress or do we focus our attention and energy on reaching out with care and love to those we see that are not able to get their needs met.    

The pharmaceutical industry and many psychiatrists have tried to convince us the solution lies in brain altering drugs while ignoring the causes.  I believe this is like the guy who was given Motrin for the arrow in his back and instructed on how to put on his shirt over the arrow.    I appeal to all of us, ordinary folks and especially those we trust with our health care.  Let’s shift our focus from medicating symptoms to discovering and dealing with causes.

1 thought on “Symptoms or Causes?

  1. That is a very powerful image of someone trying to cover up the arrow with the shirt! I love it! I also am concerned about the trend towards symptoms not causes.

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