Handling the tricky stuff

Handling the tricky stuff

Sunday, November 29, 2015

We’re All Not In It Together: Fantasy Trout Fishing in Delusional America -- 3

3: Epidemic

"‘Tis bitter cold. And I am sick at heart"
Hamlet

How yuh doin’?

“I’m doing well,” is the standard answer around here, but this is just a thing we say without meaning it, because no one is, in fact, feeling well.

As a number of the pundits on the left noted in the last Congressional election, though the country is economically on the upswing from “The Great Recession,” the mood of the country remains sour. Unhappy. Cranky.They took it out on the President, who seems nice enough to me, and they elected some more really angry people to Congress. Perhaps it was the way wages for most of us have stagnated, while the wealthy are going back to getting wealthier,  as some pundits have suggested. Perhaps -- but I see signs that it runs deeper than that. I feel like it’s deeper than that. Superficially, I’m doing well, but I don’t feel like all is well and I’m angry, though I’m not quite sure at who.


 To dwell on unwellness, I’ve noticed that we live in the age of “epidemics.” Yes, there was Ebola, the bird flu, and now MERS, throwing everyone – or anyone who is paying attention -- into a panic. But that’s not what I mean: there are other epidemics going on that frighten us much more deeply.

“Epidemic,” in fact, is one of our favorite words for qualifying the things in contemporary life that seem to afflict or worry us the most. The following is a short list of some recently described “epidemics”:

The autism (or autism spectrum) epidemic
The epidemic of police violence against Blacks
The epidemic of violence against police
The ADHD epidemic
The opioid epidemic
The psychiatric drug epidemic
The epidemic of campus rape
The epidemic of victimization
The “trigger warning” epidemic
The depression epidemic
The epidemic of peanut/nut allergies
The anxiety disorder epidemic
The epidemic of gluten intolerance
The teen suicide epidemic
The epidemic of sleep disorders
The chronic fatigue epidemic
The epidemic of lactose intolerance
The epidemic of internet addiction
The epidemic of gun violence
The obesity epidemic
The epidemic of narcissism
The Alzheimers epidemic
The epidemic of abortion
The epidemic of religious fundamentalism
The (breast, prostate, liver, lung, etc.) cancer epidemic

Any number of these have claimed me as a “victim,” and, if I didn’t fight against it, I could easily be convinced that some sinister entity, environmental cataclysm or force out there is out to ruin my life. This is a natural tendency many of us share – trying to understand all the difficulties in our lives discover a simple root cause for all the distempers we feel. The only problem is, there are too many culprits for me to focus on just one…

Everything on this list, however is perceived by a large group of people as a problem that is growing and perhaps even spinning out of control, which makes the “epidemic” in question an issue of great concern – a concern that in general overshadows the affected group’s concern over actual epidemics like flu, Ebola or AIDS.  Unlike an actual epidemic disease, however, each of these epidemics,  whether it is a social or a public worry, is hard to document with actual medical statistics that prove it is spreading and growing like an epidemic: the issue is mainly perceived to be increasing at an alarming rate, and it has advocates who demand that public notice of the problem. None of these issues are really new things (like H5N2 influenza or Ebola), but are issues that have generally been around for a long time (pick holes in this assertion if you like) but now seem to be becoming much more important… at least in our awareness.  The epidemics issues I listed all concern our mental state or our health state or our social state but are not actual contagious diseases – they all concern our state and thus are seen as critical to our well-being. No wonder we are concerned.

But should we be? Each of these “epidemics” also has its critics who insist that either nothing different is going on, or that it is only an “epidemic” because we have decided to notice something that has always been out there in normal life and now we are seeing it everywhere. For most of the items on this list, I tend to fall on the second camp, but I will admit that life is complicated, and some of these things may be increasing in a way we perhaps should be concerned with.

Let me give an example of one item on the list: ADHD. I pick this because I have some personal experience with it and have two members of my family who have been diagnosed with the condition. If you’ve had children (especially boys) in the last 30 years, or are under 35 or so, you are aware of how “epidemic” attention-deficit disorder is – a huge chunk of our children and many adults are now diagnosed with it, and are treated by being given regular, daily or twice-daily doses of something like an amphetamine. The general diagnosis of the “disorder” is that the person with ADHD is unable to focus or even sit still for more than a brief period, which makes it hard for them to stay on task and complete a long or difficult task. In children, this often is first noticed with bad grades and/or complaints of bad behavior at school.

Sounds pretty serious, doesn’t it? One might expect widespread panic when so many of the nation’s children are afflicted with such a serious brain disorder, but the cure is cheap and generally very effective (children -- including my own – have tended to give testimonials, like “wow! I feel so much more awake and able to concentrate
now!”). In fact, it’s so easy and effective that parents whose children are performing only slightly sub-par (or adults who are having a hard time keeping up at work) have been known to take the “afflicted” into the office and demand a diagnosis and a prescription. No one wants to be at a disadvantage because they don’t have the benefit of the drugs.

And yet, a generation before, though similar drugs were already available, no one had heard of this “disorder.” Sure, some kids did not do as well in school, but they were otherwise considered “normal,” and many grew out of their academic difficulties. The drugs, though sometimes prescribed by psychiatrists to improve people’s moods, were generally considered to be strong stimulants or “uppers” that could help you stay awake if you were really tired, like super-strong coffee. Other than as carefully prescribed psychiatric use they were generally seen as powerful drugs that could be abused. In the 60’s (when I grew up) kids  bought them from drug dealers and took them to get high.

What happened was that modern psychology decided that inability to concentrate well was a “disorder,” and probably the result of a mental defect. Actual causes of the disorder were not clear, nor was the permanence of the condition. Once it was defined, we began seeing it everywhere, and the word “epidemic” slowly began to be used. If it really was an epidemic – a sudden, alarming increase in a bad mental condition, what was causing it? A virus? Chemical pollutants? Vaccines? Preservatives in our foods? Bad parenting? Television or video games? Possibly, I guess, for some of these, though nothing like any of that has ever been proved.

What does seem to be a possible cause are changes in the school environment, larger classes and the cutting of break times like recess in order to get more academics into the too-short school day – all really negative effects of underfunding public education. Kids are expected to “focus” for longer periods in more difficult conditions and more and more of them are not up to it. We could notice the environmental problem here and try fixing it by spending more money, but… the pill fix is easier. I first became aware of ADHD 24 years ago when my oldest child was entering kindergarten. The teacher called us in, suggested my daughter had the disorder and wanted us to take her to the doctor to get Ritalin. She was overwhelmed with a large classroom she couldn’t handle and she wanted the children to be docile and easy to handle, which a number of them weren’t. We refused, that daughter never was diagnosed and she did just fine in the rest of her schooling.  To be fair to the teacher though, I’m sure she genuinely thought my daughter had a problem because, as the definition of the disorder had emerged, it seemed to explain the problem she was having with children in the classroom and offer an easy – in fact, miraculous – solution.

Notice that the general story that emerges here is that we have a social problem – large numbers of kids not doing well in school, perhaps an effect of changes in schooling due to other social problems – and we define a semi-legendary medical condition/physical problem that explains it (conveniently denying the existence of another larger problem of our own making) and since the solution (stimulants all around) seems to make the symptom go away, we decide we’ve nailed the problem and move on. We’ve told a story to ourselves that makes the problem go away.


 So this is why I tend to fall into the skeptic camp on any number of our modern “epidemics”: I generally think are either the symptoms of pre-existing social or environmental problems, or predictable effects of large scale social changes. I’m a writer, and I’m well aware of the power of stories to define things and manage the difficulties of cruel reality. This kind of personal problem-explanation has been variously described in our culture as “crafting a personal narrative,” “rationalizing,” or “coming up with a worldview.” It’s telling a story to get a grip on a scary monster we can’t quite see in the dark and to make us feel like we have a plan to confront it.

Worried about getting older and sicker and slowly losing your mind? Here’s a story that may help you get a grasp on your own impermanence: there’s an epidemic of a mysterious new disease – Alzheimer’s, caused by some mysterious environmental, genetic or pathogenic cause. (Never mind that the most obvious cause is human mortality –that story has no possible resolution.) Feeling sick or have children who seem to have frequent physical illnesses? It must be food allergies – let’s pick something common in the diet and scientific sounding (like gluten) – that must be it! (This is not to say that some people do not have serious, life-threatening allergies to some foods, but they always did – just not in the numbers we see now.)

Stories are powerful, and the serious problems of a few can become explanations for the more minor problems of far more of us. Profound autism – a very serious set of mental problems in a very small fraction of the population can be seen as a spectrum of “similar” behaviors in far more of us – which are now seen as “disorders” because of their relationship to the really debilitating conditions. It’s all in how someone tells it and and then in how you choose to see it.

But then, we all tell stories and we all think they make sense out of chaos. I’m telling you one right now.

Why are there currently so many stories about epidemics? Epidemic “disorders” make perfect sense because life feels disordered. We’re telling ourselves that there are disorders and diseases suddenly emerging and we are seeing them everywhere. We sense that there is something(s) wrong in our being – it’s not well. I guess that finding a plausible villain responsible for life’s troubles makes reality easier to handle, to control. As I said in my first essay in this series, I’m all for the illusion of control.

De Nile
On the other hand, de Nile is not just a river in Egypt. Maybe, just maybe, we need to be tackling our problems with modern reality at a more fundamental level…  and find a cure for our epidemic of denial… For now, that’s my story and I’m sticking to it.

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