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The Myth of Diagnosis

The Myth of Diagnosis

Today I want to revisit a topic that is still very relevant. I believe that we put too much emphasis on naming diseases. Sure, the names we give disease are useful for finding the right medication, but they are not helpful for truly getting to the root cause or creating a healing response. As my team and I were preparing to make the Broken Brain Docuseries, we revisited one of my first books, The UltraMind Solution, and I found the passage below. So much of this still applies to current thinking, and I am hopeful that Functional Medicine, which I believe to be the future of medicine, will guide healthcare providers away from naming and blaming and toward discovering and treating the root cause of disease.

MYTH:  If You Know the Name of Your Disease, You Know What’s Wrong With You

This myth is pervasive throughout medicine, and it is THE single biggest obstacle to changing the way we do things and finding the answers to our health problems.

The problem is simply this—we are in the naming and blaming game in medicine. It is what we were trained to do. Find the name of the “disease,” then match the drug to the disease. You have “depression,” so you need an “antidepressant.” You are “anxious;” you need an “anti-anxiety” medication. You have bipolar disease or mood swings, so you need a “mood stabilizer.”

Unfortunately, this approach or method of thinking is outdated, increasingly useless, and often dangerous. In some ways, it’s even tyrannical. Once you have a label, you are put in the group of people who have the same label, and it is assumed you carry the attributes of this group.

For example, a group of psychologists, psychiatrists, and lawyers headed by Dr. Rosenbaum, a Stanford University professor of law and psychology, pretended to be hearing voices and got themselves admitted to psychiatric hospitals across the country.

Once they were admitted to the hospitals, they resumed acting normally. The hospital staff and physicians then viewed all their “normal behavior” such as note-taking, as “abnormal.” It was only the regular “crazy” patients who could tell them apart.

The same thing happens to you once we assign you a label—you have depression, schizophrenia, ADHD, dementia—we throw you in the same group with everyone else who has that diagnosis and assume you all have the same problem, even if evidence is found that you don’t necessarily suffer from exactly the same problem.

But these labels or diagnoses are just names we associate with a collection of symptoms. This name has NOTHING to do with WHY you have those symptoms—with the root causes of the “disease.”

The future of medicine is personalized treatment, not “one-size-fits-all.” The outdated method of naming the disease and then assigning a drug to fix it clearly isn’t working.

Unfortunately, few in the medical industry today seem to understand this. The truth is that medical practice is virtually predicated on the myth of diagnosis.

I want to help you understand how serious this problem is. It is not trivial because it changes EVERYTHING about how we think about disease and what to do about it.

A very few fundamental problems exist that explain nearly every disease. It doesn’t matter what specialty your disease falls under. As Pierre Laplace said, a very few fundamental laws can explain an extraordinary number of very complex phenomena.

These underlying problems are the link between most chronic diseases. In almost every disease, the same few things go wrong. And those same few problems are all interconnected. One affects the other in a giant web of biology. Pull on one part of the web and the whole web moves.

This web is built of the 7 keys of UltraWellness, which I’ve written quite a bit about. These keys are the underlying causes of ALL illness.

This new roadmap turns the myth of diagnosis on its head, and in doing so reveals one of the most radical concepts to emerge from this new medical approach: The name of the disease bears little relationship to the cause of the disease.

One Disease, Many Causes—One Cause, Many Diseases

One disease can have many, many different causes, ALL of which manifest the same symptoms. Take depression for example. It may be caused by many different factors, yet the symptoms we see are the same across the board. The DSM-V accurately describes these symptoms (100 percent accuracy), but it says nothing at all about the causes (0 percent validity).

Imagine a room full of people with depression.  They all meet the DSM-V criteria for depression, and they would all be prescribed antidepressants for their “disease.”

However, neither this diagnosis nor the treatment provided takes into account their genetic individuality. It doesn’t tease out the reasons each of them became depressed in the first place.

These problems arise because the real causes of depression are not addressed with antidepressants.

It may be there are many “depressions,” not just one generic “depression.”  These “depressions” may be the result of a multitude of causes: folate, B6, or B12 deficiency; low thyroid function; “brain allergies” to foods; an autoimmune response to gluten that inflames the brain; mercury poisoning; abnormal proteins called gluteo- or casomorphins from mal-digested food that alter brain chemistry; brain inflammation from a hidden infection; blood sugar imbalances; low testosterone or other sex hormones; a deficiency of omega-3 fats; or adrenal gland dysfunction from excessive stress among many other possible causes.

These are some of the real causes of “depression” as well as many other mental illnesses and neurological conditions.  Without addressing core, underlying issues like these, we can never have optimal brain function or mood.

There is really no such thing as the “disease” called depression, just many different systemic imbalances that cause the symptoms we collectively refer to as “depression.”

One disease, many causes …

On the other side of the spectrum, there can be one factor in a person’s diet, lifestyle, environment, or genetic make up that can cause dozens of different and seemingly unrelated “diseases.”

Gluten, the protein found in the most common grain eaten in America—wheat—as well as barley, rye, spelt, and kamut is an excellent example. Gluten is one common factor that can create so many illnesses and diseases it would be hard to count them all.

The reasons are many.  They include our lack of genetic adaptation to grasses, and particularly gluten in our diet. Wheat was introduced into Europe during the middle ages, and 30 percent of those of European descent carry the gene for celiac disease (HLA DQ2 or HLA DQ8), which increases susceptibility to health problems from eating gluten. Keep in mind that American strains of wheat have a much higher gluten content (which is needed to make light fluffy Wonder bread).

A review paper in The New England Journal of Medicine listed 55 “diseases” that can be caused by eating gluten. These include many neurological diseases including anxiety, depression, schizophrenia, dementia, migraines, epilepsy, and neuropathy (nerve damage).  

Besides making the brain inflamed, gluten can be broken down in the gut into odd little proteins that are almost like psychedelic drugs (opium-like peptides called gluteomorphins).  These change brain function and behavior.

Gluten also contains significant amounts of glutamate, a molecule that accelerates, activates, excites, and damages brain cells through a special brain receptor or docking station called the NMDA (N-methyl-D-aspartate) receptor.  Overactivation of this receptor by glutamate is implicated in many psychiatric disorders.  Glutamate is called an excitotoxin (a substance which over-excites and kills or damages brain cells).

So gluten can cause brain dysfunction by 3 different mechanisms—inflammation, odd morphine or psychedelic proteins, and as an excitotoxin.

So gluten, we see, can be the single cause behind many different “diseases.” These diseases are not treatable with better medication, but simply by 100 percent elimination of gluten from the diet.

One cause, many diseases …

One disease caused by multiple factors, or one factor that causes multiple diseases? How could this happen? It completely upsets our current thinking. And it should!

But the reason this is true is simpler than you might think.

We are all unique, biochemically and genetically, and have different responses to the same insults.  In one person gluten may cause arthritis, in another, it can cause depression. Depression may be caused by gluten in one person; in another, it may be caused by B12 deficiency.

The beauty of Functional Medicine, and the science of nutrigenomics, is that they take these factors into account to help create health for each individual.

Medicine has been looking in the wrong place for answers. Finally, science has provided a gateway to a different way of thinking about mental illness and brain disorders. We need to get out of the “name it, blame it, and tame it” game —the myth of diagnosis—and start thinking about how the body works, how to personalize our approach, and how to not suppress symptoms but to restore normal function.

Wishing you health and happiness,
Mark Hyman, MD

 

Mark Hyman MD is the Director of Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.