The burden of chronic disease is crushing us while we have the answers right in front of us. A recent summary reported that the total cost of chronic disease in the US is 3.7 trillion dollars a year, which is approximately 19.6 percent of the country’s gross domestic product. (1) This issue is not new news. It is well-defined and has been discussed for decades. Why are we not solving it? It is because medicine is overlooking the deep data regarding the nature of chronic disease, is focused on illness instead of wellness, and keeps treating structures when the root causes are usually physiological.
The nature of illness
All physical and mental symptoms are the result of you gathering data from your surroundings from different sensors, your brain interpreting the sum total as safe, neutral, or threatening, and then you automatically responding in a manner to ensure survival. You may or may not be aware of the reactions. They can be dictated by signals from chemicals, small proteins (cytokines) produced from your cells, signalers from the nervous system (neurotransmitters), or signalers from our glands running through our blood (hormones).
The term, “mind body” is not a useful term in that it implies that there is a separation between them. There is actually just you; one system that responds as a unit. Your nervous system, including your brain, is simply one of the many ways your cells communicate to coordinate your functions. The mind and the body are inaccurate constructs and distractions to understanding illness and disease compared to wellness and health.
With cues of safety from your environment, including your mind, your response will be signalers such as safety cytokines (anti inflammation and pr- anabolism), GABA (calm), acetylcholine (restoration), serotonin (contentment), dopamine (rewards), oxytocin (connection and bonding), growth hormone and growth factors (regeneration). The immune response will be strong yet inflammation low when stimulated by safety cytokines. Clinically the result is feeling less inflamed, less painful, relaxed, composed, present with a slower heart rate, blood pressure and breathing. The more time that can be spent in this regenerative state the better for health and wellness.
Your body’s goal is to survive. Defeating or dissipating threats and discord and maintaining safety and harmony to keep your range of behaviors and chemistry in a stable restorative and regenerative zone is key to thriving. The nociceptive (pain) and the emotion systems, both with and without awareness, guide you to take actions to avoid harm. When you experience an uncomfortable or unpleasant feelings from any source, it is simply signaling danger and then you can take appropriate steps to find safety.
Environmental cues of threat or internally generated ones are met with a defensive response including stimulation of your immune system with elevations of inflammation, elevated metabolism to provide fuel for defense, and increases in multiple stress signalers including the threat cytokines (IL1, IL6, IL17, TNF), inflammatory chemicals, (histamine, prostaglandins), mobilizing neurotransmitters (glutamate, dopamine, noradrenaline), and stress hormones (adrenaline, cortisol, aldosterone, vasopressin and endorphins).
Clinically, you are on “high alert” and there are numerous bodily responses to threat. The basic ones include an increased heart rate, rapid breathing, increased speed of nerve conduction (increases pain), elevated blood pressure, sweating, muscle tension, and a sense of danger that we call anxiety. There also numerous symptoms created by this physiological state. They include tension and migraine headaches, neck and low back pain, skin rashes, stomach cramps, depression, bipolar, burning sensations in various parts of your body, and there over 30 different responses. Although the chemical environment encompasses your whole body, each organ and organ system will manifest its unique response.
Symptoms, illness, and disease
When the threat is transient or resolvable, there will be different physiology that will quickly abate the symptoms. When the threat is more prolonged, people will develop illnesses and diseases that, also, are reversible with appropriate treatment including the removal of threats and restoration of safety. When threat is sustained people can develop serious illness and diseases that may cause permanent tissue damage and create physical, mental and social havoc.
What causes disease? There are two aspects consider.
- Your nervous system/ body
- Your inherent coping skills
- Your current state of reactivity influenced by diet, exercise, sleep, meds, etc.
- Your environment or perception of it
- The magnitude and duration of threat – the inability to find safety
So, it is the interaction of the surrounding stressors with the human organism that determines the manifestation of physical and mental symptoms; illness and disease versus wellness and health.
The current state of “mainstream” medicine
Modern medicine has nullified these aspects of care in that we are not given the time nor are we encouraged to talk to our patients. From the beginning, we are not providing cues of safety. Then, we don’t know our patients and their coping capacity and really don’t know much about their environment. We are given only the time to treat symptoms. We are ignoring the root cause of the problem–total threat load. It is similar to putting out a major fire with a garden hose. It can’t and doesn’t work. Indeed, there is an ongoing and growing epidemic of chronic disease – both mental and physical, social and spiritual.
Solving our medical care crisis
Our medical care crisis could be solved with one simple move – significantly increase the reimbursement for talking to patients. This would allow a sense of safety, allow providers to assess both the patient and his or her surroundings, and direct them to resources to reduce the threats in their lives, improve safety, coping and connection skills and provide tools to more effectively process their stresses.
The other half of the equation is to quit paying as much for procedures and also not reimburse for interventions that have been proven to be ineffective or damaging.
Addressing root causes
A basic concept in extinguishing a fire is to deprive it of its fuel. Forest fires are the classic example. Fire breaks eliminate fuel and are only ineffective if the fire is so powerful as to jump over them. Fire retardants cover wood in a manner that it cannot be consumed. If water is used, it may be delivered in a mist, which helps lower the oxygen available. Water also removes heat. A carbon dioxide fire extinguisher displaces oxygen and suffocates it. The bottom line is that to fight a fire you have to address one of the root causes of it – oxygen, heat, or fuel.
Treating only symptoms is not only ineffective, the “fire” will continue to burn causing ongoing tissue damage. Successfully minimizing the impact of chronic illness requires minimizing the multitude of threats and maximizing access and opportunities for safety. coping and connection while also improving skills to better process toxic environmental inputs.
Every mental and physical symptom is created by the interaction between your surroundings and your body. Your body contains trillions of sensors that collect data that is sent to and processed by your central nervous system. Unpleasant sensations compel you to take action signaled by your brain and local tissues to resolve threat. Pleasant input causes you to take actions that are restful and regenerative.
The two factors creating symptoms and disease are you (and you coping capacity) and your surroundings (stressors). When you stresses overwhelm your coping capacity, you’ll experience symptoms, maybe become ill, or develop a serious disease. The solution lies in 1) increasing your coping capacity and 2) teaching you skills to more effectively process stress so it has less of an impact on your body, health, and sense of well-being. As you learn to regulate your body’s neurochemistry, you’ll have control, a sense of safety, and thrive. The DOC (Direct your Own Care) Journey presents a well-traveled sequence of lessons that will allow you to master these skills.
1. O’Neill Hayes, Tara and Serena Gillian. Chronic disease in the United States: A worsening health and economic crisis. Americanactionforum.org; September 10th, 2020.
Plan A–Thrive and Survive COVID-19, 2nd edition; Loving Life Lengthens It