As we embark upon the 5th decade of the Information Age, our health and our performance has never been so intertwined. In the first decade of the new millennium 80 cents of every dollar in the United States came from the Service Sector. To me, an Internist and Psychopharmacologist, Service means Cognitive Functioning. In other words, as compared to just a generation or two ago, we derive our livelihood in this nation primarily by using our brains a lot more than our brawn. Consequently, the meaning of health has changed dramatically. The primary impairment to our work performance is no longer just our backs, our wrists or our shoulders; it’s our Cerebral Cortices.
When we think about this from an Evolutionary perspective, this makes perfect sense. 100 % of the 1 or 2% difference between Chimpanzee and Human DNA went into the design of the Human Cerebral Cortex; the seat of our superior ability to reason, speak, discover, create and deceive. For better or for worse, it follows, that the part of us that makes us distinctly human, our Cortex needs to be in command of the rest our beings; when it’s not, our health and our performance is rendered suboptimal.
From this vantage point, one will see just how arbitrary the border separating the mind from the body is. For example, 9% of Americans suffer from a major depressive episode each year. Amongst people with Type 2 Diabetes, 25% have a major depressive episode annually. A single chronic health condition is associated with a nearly three-fold increased risk of Depression! What’s more, in people that have both Type 2 Diabetes and Depression, those that have their depression treated have much improved control and reduced complication rate of their diabetes than in those that do not have their depression treated. The implication of this for me as a physician is that for me to optimally treat Type 2 Diabetes, the most common chronic condition in the United States, I must also be able to optimally treat depression.
I use Diabetes and Depression simply as a graphic example of the folly and the danger of the prevailing view of the separation of Mind and Body that continues to persist in our society in general and in our healthcare system in particular. With our ability to perform in our world being such a cerebral experience, anything from a bad night’s sleep, to skipping meals to chronic pain or having multiple chronic health disorders will have an effect on a persons’ ability to learn, work or interact socially with family members friends and co-workers. The time has come where we must completely reject this concept of the separation of mind and body or physical and mental; our lives and our livelihoods depend on it!
Welcome to the Evolution.
Mitchell R. Weisberg, MD. MP