Every morning, after coffee and pills, I sit in bed and review my news feeds – The Brew, Punchbowl News, and a variety of Medscape specialty feeds (Internal Medicine, Oncology, and Psychiatry). I used to read the NYT Morning, but I somehow managed to accidentally nuke that subscription. So it goes.
This morning, I read the Medscape Psychiatry item titled When Suffering Defies Diagnosis. This is a very accessible essay on certain aspects of human behavior and human suffering that don’t fit neatly into the syndromic DSM classifications of mental illness. Its author, Dinah Miller, MD, writes in a jargon-free style that is clear to both clinical folks and folks outside of healthcare disciplines.
Consider the hatred of people of a different race or religion; we shouldn’t accept that as normal, but it is very common. Yet, it does not fit neatly into a mental illness category. The same can be said for the desire to kill strangers as occurs almost daily in our country. We easily fall into the habit of referring to the perpetrators of such mayhem as mentally ill, when in fact, we just mean that we cannot imagine doing such things and that anyone who does is severely broken. The truth is that people with mental illness diagnoses, except perhaps those with personality disorders, are far more likely to be the victims of violence rather its perpetrators.
As I read Dr. Miller’s essay, I thought of the song Under Pressure that was a collaboration between Queen and David Bowie. I read somewhere that they came up with this song during a jam session. It’s probably my favorite Queen track. When I read Dr. Miller’s quote from Viktor Frankl, I knew I would have to write this essay just for the sake of sharing his thoughts and hers with my friends. The gist is that suffering is part of life, and to cope with it, we must find meaning therein. The same might be said of various forms of brokenness – our imperfections as well as those of the people that we love. Perfection is an aspiration that is not obtainable. Perfection should inspire us to work towards becoming our best selves, but it sometimes becomes what keeps us from that very goal. Alas.
Later, in the afternoon, I received another Medscape Psychiatry article. This one was titled, Religious Fundamentalism and Later-Life Anxiety. You may recall that I have commented in other essays that the most common mood disorder in Geriatrics is Generalized Anxiety Disorder (GAD). This new essay, also by Dr. Miller, addresses GAD in the context of strict, religious fundamentalism. She writes about a friend, a pastor, who has recently published an autobiographical book titled, Evangelical Anxiety. I haven’t read it, but I can definitely identify with having to deal with irrational anxiety – claustrophobia, in my case, except that I am a heathen, of course.
We are all under pressure. We just need to find a way to cope with “the terror this world is about.”