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While many people today are plagued with excessive fear and anxiety it
seems that there are others who have too little anxiety, a condition which
has been termed "hypophobia" (1, 2,
3,
4, 8).
Since anxiety is a defensive or adaptive emotion which serves to protect
us from dangers (see Darwinian Medicine), those
who lack such normal fears may fail to perceive the dangers which confront
them everyday. Such people may be seen as foolhardy or risk takers since
they lack the normal inhibitory fears which serve to prevent excessive
risk taking. It is for this reason that the frequently unrecognised
hypophobia may be a rather dangerous condition. As has been noted by Nesse
(5),
"too little anxiety may be worse than too much."
One example of the danger of insufficient anxiety is cited by Poulton and
Menzies (8)
in connection with fear of heights in children. These workers point out
that injuries from falls are confined to those children who have no fear
while those who were afraid of heights avoided injury. Poulton and Menzies
state (8):
"in perhaps the first clear evidence of hypophobia, we showed that the absence of adult height fear was associated with an elevated history of serious falls in childhood. It is suggested that children without sufficient fear are likely to fall when in high, vulnerable positions. Further, directly opposed to a conditioning position, such children do not go on to develop height fear in adulthood. Instead, they continue with less fear than those individuals who have never
fallen." As is also evident from the ability of antidepressants
to elevate individual monkeys to a position of social dominance (1, 5;
see also Over Adaptation), this
evidence clearly indicates the greater importance of nature rather than
conditioned learning (22).
It is absolutely astonishing that science is just beginning to discover
that susceptibility to fear frequently has a constitutional basis.
Hypophobia has been described by Nesse thus (3):
"some individuals have hypofunctional anxiety systems, whether from genetic, traumatic, or toxin induced defects that prevent anxiety expression, from drugs that block anxiety, or simply from being at the low end of the anxiety distribution. They should show decreased ability to avoid and escape dangers and increased rates of death and
harm." Nesse notes that (2)
"such people follow their drives, betray their friends, annoy their relatives, and, unless they are very clever, get in terrible
trouble." Nesse and Williams(1) further point out that
hypophobics "don't complain and don't seek psychiatric treatment but instead end up in emergency rooms or fired from their
jobs."
The condition of hypophobia calls into question again the very definition
of "normality". What is normal? I have cited evidence elsewhere
that indicates that the "normal" person is excessively
optimistic and tends to look at the world through "rose coloured glasses"
( see Body
Types), a view which further calls into question the modern scientific
definition of normality. The normal person has an inability to correctly
and fully perceive reality. This has also been noted by Nesse and Klaas (6)
who point out that "studies by social psychologists have recently shown that normal people have systematically distorted perceptions of
risk" and a "tendency to unjustified optimism."
According to Nesse and Williams (1) "recent studies have found that most of us consistently overestimate our abilities and our effectiveness. The tendency to optimism helps us to succeed in social competition, where bluffing is routine, and also keeps us pursuing important strategies and relationships even at times when they are not paying
off."
If the normal person is unjustifiably optimistic does this mean that the
normal person is also hypophobic? There seems no doubt that the
"unjustifiably optimistic" person could be considered to have a
level of anxiety which is below optimum. Conversely, the optimism of the
hypophobe would hardly seem justified. While unjustified optimism does not
necessarily seem to translate into the same type of risk taking actions as
is typical of hypophobics, the underlying attitudes seem the same. Both
involve a disordered view of reality and and inability to accurately
perceive risks and consequences. Perhaps the hypophobe merely demonstrates
these disordered perceptions in a more obvious physical manner than does
the normal person who fails to act on them in such an obvious physical
way. Whatever the explanation for these inconsistencies modern science is
clearly in urgent need of a precise definition of normality. Until this is
achieved then obviously it is impossible to define what constitutes a
"disease" (ie. deviation from normality).
The positive consequences of unjustified optimism or "high mood"
have been described by Nesse (5):
"high mood tends to increase fitness in situations of opportunity, whereas low mood tends to stop investment in hopeless endeavours and facilitates consideration of alternative strategies or
enterprises." However, while high mood may "increase fitness in situations of
opportunity", this is counteracted by the fact that high mood
also interferes with an accurate perception of risks and consequences. In
other words, what is perceived as an opportunity may not be an opportunity
in reality.
These facts underline the potential for social conflict which may be
caused by the widely varying perceptive abilities of different personality
types. While the totally justified concerns of the realist for instance,
may be dismissed as "alarmist" by hypophobes or those with
unjustified optimism, the "blindness' and indifference of the latter
on the other hand, may be viewed as incompetence or callousness by the
realist.
In discussing mood disorders, normality, and risk perception the
limitations and restrictiveness of these terms should be fully realised.
Perceptual difficulties for instance may be highly specific rather than
global. One example of this is the lack of
insight which particularly effects the excessively optimistic,
extraverted, or manic person. Not only may perceptual difficulties defy
precise scientific description, but there are also considerable problems
in defining precisely what constitutes a "risk".
Discussions of "risk perception" are commonly limited to
immediate or easily discernible physical threats even though the main
causes of premature death in modern society are chronic diseases such as
cancer and heart disease. Yet, in spite of this, many people would be more
fearful of terrorists, sharks and snakes even though heart disease kills
far more than all these combined. Risks which predispose to the
development of heart disease such as poor nutrition, diet, smoking and
alcohol are therefore frequently not perceived to be risks at all. It is
the long term risks which result from political, legal or medical
decisions with which I am particularly concerned. Such risks, since they
may not materialise until further down the track, may challenge our
perceptual mechanisms and may therefore be the first affected if there is
any reduction in our perceptive capacity.
Konner (23)
for example, has recently pointed out, in regard to the increased
incidence of heart disease in the 1960's and 70's, that this increase was
"iatrogenic" because of inappropriate dietary advice from
the medical profession. According to Konner the introduction of
Darwinian medicine influenced the scientific
acceptability of treatments which have been described as
"natural" and permitted doctors to understand the possibility of
a connection between diet and heart disease. Prior to this apparently,
they were completely incapable of perceiving the remotest possibility of
such a connection.
A similar example of disordered risk perception involves the decision of
doctors in the 1950's to advise pregnant women to practise semi-starvation
so they may have smaller and more easily delivered babies (see
Darwinian Medicine, Nurition is for the
Birds). Even at that time I would suggest, there would have been many
members of the general community whose perception would have permitted
them to recognise the potentially hazardous nature of that advice. We now
know that low birth weight infants are predisposed to a range of chronic
health problems, including lung disease and asthma (24,
25, 26,
27,
29,
32,
33,
34,
35;
see also Body Types) and adrenal insufficiency (28,
30,
31)
and yet we wonder why such diseases have now become so epidemic. Not
only may inadequate nutrition during pregnancy result in disease in
later life, but furthermore, the science of epigenetics has now revealed
that these diseases may be genetically transferred to succeeding
generations (see Nutrition Breakthroughs).
Although scientists now realise that deliberate medically advised foetal
starvation would be expected to continue to have dire consequences in
succeeding generations, it is clear that doctors were completely
incapable of perceiving these hazards at that time.
While some may suggest that these medical "mistakes" were the
result of incorrect training (which may also have been the result of
disordered perception - but that is another story) rather than perceptual
problems, this does not provide a convincing explanation. Why for
instance, were many doctors and scientists who had the same training
warning of the critical importance of nutrition during pregnancy (see
Nutrition and Megavitamins) while the
remainder of the profession arrogantly dismissed this advice? Similarly,
advice by some doctors that heart disease could be caused by poor
nutrition and diet, even as early as the 1930's and 40's, was scoffed at
by many in the medical profession (see
Nutrition and Megavitamins). The persistence of this incredible anti-nutrition bias
(see
Medical Bias) would only seem possible in the presence of a complete inability to perceive the obvious common sense benefits of nutrition.
In both these instances there are clearly factors at work other than
science or medical training. Interestingly, Konner (23)
has recently pointed out, in regard to breastfeeding, that it was "extreme arrogance that allowed them
(the medical profession) to recommend strongly against breastfeeding and try to abolish childbirth without
anaesthesia." This is an extremely important point since it
indicates that such medical decisions are not based upon science or
training but rather are the result of the attitudinal or personality
characteristics of doctors. So important is this influence apparently,
that it may completely negate any tendency towards common sense. There are
serious implications here because of the well known "blindness"
and perceptual difficulties which are associated with arrogant
personalities. As has been noted by Kothari (20),
the greatest scientists are also the most humble, a fact which results
from the negative effects of arrogance upon perception and open
mindedness. Arrogance is rooted in self interest and protection of the
ego, both of which have a negative effect upon perception and the pursuit
of truth. In some instances at least, doctors have
apparently been so arrogant as to be (21)
"unable to perceive their own ignorance."
Since personality characteristics are known to be related to our
constitutional make up and the effects of the various hormones within our
bodies (see
BodyTypes) it is instructive to examine the
emotional features of the various constitutional types. In traditional
Chinese medicine excessive anxiety is a feature of the "Wood"
person or the "Fire" person (see Traditional
Medicine). Similarly, it is the "Earth" person and
the "Water" person who are described as
"optimistic" and "fearless" (see
Traditional Medicine). Far from disproving the
validity of these various body types, modern endocrinology and genetics
have reinforced them and provided more information regarding their
possible glandular basis. According to modern medicine for instance, it is
the
Adrenal type (ie person with dominant adrenal glands) who is
"optimistic" and "fearless" (see
Traditional Medicine, Body
Types) and who therefore frequently rises to positions of power or
dominance. This is also true in animal communities where it is the monkey
with the highest cortisol level that becomes the dominant male (7).
Perhaps Nesse (36)
was alluding to the constitutional basis of excessive anxiety when he commented: "I am impressed that most
anxiety and depressive disorders occur in the 15% of people who are
'sensitive'." If the excessively anxious person has a
"sensitive" constitution does this also mean that the hypophobic
person has an insensitive constitution? How does medicine define and
diagnose a "sensitive" constitution?
What is most disturbing about the above observations is their implications as far as perception is concerned. The Adrenal type, or the person with high levels of endogenous cortisol, tends to be very
insensitive and dismissive of risks. Cortisol is well known for its ability to induce a feeling of being superhuman, invincible, and
indestructable. It produces a sense of euphoria which tends to insulate us from reality.
Adaptive hormones such as cortisol increase the ability to cope with
immediate physical threats at the expense of the ability to cope with, or
even be aware of, more long term threats. Yet, because of the aggressiveness of people with
dominant adrenal glands they will tend to rise to positions of power or dominance and determine the values and standards which we must all live by. Such persons
may be the risk takers or
Sensation Seekers of society (9), a trait which is largely genetic
(9). Presumably the
nature of the sensations they seek will change as they mature and become
older.
The ability of adaptive hormones to make us relatively immune to
stressors and thereby effectively insulate us from reality underlines the
importance of adopting a more holistic means of evaluating normality.
Attempts to define normality by levels of anxiety or optimism, or accuracy
of risk perception, are inherently restrictive and fraught with problems.
Perhaps what is needed is a more holistic perspective which embraces all
aspects of human sensitivity, which after all is a measure of our
responsiveness to the full range of environmental stressors and stimuli.
This would include our physical tolerance of stimuli such as weather,
allergens, infections and exercise in addition to our attitudes and
emotional responsiveness. Perhaps we should be highlighting again the
importance of those traditional holistic teachings regarding
constitutional balancing rather than becoming obsessed with levels of
anxiety or optimism (see Body Types, Traditional
Medicine).
Another very worrying aspect of this whole matter is the possible effects
of mood altering drugs upon our perception (1,10, 11).
I have previously made the point that since "normal"
people are said to live in a "dream world of excessive
optimism" (see Body Types), and since it
is the task of antidepressant treatment to restore depressed patients to
"normal", then "the aim of antidepressant treatment is to create a dream world of excessive
optimism" (see Body Types).
Interestingly, this may not be too far from the truth. Nesse and Williams
(1) have recently pointed out that the use of psychoactive and
anti-anxiety drugs is producing hypophobic patients whose abnormal lack of
inhibitory fears is causing them to make irrational and foolhardy
decisions.
Nesse and Berridge (11)
have also noted the potential dangers of psychoactive drugs: "they are inherently pathogenic because they bypass adaptive information processing systems and act directly on ancient brain mechanisms that control emotion and behaviour. Drugs that induce positive emotions give a false signal of a fitness
benefit." These workers continue: "our understanding of the functional significance of negative emotions grows slowly, while new psychotropic drug development races far ahead at a furious pace. We lack the scientific knowledge about emotions that would support detailed advice on when these agents should or should not be
used." These concerns are reinforced by the "unintended
consequences" that have resulted from the introduction of
tranquilisers, sleeping tablets, narcotics, and other so called
"social drugs". If we add alcohol to this list it is abundantly
clear that many people will enthusiastically accept any chemically induced
stupor or insolation from reality. Rather than seeking to further
facilitate this journey into a dream world, doctors and pharmaceutical
companies should be promoting treatments which restore an accurate
perception of reality.
According to Nesse (10),
although antidepressants do not normally cause "euphoria",
they do nevertheless prevent normal inhibitory emotions such as "fear"
and "sadness" which serve to protect us from making
irrational or foolhardy decisions. I should point out however, that
virtually all antidepressants may induce a state of euphoria or "mania"
in manic depressive patients (13,
14, 38,39,40,41,42,43,44,45)
and perhaps also in others who have no history of manic depression (57,58,59).
As has been noted by the American Psychiatric association (51),
"virtually every available antidepressant agent has been
associated with the emergence of mania in bipolar patients."
This also applies to the
over the counter antidepressant,
SAMe (12).
Symptoms of mania include euphoria, aggressiveness, overactivity, insomnia
and reduced need for sleep, talkativeness, excessive religious fervour or
fanaticism, excessive and uncontrollable spending, lack of insight,
overbearing and intrusive behaviour, unrealistic ambitions, excessive risk
taking and lack of concern about consequences (15,16,
17, 18,19).
People who are manic may also become violent. According to Soreff and
colleagues (46):
| "Persons in mania can be openly combative
and aggressive. They have no patience or tolerance for others.
They can be highly demanding, violently assertive, and highly
irritable. The homicidal element particularly emerges if these
individuals have a delusional content to their mania. They are
acting out of the grandiose belief that others must obey their
commands, wishes, and directives. If their delusions become
persecutory in nature, they may defend themselves against others
in a homicidal fashion." |
Considering the severe consequences that can result from mania, and in
view of the well known fact that "antidepressants can propel a
patient into mania" (46),
it is hardly surprising that antidepressants have been associated with
extremely serious consequences (47,49,52,53,54,55).
According to Murray (47):
- "Joseph Wesbecker burst into a Louisville, Kentucky printing plant in September 1989 with an AK-47 assault rifle after taking Prozac. He killed eight people and wounded 20 others before turning the gun on himself.
- The New York Times reported that El Sayyid A. Nosair was taking Prozac at the time he allegedly murdered Rabbi Meir Kahane, the founder of the Jewish Defense League.
- A woman reported withdrawing into herself on Prozac and plotting the death of her four children, while another woman on Prozac acted on her feelings and killed a friend and then herself.
- A woman held her psychiatrist "hostage" with a razor to her own wrist sued Eli Lilly (the manufacturers) concerning self-mutilations inflicted while taking Prozac. A defense attorney argued that a former teacher, while under the influence of Prozac, shot a woman to death.
- A thirty-nine year old woman suffered a striking personality change on Prozac, including "distraction, extreme agitation, restlessness, insomnia, homicidal ideation and actions," and strangled her mother to death.
- A woman on Prozac axed her husband to death, set him on fire, and then shot herself in the head with a hunting
rifle."
|
Increasing scientific evidence
links the use of antidepressants to various incidents of violence including the
tragic Virginia Tech school shootings as well as other school shootings
(61,
62,63).
To make matters even worse, doctors frequently fail to diagnose manic
depression until a severe manic episode has been precipitated by the
inappropriate use of antidepressants (50):
| "Patients with bipolar disorder,
particularly those who are undiagnosed or in the early phases of
their illness, often first seek medical help complaining of
depression. Inexperienced or inadequately informed medical
personnel often take these complaints at face value and prescribe
an antidepressant, which frequently induces an episode of mania in
the patient." |
While the diagnosis of manic depression frequently depends upon the misuse
of mania inducing antidepressants, the long term prognosis for such
patients, even after "correct" treatment is initiated, may leave
much to be desired. According to Perugi and colleagues (60):
| "Even with current therapies a
significant number of people with bipolar disorders have a deteriorative
outcome associated with the gradual disappearance of acute mania
with an increase in megalomanic delusions, alienation from loved
ones and decreased likelihood of medical and
psychiatric care." |
It should be noted also that manic depressive syndromes have been linked
to stress and elevated levels of cortisol (46)
while adrenal hormones such as cortisol and DHEA are also known to cause mania (see When
Changing Genes is not Possible). Not surprisingly, antidepressants may
be poorly tolerated in those who have steroid psychosis from elevated
levels of cortisol (56).
While antidepressants may not necessarily cause mania in the "normal"
person as they do in manic depressives, they do in fact, as has been noted
by Nesse (10),
block normal inhibitory emotions. According to Nesse (10)
in this regard, some patients "report that they become far less cautious than they were before, worrying too little about real
dangers." Like drug induced mania, loss of inhibitory or protective mechanisms as a result of
antidepressant treatment may also have tragic consequences. Gregory
and Jindal (37)
cite the case of a woman in an abusive relationship who was considering
terminating the relationship until she was treated with antidepressants.
In this case antidepressants seem to have been directly responsible for
the continuation of an abusive relationship. Another case cited by Gregory
and Jindal (37)
involved a depressed alcoholic whose desire for rehabilitation ceased when
he was treated with antidepressants. Gregory and Jindal (37)
point out, in regard to these patients, that they "continued to
lead dysfunctional lives, and their motivation for major lifestyle changes
seemed to decrease as depressive symptoms improved." The different effects of antidepressants in normals
(ie.
those with unipolar depression) and manic depressives may be simply a
matter of degree since this same mechanism (ie, loss of inhibitory
controls) appears to be operating in both cases.
It is clear from these examples that modern medical science regards
resolution of depression with lack of concern about one's health or
safety. Apparently antidepressants create an inability to perceive, or an
indifference to, threats to personal health and safety. How many doctors
inform their patients of these hazards before commencing treatment with
antidepressants?
Nesse (10)
also expresses concern about the possible consequences of antidepressants
upon the risk taking behaviour of large investors in the stock market:
"human nature has always given rise to booms and bubbles, followed by crashes and depressions. But if investor caution is being inhibited by psychotropic drugs, bubbles could grow larger than usual before they pop, with potentially catastrophic economic and political consequences. If chemicals are inhibiting normal caution in any substantial fraction of investors, we need to know about
it." While investor behaviour may be adversely affected by a
chemically induced removal of normal inhibitory emotions and a consequent
lack of perception of risks, I would be far more concerned about such
effects influencing politicians and others who occupy positions of power
and have the ability to affect thousands or millions of people. If such
persons are not fully in touch with reality then clearly the results could
be disastrous.
Nesse (10)
sums up the worrying aspects of psychoactive drugs: "the social effects of psychotropic medications is the unreported story of our time. These effects may be small, but they may be large, with the potential for social catastrophe or positive
transformation." The ability of antidepressants to transform a
"subordinate monkey" into the "boss monkey"
(see Over Adaptation) underlines
the dire consequences which may result when a number of employees are
treated with these drugs (1), a problem which becomes even more important
given the medical profession's ever increasing reliance upon
antidepressants (48).
The bottom line when it comes to hypophobia is that most persons are most unlikely to attend their doctors demanding treatments to increase their anxiety (1,
2). To take this a step further, normal people would also be most unlikely to demand treatments to make them less optimistic and more realistic. Few people today would be prepared to take off their rose coloured glasses - even for an instant. Added to this, many people in power would probably be unable to perceive the problem anyhow!!
It is abundantly clear that a fundamentally holistic approach to health care is absolutely essential if we are to overcome the constantly
occurring failures and limitations of orthodox medicine's fragmented reductionist approach. The massive amount of human suffering which has resulted, and is still continuing, as a result of medicine's anti-nutrition bias casts a very dark shadow over the
reputation of doctors and scientists, and even science itself. Science seeks
praise for its successes but it seeks silence and denial of accountability for its failures. Amazingly, although so many millions of people have suffered needlessly because of medicine's neglect of nutrition, this problem, and the suffering it caused, still remains
largely unrecognised in scientific circles. Since the problem remains unacknowledged and unrecognised, we are a very long way from
beginning to examine the attitudes and perceptual difficulties which led to this massive abandonment of common sense.
How can we possibly avoid repeating past mistakes when we have yet to identify the
mistake?
It is clear, from the past 100 years of medical history, that the
future direction of our health care system should be guided predominantly
by those whose perception ensures they have a more accurate grasp of
reality. The track record of many in mainstream medicine and science has
been exceedingly poor. They have repeatedly failed to foresee the
consequences of toxic drug treatments, the consequences of concealing
symptoms while ignoring causes, the consequences of suppressing the body's
natural defensive processes, and the consequences of ignoring nutrition.
In all these cases, concerns were arrogantly dismissed and even scoffed at
and ridiculed by most of the medical profession.
Many alternative practitioners on the other hand, have been able to
perceive the consequences of all these methods with total accuracy. We
must explore why this is so as a matter of absolute urgency. How could
so many in orthodox medicine be so blind to hazards which were so obvious
to others? Why is it for instance, that alternative practitioners were
aware of the importance of supporting the body's defensive processes
hundreds of years before mainstream medical practitioners? (see Darwinian
Medicine) How is it possible that virtually every mainstream scientist
and doctor in the world was unaware of the natural purpose of coughing or
diarrhea? Are alternative
practitioners better trained? Are they more intelligent? What is the
explanation?
Politicians, scientists and doctors now more than ever, should be
guided by that section of the health care profession which time and again
has proven to be so accurate at predicting well in advance the
shortcomings of modern health care. These insights are capable of
preventing
tomorrow's catastrophes.
The solution to the problems of hypophobia and disordered perception is obviously exceedingly difficult. However, the first step is obviously to create an awareness the problem exists and for this Nesse and colleagues are to be commended. They are showing the way in a very dark and unexplored chasm.
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