What Constitutes A Disease?

I have a confession to make.

I am not proud of this, but I have vowed to be as honest and representative of myself as possible on this blog and I owe you guys the truth:

I watch Celebrity Rehab with Dr Drew.

There. I said it. In fact I more than watch it. I am quite addicted to it. Yes, I am addicted to a show about addiction. There is some kind of pathetic irony there. But I’m not going to explore the pathetic irony. Not today, at least, but I do admit that it is a terrible thing to be addicted...  To anything!

Now, for another admission: I have to admit that my addiction to Celebrity Rehab is not quite as harmful to me as my fascination with the show Intervention. I used to love to enjoy a glass or wine or cognac while watching Intervention, which even I admit is kind of weird.  Celebrity Rehab does not inspire the same alcoholic cravings for some reason. Maybe just for some spicy food, which is not yet known to be bad for someone with my conditions (give it time. Eventually everything I love will be Verboten).

But one thing that puzzles me in the show is the constant references to addiction as a “disease”.  "It’s this disease, man! It’s the Dizeeeze”

Hmmmm.I have to admit that while I know –only too well- that alcoholism and other addictions can be really bad; life threatening, life altering and life ruining -I don’t want to take anything away from that. However, I have trouble getting my head around the concept of alcoholism or similar as a disease. I always thought of a disease as something that invaded the body. Or caused the body to attack itself. In other words I always thought of disease as being completely involuntary.

Let's face it: Alcoholism is not completely involuntary. There is a voluntary element. An element of choice. I am not saying it is an *easy* choice, but choice is there;- as opposed to something like cancer or Lupus, which is just going to come and get ya without a bye or leave.

I looked up the word “disease” in Webster: This is a partial excerpt:

dis·ease

 2: a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms : sickness , malady

OK no mention of voluntary or otherwise. Just a condition of the living body that impairs normal function. I suppose alcoholism fits that definition. Certainly the drunk alcoholic fits it.

But what about the sober alcoholic? Is normal function impaired then? If a person has a physical dependence; then yes. A physical dependence probably indicates progression to the point of disease.

But what about the person who only has a mental or emotional dependence? Or who binge drinks and can go for weeks or months sober?Is it still a disease then? This is what confuses me. And probably many other people with medical issues. And maybe even some people with alcoholism.

And I wonder about the whole concept of “disease”?  Because to me, the word suggests a lot more that the Webster definition: To me, there are implications of happenstance, as opposed to choice; of  treatability (check), and of …invasion.  I always see “disease” as the body being under attack; either by infection, cancer, autoimmune or a deficiency of some kind (beri-beri, scurvy, Fabry's). And often progressive.  However I see most disease as having a cure or a treatment. Disease is –or can be- transient.

I don’t consider that I have a disease. Correction: I don’t think of any of my known diagnoses as “diseases”. Ehlers-Danlos Syndrome is a genetic condition with no cure.

And if I am not diseased, what am I? And what is an alcoholic if not diseased?

I looked up a few other words, to see what Webster’s had to say about them. All are nouns, except interestingly; “Disorder”, which is a transitive verb

 

sick·ness

1 a: ill health : illness b: a disordered, weakened, or unsound condition

2: a specific disease

3: nausea , queasiness

 

con·di·tion 

4 a: a state of being <the human condition> b: social status : rank c: a usually defective state of health <a serious heart condition> d: a state of physical fitness or readiness for use <the car was in good condition> <exercising to get into condition> eplural : attendant circumstances <poor living conditions>

dis·or·der

to disturb the order of

2: to disturb the regular or normal functions of

3: a disease or disorder of the animal body

4: an unwholesome or disordered condition

mal·a·dy 

1 : a disease or disorder of the animal body

2 : an unwholesome or disordered condition

ill·ness

wickedness unpleasantness

an unhealthy condition of body or mind. "sickness"

I think if I wasa going to choose any of these for alcoholisam, it would be "malady". Because alccholism is certainly unwholesome and disordered.

But I still haven't really found any words that I think really apply to me. And I have been sitrting on this post for days, trying to work out why. I tihnk I have finally figured it out:

There is ony one word I want to use in application to my health, and I am going to keep fighting until I can apply it:

That word is "Well".

Yes, I know you guys are going to say I am in denial, but I have to believe that I can be -if not well then ...well, ...weller.

Comments

[yanub]

I certainly wouldn't call EDS a disease. I am not even certain about calling it a disorder. A condition, yes, that makes sense. A heritable condition that has its plusses and minuses, though some people mostly get the plusses and others mostly get the minuses. Even addiction--well, maybe the ability to become addicted isn't so bad. Maybe people who become addicted have some other associated trait that is a good thing, the way being able to easily pick things up off the floor with our toes is a good EDS thing, or wash our backs without a scrubby, or clean the bottom of ice tea glasses without a special brush. The doctors always ask me why I don't take XYZ medicine everyday as prescribed, and my answer is always the same. I just can't get into the habit. And I wonder, maybe having a propensity for acquiring habits is something addictive personalities have that I don't.

Autism--there's something else I don't think of as a disease or a disorder or a malady. It's a condition, too. Not necessarily bad, not necessarily something to get rid of. Something to take into account and live with. Like being lefthanded or having oily skin.

Seizures, though, that's a disorder and something it would be nice to have cured, no matter what the condition that brings them about. And a dislocation or hemorhage--those need to be cured. And a health-threatening addiction, like heroin or tobacco, needs to be cured.

Now I'm wondering...it's the normal, healthy condition for humans to have certain bacteria on our skin and in our guts. But either too much or not enough of any particular type can make us virulently ill--can cause disease. Maybe, then, what disease is is a lack of balance.

Well, this appears to be making less and less sense, so I appear to have come to a natural end. Good bye, cruel paragraph!

[One Sick Mother]

Yanub,

Yes. I hear you on the lack of balance thing; the whole "hemeostasis" issue. I totally get that (because I'm there).

And indeed the same argument may translate to alcoholism and other addictions. That people are self-medicating to redress an imbalance is certainly possible, and indeed is well documented in some conditions, most notably bipolar disorder.

It is easy to talk oneself into a circle on this stuff, isn't it?

But it's an interesting topic to explore, all the same.

[Lisa Moon]

Late comment, but here it is nonetheless.

I've wondered the same thing, actually!

I have Complex Regional Pain Syndrome (CRPS), formerly known as, and still often referred to as, Reflex Sympathetic Dystrophy (RSD). CRPS develops often after an injury - even a very mild one - which triggers a reaction in the nervous system... it's a syndrome, which means mostly that they still don't know all the Whys and Hows, and are still learning so much. In a nutshell, the nervous system is 'stuck' in the phase of acute injury, even when the injury is healed. It also progresses, causing muscle spasms and can lead to bone density loss and more.

I didn't 'catch' anything contagious and I don't have something growing, like a tumour (thankfully). Although I've seen people refer to CRPS/RSD as a disease, I tend to think it more fits the term 'disorder' or perhaps 'condition'.

I have to say, I've used the word disease when trying to convey a sense of severity in a couple of situations where the explanation was extremely limited.

Also, when I was in school studying social work, we did cover topics of addiction. I, too, questioned the use of disease for alcoholism, to some controversy. It seems like a way to deflect responsibility, which doesn't seem to fit with my understanding of recovery; doesn't one need to take responsibility for their alcohol use/abuse?

I certainly do NOT want to offend or hurt anyone with my thoughts.

Your comments above about self-medicating is also quite an interesting point. But as you say to 'redress and imbalance' is that disease, or dysfunction?

Might be splitting hairs to some, but it's certainly rich fodder for thought! Thanks for the posting. :)