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Invisible Illness

David Epstein, MD, MS, FAAP explores why we respond differently to visible and invisible illnesses or diseases.

Reflecting upon some curiosities in medicine, my mind wandered to how humans fear illnesses and diseases that they can see with their own eyes more than those maladies that they can’t see.

Of course, there are exceptions, but I have generally noticed that people respond differently to visible and invisible maladies. What is it about the things that we can see versus those we can’t?

In the pediatric intensive care unit and urgent care, I have seen the strongest medical staff’s resolve waver at the prospect of examining a child with lice. Never mind the fact that they have been surrounded by a host of viruses and bacteria that can actually make them sick. I have never seen anyone ever get sick or die from lice, but the viruses and bacteria that abound in these pediatric facilities write a different story.

The benign lice diagnosis often gets the isolation treatment and the staff pile on their personal protective equipment while kids with obvious viral illnesses who cough and suffer from runny noses like faucets generally do not foster the same concern from those around them. This has changed a bit, since the pandemic started, of course. But, prior to the pandemic and, currently, as everyone is becoming more comfortable with COVID-19, people are more relaxed and their health protection behaviors are not as meticulous as they were at the height of the pandemic. However, lice, pox-like rashes, and other visible diseases always trigger meticulous transmission protection for those who are exposing themselves to these visible diseases, and their behavior never wavers.

Another invisible disease has to do with mental health. Again, the pandemic has brought mental health to the forefront with all of the mental trauma, grief, anxiety, and burnout that it has caused. However, someone else’s mental health issues are something that we can’t necessarily see and can’t personally experience. So, the tendency is to take these issues less seriously. The stress of a job or the mental anguish that one experiences with a traumatic event are just very simplistic examples of mental health issues that are likely taken less seriously than the visible terror witnessed by someone who was stuck in a room with a lion. Again, it is the enemy that you can’t see versus the enemy that you can see.

 

someone else’s #mental health issues are something that we can’t necessarily see and can’t personally experience. So the tendency is to take these issues less seriously. Click To Tweet

 

So, what is it about the dangers that we can see versus the dangers we can’t see that make us respond differently? Our senses provide us with information about our environment. While smelling, tasting, feeling, and hearing are important for processing the dangers of our world, vision seems to be what we rely on the most. Seeing something brings a sense of reality to the danger. If viruses and bacteria were things that we could see with the naked eye, then we would likely pay more attention to them like when we see a line of ants marching through our kitchen and swarming some food that we forgot to put in a sealed container. If there was a way to visualize poor mental health with a special device that showed that it was real, tangible, and quantifiable, then it would likely garner more attention than it currently does.

 

If there was a way to visualize poor mental health with a special device that showed that it was real, tangible, and quantifiable, then it would likely garner more attention than it currently does. Click To Tweet

 

In the end, I have no brilliant insight into this query, but I can’t say that it doesn’t have something to do with the old saying, “out of sight, out of mind”. The fact that we can’t directly see a danger may make us feel that it is not as real or urgent. The invisible threat may not capture our attention in the same way that a visible one does. And, maybe, it is just as simple as we feel that something doesn’t actually exist if we can’t see it.

Do you feel like people respond differently to illnesses that they can see versus those that they can’t?

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