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Etiology and symptom- what is the missing link?

Posted by Kev on February 1, 2000, at 20:08:51

It seems to me (albeit my knowledge of the lit is very limited) that the scientific study of depression, anxiety, etc. either stays at the level of cataloguing symptoms (in which case it resembles pre-modern medicine [cf. Foucault, "The Birth Of The Clinic], or else it goes too far in the other direction and focuses exclusively on some hypothetical underlying patho-physiology (malregulated serotonin re-uptake, etc.). In both cases, what seems to be missing is an account of the link between cause and effect: what are the mechanisms which translate an underlying pathology into a given behavioral syndrome?
This question is particularly relevant in light of the hypothesis that depression and many anxiety share a common underlying cause (since they all respond to anti-depressants of one sort or another), which implies that they are variable manifestations of the same underlying phenomenon. In order to start to make sense of this, it seems appropriate to try to conceive of a common mechanism- itself the effect the chemical imbalance- which is capable of undergoing variable transformation.
The thought of Freud has fallen into disrepute these days, and with good reason, but Freud- who was a genius in the field of scientific concept formation- postulated the existence of a generalized neural energy, which (by way of condensation and displacement) undergoes variable transformations and is thus manifested at the level of concrete behavior in the form of various mental disorders ("neuroses", etc). I am not advocating the revival of Freud's semiotic approach to understanding these transformations (doubtlessly we won't get far in trying to elucidate the symbolic meaning of depression vs. that of panic, etc), but the general hypothesis seems like an eminently elegant way to conceptualize the phenomenon, and the goal of scientific knowledge is to construct simple models which can subsume the most possible facts.

-Kev


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