Let’s start with a quick definition of the terms disease and illness. Then I’ll look at the idea of health and wellness as being on a continuum rather than a yes/no situation.
The shortest and most eloquent definition I’ve found for these terms goes as follows:
“Illness is what a person feels on the way to the Doctor’s office, disease is what they have when they leave.”
For a more technical look, we return to Dictionary.com:
Disease: noun – a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness;sickness; ailment.
Illness: noun – unhealthy condition; poor health; indisposition; sickness.
Defining wellness using terms like disease and illness brings up some issues. First, the two don’t have to have anything to do with each other. Next, putting disease/illness opposite wellness necessitates seeing things in a good/bad kind of way – and that’s not always the case.
Disease is a malfunction of an organ or system in the human body and illness is – well, it’s “feeling bad.” Put another way, disease resides in the body, illness in the mind. Where does this take us in terms of our discussion of well-being? It takes us to the idea of the Sense of Coherence and to seeing health and well-being as existing on a continuum, that “health” is a heterostatic thing that will change over time, rather than the more pervasive idea that it is homeostatic (you’re either healthy or you’re sick, there is no middle ground or grey area).
OK, now we pause for more definitions. The Sense of Coherence is an idea put forward by Aaron Antonovsky in 1979 as an attempt to explain why some people got sick and others didn’t. To quote directly from Antonovsky:
Sense of Coherence (SOC): A global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (1) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable and explicable; (2) the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement.
In other words – a person who has the resources to deal with what comes their way, and knows they have these resources, has a high SOC and stands a better chance of staying healthy. The short version – a high SOC can stop an illness from becoming a disease. There are several factors that go into an SOC, and many scholarly articles have been written on the subject – however for our purposes I’m going to leave it there.
Homeo- and hetero- stasis are terms describing the condition of our internal systems in the face of constantly changing external conditions. It’s long been assumed that “health” was a homeostatic condition. Either you were healthy, or you weren’t. Health was seen as a set point that a person’s body either was at, or they weren’t healthy.
The idea of health as being heterostatic is a newer concept that grew out of the investigations into SOC. In essence this idea states that human health is a moving target. What health means for someone at age 24 is one thing, when that same person gets to 42, that definition will likely have changed. This also applies one person to another, what I consider healthy for myself is different than what the person sitting next to me as I write this considers healthy for themselves.
What was I talking about? Oh yeah, disease vs illness. We can now see that a person can have an illness without having a disease – and that it’s also possible for someone to have a disease without the accompanying illness. There are also multiple stages in between, depending on each individual’s SOC and ability to deal with what they’ve been handed healthwise.
What does all this add to our discussion about wellness, besides muddying things up real good that is? It highlights what I said way back in part 1 – that wellness is a moving target. What I hope you take away from these 3 posts is that wellness and overall well-being is not one static thing. Achieving it takes work. It takes accountability. It takes time. And most importantly for today’s discussion – it takes experimentation. Trial and error is how I lost 80 pounds. The key is not seeing the errors as failures. They’re signals that you might want to try something different. That’s all.
And now for the obligatory self-promotion. If you think you want to get started making some changes in your well-being and aren’t sure where to begin – get in touch. Initial consultations are always free, and I’d love to talk you through some ideas and see if working together will benefit you in your wellness journey.