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What do you think you know?

My wife was preparing to give a presentation to a group on the effects of chronic pain on depression and she made an interesting point to me that I think is worth sharing.  First of all, she knows a lot more about the brain than I will ever know.  Apparently there are more parts of the brain than one big “gray-smooshy” part; so that was a good reminder of high school biology and I learned something!

After getting me back up to speed on the brain parts she made a point that struck me as very interesting and a bit counter-intuitive.  I had always been told that depression, while it can be caused by many different things, has a single physiological description which is that it is at its core a chemical balance problem.  Basically the monoamine theory (big word, I hope you are impressed!) states that depression is primarily an issue of a chemical imbalance in the brain.

The common anti-depressants in use today; Prozac, Effexor, Wellbutrin, Adderall, etc. all work by manipulating the various chemical concentrations or our brains ability to absorb/connect to them.  This theory first developed the early 1950’s and the resulting pharmaceuticals have been the standard of treatment since then.

There has always been a nagging problem with this theory though.  When a patient takes the medication the brain gets washed with these chemicals almost instantly…so why does it take a minimum of 2 weeks and up to as many as 6 or 8 weeks for a depressed patient to feel better after being treated?

The theory that explains this is basically that the brain has adjusted to the low levels of good chemicals in the past and that the brain needs a proverbial wall broken down before it can be appropriately sensitive them.

As I’m sure you are beginning to guess, there is a new idea which better explains all of this and is causing some second thoughts in the medical world.  First let’s start by describing where this monoamine theory first came from.  In a phrase…they backed into it.  A drug called Reserpine, which was used to treat high blood pressure, also caused depression.  They determined that it shut down the brain’s ability to absorb the good chemicals so it only made sense that these chemicals and the wiring in the brain was the problem.  Around the same time, another drug, Iproniazid was found to cause “euphoria” in patients; this drug takes the brake off of our brains ability to absorb the happy chemicals.  So with these data points, they did some correlating studies and suddenly they have a model which solves depression!

Like many problems in our businesses they found a data point and associated it with a known and like magic a massive industry is created!  Last year in the US we spent over $12 billion dollars on these pharmaceutical solutions to a very real problem affecting 9.5% of all US adults.  For the record, I have no problem with these drugs and the massive and demonstrative decrease in suicides and increase in productivity more than justify the importance that the drug companies have been putting into these medications.  I just disagree with how they got there…and the more than $1 billion spent on advertising last year for one drug alone.

The real problem that I’m bringing up is that new research is showing that the drugs don’t do what we think that they do, or at least not directly.  Certainly they increase the good chemicals in our brains…but it doesn’t appear to make the patient less depressed.  Scientists are proving that the real physiological description of depression is not one of a chemical imbalance but rather that unhealthy nerve-cell connections are being found in the regions of the brain that create our emotions.  Guess what, these antidepressants have an effect here, a side-effect is that they stimulate growth of new nerve cells in this area of the brain after a few weeks of taking the medication.

So to recap, we have a tried and true solution for depression which is based on years of study and research and it is a side-effect.  Yep, we’ve been throwing billion dollars at a “close enough” solution.  Not that it is all bad, but it was still a misguided effort because doctors were tied into believing a correlation and assumption that simply wasn’t what they thought it was and they could have been looking for something with fewer side effects and a more direct positive influence.

So let me bring this back to business intelligence for a second.  The reason for this blog is that I’m seeing more and more cases of people using power BI tools to simply confirm relationships that they already know…or think that they know and understand.  They want the new system to just say the same information…in a different way.  They aren’t looking to challenge any assumptions or currently held beliefs.  One of the huge powers of BI is the ability to find unknown relationships or contrary indicators and yet we don’t use the tools to find them for a myriad of reasons that seem good at the time.

Here is a check list of sorts to see if you are just using your BI investment to tell you what you already know:

  • Does your BI landscape tell us something that we are surprised about more than once a month?
  • Do the change agents (you know, the people no one likes) in your organization seek out your data and access to your tools?
  • Do you change business rules and formulas until the data “looks right”?
  • Do you have reports and dashboards which are designed to disagree with your organization’s business plan?  i.e. shows that the marketing increases don’t increase sales for instance.
  • Do you have someone assigned (and evaluated on their performance) to be a devil’s advocate?

In the end, I think the real question everyone should be asking is that if your entire BI solution has been defined and built to satisfy your current vision, perspective and plans…then not only are you not taking advantage of the investment that you’ve already made in your BI space, but you also have no chance of finding the next paradigm shifting idea and discover that maybe you were off-base all along!

Now this challenge I’m offering isn’t for the faint of heart, think for a second about the doctors who are researching this alternative theory of the biology of depression.  How many friends do you think that they are making?  They are researching to show that this massive industry is off-base and that the billions being spent on these drugs are misdirected.  They are researching to show that everything that we’ve ever known about depression and everything that they were taught since high school health classes is off, that every doctor and scientist working on it was misled by a fundamental bias which they should have been prepared for.  The question is of course, is it worth it?

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