Discussion in 'Fibromyalgia Main Forum' started by lenasvn, Aug 3, 2006.

  1. lenasvn

    lenasvn New Member

    A New Mental Illness?

    By Frank Albrecht

    From the CFIDS CHRONICLE, July/August, 1999

    Used with permission


    My daughter is the only person I’ve ever known who can strain an ankle while standing still on a carpeted floor. If you look at her too hard one of her joints can pop out. Her life is filled with sprains, strains, and dislocations—name something bad you can do to a muscle, joint or ligament and she’s done it more than once. "Accident prone," people said. "School avoidance," "Attention getting," "drug seeking," they said. All those kinds of things. Finally she was diagnosed with Ehlers-Danlos Syndrome, an inherited collagen disorder that is common among young people with Chronic Fatigue Syndrome (YPWCs)—and which causes sprains, strains, dislocations, and pulls! It wasn’t mental or attitudinal after all—though none of those who said it ever apologized.
    She also has had severe abdominal pain. Sonograms, X-rays, CAT Scans, MRIs—nothing! All in her head, they said. Exaggeration, bad family dynamics, could be it’s Munchausen Syndrome by Proxy, certainly there is No Physical Cause! The TESTS are negative, they said, and that proves it! It’s mental!

    Finally a specialized scan showed a condition my wife and I had never heard of—varicose pelvic veins. Most doctors have never heard of it either. It’s an extremely painful condition that’s hard to detect.

    The veins were fixed and the pain is gone. But again, no apologies.

    It’s certainly common for person with Chronic Fatigue Syndrome (CFS) to face disbelief from practitioners, friends, and relatives. People get just absolutely sure you have a mental condition. I call this hysterical medicine. The doctor does his exam. It’s negative. He rounds up the standard suspects by doing whatever tests occur to him. These too are negative. So he decides without further consideration that the cause is in the mind. "Been under a lot of stress lately?" he asks. "Problems at school?" he asks the kids. "How’s your marriage doing?" he says to adults. And if the patient says "No, no problems, except that I’m sick," then of course the point is proven. She’s in denial!

    This doesn’t just happen to people with Chronic Fatigue Syndrome (PWCs)! Recently a physician told me about the case of a woman with projectile vomiting caused by paralysis of the stomach. The treatment should be a surgically implanted feeding tube. But the surgeon insisted the patient had anorexia nervosa and put her in a psychiatric ward. Eventually she was diagnosed with an atypical multiple sclerosis (and got a feeding tube), but not before she had to endure months of frustration and humiliation—and no apologies, either!

    Hysterical medicine has a long history. In the 13th Century, for instance, people "knew" you wouldn’t get bubonic plague if you lived a simple, carefree life with many enjoyable but not overly stimulating activities. In the 18th century gout was regarded as a payback for overindulgence in liquor and luxury foods. In the 19th Century everyone understood that it was emotionally sensitive people—poets, painters, artistic people generally—who got tuberculosis. The 20th century has been no better. When I was in graduate school in the late 50s we took for granted that asthma was a direct outcome of unresolved Oedipal conflict, and until the 90s everyone I knew accepted as fact that ulcers come from stress and working too hard, being too competitive.

    Plague, tuberculosis and ulcers are caused by bacteria, asthma starts with allergy and creates physical alteration of the airways, gout in a metabolic problem. The fact is that no illness affecting a diverse population has ever turned out to be primarily or predominantly mental. It is hard, though, to get this point across.

    I work in a large mental health clinic and often see people with CFS or CFS related problems. Getting them appropriate medical help is difficult. Recently, for instance, I saw a 17 year-old who had been on home instruction for a year because of dizziness, weakness, fatigue and visual problems. She’d had an extensive workup at a University Medical Center without getting any diagnosis at all. Everybody said she was a mystery. So I got her. Maybe she was depressed! Yet her symptoms fit the pattern so often seen in CFS, and she also had obvious orthostatic problems (sitting or standing made her symptoms worse). I gave her a "poor man’s" tilt table test, ten minutes of quiet standing. At the end her hands and feet were purple, her heart was going too fast, her dizziness, pain and visual problems had increased, and she could no longer stand up without support. I sent this information to her primary. He phoned me and said he could find nothing wrong with her! My client’s mother then went in to see him, then went again, and again. Finally he consented to refer her to a cardiologist for tilt table testing. After a positive test the cardiologist put her on some medication and she’s now a lot better.

    The primary produced no apologies—of course!

    In my business we have a diagnostic manual, the DSM, that lists all the mental disorders and their criteria. It’s put out by a psychiatric association. I’m going to write this group proposing that hysterical medicine is an overlooked mental illness, afflicting many physicians and some members of the general population, characterized by irrational beliefs in imaginary illness causes, deficits in good manners, and inhibition of the apology reflex.

    What do you think? If they turn me down, will they apologize?

    [This Message was Edited on 08/03/2006]
  2. lenasvn

    lenasvn New Member

    I met a physician in Seattle for a short visit, and he was very young, and very openminded too. Unfortunately I don't live there anymore. He was neat, he unexpectedly asked me:
    "what do YOU think it is?". At the time I was there for lots of sinus pain.

    He didn't find any inflammation with ultrasound, but went by my judgement and treated my sinus pain as such since I felt this is what my problem was. It prooved I was right.

    I think I need to move back there and find him now when I hopelessly try to get a diagnosis,,,LOL!
  3. lenasvn

    lenasvn New Member

  4. lenasvn

    lenasvn New Member

    You said:"Ahhh! My question is, did they run the standard tests, or did they take the time to do other tests that could show there really is a problem? Failure to run the correct tests is also one of their symptoms!"

    EXACLY! There are TONS of tests they can do! Odd,unusual ones, or, like in the old days- ask a collegue if they don't have the answer themselves.

    I also thought of something funny: In Sweden it's not unusual (rather the norm) for a doc. to pull out books and medical research papers from the shelves and start reading while you sit there. It might be seen as bad in some countries, but I appreciate a doc. daring to look for something he doesn't recognize!

    I'll rather have him admit his imperfection right in front of me than sit there and be a "know-it-all".
  5. victoria

    victoria New Member

    is not running any tests and assuming for some unknown reason it is 'somatisized', the new word for psychosomatic, which in turn replaced 'hysterical'...

    My DH was a psychologist and had referred to him by a neurologist a patient for psychosomatic foot pain... but no one had done an x-ray. DH sent him to a podiatrist, and guess what, foot was fractured! (Can any one say 'duh'?)

    He also had a woman sent to him for help with 'mysterious' symptoms who'd been suffering for years... while MDs had run tests, no one knew what was wrong. He told her to keep looking, he felt it was real. A couple of years later he heard back from her that she was finally dx'd with brucellosis.

    There was a study a good while ago that found upwards of 60-70% of pts originally dx'd with psychosomatic, excuse me, 'somatisized' disorders were found to have real disorders eventually. Woe to those who still hadn't gotten a dx...

    also read that for chronic lyme pts, it takes an average of $65K spent to finally get a dx...

    all the best,

  6. lenasvn

    lenasvn New Member

  7. Seeseaisme

    Seeseaisme New Member

    I was in a huge flare . I was working full time, had just moved into a new house, and my father was hospitalized and lost kidney function. I was, at that time, being treated for pneumonia, bronchitis and asthma. I had to check in at the doctor's office about every 5 days for 3 weeks.

    My usual primary physician was always overscheduled and I would see a phsysician's assistant for my follow-up visits. I told her I was so sore and tender along my collar bone and chest, I felt like someone had beaten me.

    The PA then proceeded to "poke" and I mean really hard every tender point for fibromyalgia and I almost screamed, it hurt so bad. She then looked me in the eyes and said, "I think its fibromyalgia, it's a psychosomatic thing".

    Okay, so what? Now I'm a dumb blonde that doesn't know what that means, so it's okay to just go ahead and tell me that I'm nuts. It really peed me off.

    I fired that doctor and found a new one. My current physician is a caring, sweet man. He does look up information on the computer, in front of me. He excuses himself and brings his medical books back to the exam room and looks up info. He checks the meds I'm on against what he will perscribe for me to reassure me there won't be drug interactions. I have psoraiasis (spelling?) on my feet and he even takes my shoes and socks off without gloves and checks out my feet. I think he's great, and I trust him 90%, not 100%. He is human after all.

    Well, that's my 2 cents worth.

    Have a great day, Seeseaisme
    [This Message was Edited on 08/04/2006]
  8. lenasvn

    lenasvn New Member

    I'm glad you finally found a doc that works for you!

    Can I borrow him by any chance? LOL!

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