On Psychosomatic Illness

I don't know anything about Fibromyalgia, yet I wince when someone says it's psychosomatic. I wonder about almost any conditioned considered psychosomatic now.

I realize I'm using the term in the vernacular to mean "it's all in your head". That's how it is largely understood even though, technically, psychosomatic illness can refer to anything without a medical explanation. People communicating with the public have to understand the common usage of the term as it's being heard.

Jane Brody wrote about the concern with this label almost a decade ago (in full at the very bottom):

"When I was given a diagnosis of breast cancer in February 1999, many friends and readers wondered: 'Why did you get breast cancer? You take such good care of yourself!' . . . It seems that many people believe that if you do everything 'right', bad things won't happen. But bad things can and do happen. And they happen to the 'best' and the 'worst' of us. . . . If you're blessed with good health, you can say, 'I did it.' But if you lose your health, you know that external forces beyond your control can get in your way. Healthy people tend to act as if beneath every sick person is a healthy person trying to come out. . . . 

Wasn't it Susan Sontag who pointed out that whenever the cause of an illness is mysterious, it's assumed to come from psychological problems or a moral weakness? And once science finally figures out the medical root of the illness, that assumption disappears. Will we one day have a better -- that is, more scientific -- understanding of ailments like chronic fatigue syndrome, fibromyalgia, Gulf War syndrome, multiple chemical sensitivities or any of the other current 'wastebasket' diagnoses that many medical and lay people consider psychosomatic? 

I certainly hope so. After all, we now have scientific explanations for past 'mysteries' like depressions, PTSD, fainting spells and ADHD. And we now know that autism, migraine headaches, and [transgender] are not caused by bad mothering. . . . We should not be too quick to dismiss symptoms that seem to lack a physiological basis. A little empathy can go a long way while medical scientists continue to uncover physical explanations for what may now seem to be psychosomatic symptoms."

More recently Brody wrote about how far people have come in understanding ME/CFS. Studies have found possible viral causes for ME/CFS, taking it out of the realm of psychosomatic illness for many. We have learned so much in studying how the HIV virus affects the body in a multitude of ways, and now we're seeing that with how the SARS-CoV-2 virus leads to Long Covid with a multitude of organs effected in a variety of ways. 

ETA: And this article came out 19 years ago:

Here's the thing: If we didn't know about or isolate SARS-CoV-2, for instance, like if people got Long Covid years after getting a virus that didn't have fatal acute cases, then the Long Covid cases might not be seen as remotely related to an earlier case of a random flu -- and many of those cases would be seen as psychosomatic. 

Even with all we've seen, even with proof of Covid's effects in the bloodstream, many people are still ending up in front of doctors who tell them their Long Covid symptoms are due to stress or not enough exercise or whatever and not actually treating it because they don't know how to treat it. I get that from a psychological point of view - that it's very uncomfortable for someone with high academic success to have patient after patient without a clear path towards healing. Having no answer to a question in our field of expertise is hard for the best of us. And saying it's just stress has been an accepted practice. But it's still a shitty thing to do.   

So why are some people still so confident that fibromyalgia is psychosomatic? It would be miles better to hear that fibromyalgia seems psychosomatic at this point, opening up the possibility that one day they'll find a virus that causes that particular collection of symptoms in people. I mean, who knows?!? Science isn't done sciencing. 

ETA: A study just out used an MRI to compare brain neurochemical levels in people with Long Covid, ME/CFS, and healthy controls. They found a signficantly elevated levels in both Long Covid and ME/CFS participants. 

"Long Covid and ME/CFS have a remarkably similar neurochemical signature, providing further evidence for a significant link betwteen the two conditions. This novel study reveals the level of neurochemicals in the brain were associated with symptoms such as cognitive impairment, unrefreshing sleep, pain, and physical limitation in Long Covid and ME/CFS patients."

You'd think from looking at AIDS, ME/CFS, and Long Covid that we'd wake up to the reality that some viruses floating around cause profound long term problems affecting our ability to function, and just maybe we should be focused on cleaning the air everywhere and wearing masks anywhere people might be vulnerable to catching a virus. We don't have to live expecting to be invaded by a virus a few times a year. That's a choice we made before we had the tools to change that reality. Now we can us ventilation, filtration, and upper room UV to dramatically improve our health and well being.  

ETA: I just found the most infuriating diagnostic criteria for a psychosomatic disorder:

"In addition to the somatic symptom itself (for example, pain or upset stomach), people with psychosomatic disorder often:
* Become angry or irritable because they believe their medical needs aren't being met
* Get depressed or anxious
* Visit healthcare providers frequently, often jumping from one physician to another
* Experience difficulties functioning at work, school or socially."

So, if you have a condition that every doctors misdiagnoses, don't show any anger or report anxiety, and stop jumping from doctors to doctor or having problems at work or else, somehow, it proves it's all in your head and not, just maybe, a list of very normal reactions to being misdiagnosed over and over again. 

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