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Your post highlights some of the disconnect between doctors, patients, and research: Psychosomatic absolutely does not mean "lazy," but that's why so many peopl

Your post highlights some of the disconnect between doctors, patients, and research: Psychosomatic absolutely does not mean "lazy," but that's why so many people are resistant to the idea. Psychosomatic means "of mind and body." It means physical symptoms that are caused or aggravated by mental conditions. The key phrase here is "or aggravated by," which doesn't rule out a physical cause but does suggest that addressing the psychological aspects can, at minimum, improve some of the situation. The problem is that patients get the wrong impression that their physical concerns are being dismissed and thus they reject anything to do with a psychosomatic suggestion. I'm not suggesting that CFS is purely driven by mental health, nor are the doctors or studies that show improvements from CBT. What they are suggesting is that CFS patients, for whatever unknown reasons, benefit from CBT and other mental health treatments, regardless of the underlying cause.

Klinky 11y ago
I was suggesting the diagnosis of "Psychosomatic" was lazy on the doctor's part. I went into a doctor's office 10 years ago with digestive problems, and the doctor was ready to write me a prescription for anti-depressants within 15 minutes, without a single test run. Visits to gastroenterologists weeks later, and subsequent visits to counselors and psychiatrists were not helpful. I was dealing with gastroparesis, which is often not diagnosed correctly. Doctors instead suggest the patient has an eating disorder or blame it on anxiety. The truth is, there are a lot of uncaring shitty doctors out there. If you're on the fringe and don't fall into the DSM, good luck. You absolutely have to advocate for your health, because often your doctor isn't going to. At least in the U.S., most doctors aren't going to walk you through the process to get setup with CBT, and your health insurance may consider it a mental health treatment, which has additional limitations on it. If you combine being skeptical that your doctor is using mental health as a cop out, and then it's a pain in the ass to get started, you're going to be more resistant to it. It's great CBT works for some CFS patients, just like mindful meditation works for some people with chronic pain, but in no way should it be treated like a cure or a reason to stop researching it, just like we're not going to treat meditation as a cure for chronic pain.
- cpncrunch 11y ago
  My guess is that it wasn't laziness on the doctor's part, but he/she looked at your symptoms and diagnosed it as most likely psychosomatic based on the evidence you presented. Was there another cause of the gastroparesis in your case? I've experienced gastroparesis myself due to stress, and I would imagine that is the most common cause.
  - Klinky 11y ago
    Not lazy to assume anxiety without reviewing colonoscopy, EGD & gastric emptying study results? Perhaps I was showing signs of anxiety, but as a side effect of the discomfort I was in. There are certainly hypochondriacs out there, but there are also terrible doctors as well. One should not immediately assume the patient is incompetent and doctor infallible. Gastroparesis is a pretty severe condition that often lasts for months or even your entire life. In my research I did not see stress noted as the most common cause.
    - cpncrunch 11y ago
      I never suggested you were incompetent or a hypochondriac. I see the vagus nerve mentioned as the main cause of Gastroparesis, and stress results in decreased vagus nerve activation. And as I said, I've been there myself, having severely reduced gastric emptying etc. due to stress. What was the cause of your gastroparesis?
      - Klinky 11y ago
        Gastroparesis due to diabetic neuropathy and side effects from surgical procedures is probably more prevalent than genuine cases of stress-induced gastroparesis. The cause of my case is not known. It'd probably fall under idiopathic. I believe it was related to food poisoning or a virus.
        cpncrunch 11y ago
        I was referring to idiopathic gastroparesis. Given that stress affects vagal tone (which is implicated as the cause of gastroparesis), and given the 10:1 female:male ratio (similar to fibromyalgia), stress seems a plausible cause for temporary idiopathic gastroparesis.

Klinky 11y ago

I was suggesting the diagnosis of "Psychosomatic" was lazy on the doctor's part. I went into a doctor's office 10 years ago with digestive problems, and the doctor was ready to write me a prescription for anti-depressants within 15 minutes, without a single test run. Visits to gastroenterologists weeks later, and subsequent visits to counselors and psychiatrists were not helpful. I was dealing with gastroparesis, which is often not diagnosed correctly. Doctors instead suggest the patient has an eating disorder or blame it on anxiety. The truth is, there are a lot of uncaring shitty doctors out there. If you're on the fringe and don't fall into the DSM, good luck. You absolutely have to advocate for your health, because often your doctor isn't going to. At least in the U.S., most doctors aren't going to walk you through the process to get setup with CBT, and your health insurance may consider it a mental health treatment, which has additional limitations on it. If you combine being skeptical that your doctor is using mental health as a cop out, and then it's a pain in the ass to get started, you're going to be more resistant to it. It's great CBT works for some CFS patients, just like mindful meditation works for some people with chronic pain, but in no way should it be treated like a cure or a reason to stop researching it, just like we're not going to treat meditation as a cure for chronic pain.

cpncrunch 11y ago
My guess is that it wasn't laziness on the doctor's part, but he/she looked at your symptoms and diagnosed it as most likely psychosomatic based on the evidence you presented. Was there another cause of the gastroparesis in your case? I've experienced gastroparesis myself due to stress, and I would imagine that is the most common cause.
- Klinky 11y ago
  Not lazy to assume anxiety without reviewing colonoscopy, EGD & gastric emptying study results? Perhaps I was showing signs of anxiety, but as a side effect of the discomfort I was in. There are certainly hypochondriacs out there, but there are also terrible doctors as well. One should not immediately assume the patient is incompetent and doctor infallible. Gastroparesis is a pretty severe condition that often lasts for months or even your entire life. In my research I did not see stress noted as the most common cause.
  - cpncrunch 11y ago
    I never suggested you were incompetent or a hypochondriac. I see the vagus nerve mentioned as the main cause of Gastroparesis, and stress results in decreased vagus nerve activation. And as I said, I've been there myself, having severely reduced gastric emptying etc. due to stress. What was the cause of your gastroparesis?
    - Klinky 11y ago
      Gastroparesis due to diabetic neuropathy and side effects from surgical procedures is probably more prevalent than genuine cases of stress-induced gastroparesis. The cause of my case is not known. It'd probably fall under idiopathic. I believe it was related to food poisoning or a virus.
      - cpncrunch 11y ago
        I was referring to idiopathic gastroparesis. Given that stress affects vagal tone (which is implicated as the cause of gastroparesis), and given the 10:1 female:male ratio (similar to fibromyalgia), stress seems a plausible cause for temporary idiopathic gastroparesis.