4 ms·

I don't think any doctor says "it's all in your head" or "you're crazy". Most doctors do think it is psychosomatic, which is very different (psychosomatic means

I don't think any doctor says "it's all in your head" or "you're crazy". Most doctors do think it is psychosomatic, which is very different (psychosomatic means the physical symptoms are real, vs imaginary). That still seems the most plausible explanation, from what I can see (having researched it, and also suffered from it myself).

philipkglass 10y ago
I shouldn't have put "it's all in your head" in quotation marks, because I wasn't there in person and I too doubt that a doctor uttered those literal words. There was however an attitude of skepticism/annoyance conveyed through a combination of words and actions. One example: sibling had become dangerously underweight due to difficulty eating/swallowing. There was eventually a barium swallow test. One of the nurses excitedly told sibling after the test revealed clear abnormalities something like "wow, I am sorry, there is something clearly wrong here." The previous attitude having revealed (even if not in so many words) that she believed sibling to be a faker wasting time. I don't know if CFS was even the right label for the cluster of symptoms. Even in infancy there were many more problems with getting sick than the other kids in the household experienced. Infections and a cluster of other symptoms that ended up labeled CFS grew really severe in adolescence through mid 20s, then seemed to (mostly) go away as mysteriously as it had come. It was nearly a decade of misery that never had any clear diagnosis. I've also seen a friend with lingering complications from third degree burns suffered 10+ years ago be treated pretty shabbily as she tries to keep her pain under control. Modern medicine in the US seems pretty darn good at treating acute problems with obvious causes and fixes. It seems to be pretty crappy at treating chronic issues, especially ones that don't have good diagnostic markers. If I ever end up in the hospital again I hope it's for a nice obvious problem like a broken leg.
- rendaw 10y ago
  I have an unidentified repetitive stress injury (RSI) and doctors have universally tried some treatment, failed, then told me I'm simply working too much. This happened after I stopped all my hobbies and took a 30h/week job (flex time, with frequent breaks). The identifier RSI lends itself to this diagnosis. When the symptoms show signs of improving, the doctors immediately conclude "Well, you're getting better now, so just continue as you are now and we'll consider this resolved." An acquaintance suggested I overwork myself before going to the hospital so I don't risk being dismissed by a temporary improvement in my symptoms. I've had several sprains and a broken wrist that were resolved quickly and without complications. This article and your comments resonated with me.
  - muraiki 10y ago
    I have a friend who has struggled with increasingly severe "RSI", for lack of a better diagnosis. He even had carpal tunnel surgery on both hands. In the end he went to Mayo Clinic and they diagnosed him as having fibromyalgia. This was pretty recent so he hasn't had much time to experience the effects of the recommended treatment program, but it may be something for you to look into.
    - dredmorbius 10y ago
      NB, but AFAIU fibromyalgia is a condition that's not ruled in, but is made by exclusion -- symptoms not otherwise explained. Mayo's site gives "widespread pain for more than three months -- with no underlying medical condition that could cause pain". Several of the general / vague symptom conditions are similarly diagnosed.
gfvkdjg 10y ago
I have a chronic pain condition, and the second doctor I saw about it literally said 'given that the first doctor ruled out xxx and yyy, it seems like it's all in your head rather than anything wrong physically; we can offer you an appointment with a psychotherapist if you'd like?'
- shakna 10y ago
  Me too. Took 9 years, and 4 doctors till someone went, "Huh... Let's get you an MRI." Still not 100% diagnosed, but its in the fibro family. Which has its own issues with doctors disbelieving its existence. I struggle, looking at the medical world. Psychology is a really young science. Yet, a lot of the unknowns get passed to it, rather than an admittal that "we don't know". It might be fear, (getting sued), or arrogance (we know just about everything), or another reason. The result is the same. You have victims who don't have the knowledge required to advocate for themselves, and a tendency for the industry to place the entirety of the responsibility on them. [0]. Its hard. So hard. Where to draw the line, of whose responsible, and what ethical considerations a researcher should take into account, is a hard task. One that I am certainly not capable of... But it needs greater thought. [0] That is my experience, in my town, in my nation. Its anecdotal, and should be taken with a grain of salt.

philipkglass 10y ago

I shouldn't have put "it's all in your head" in quotation marks, because I wasn't there in person and I too doubt that a doctor uttered those literal words. There was however an attitude of skepticism/annoyance conveyed through a combination of words and actions. One example: sibling had become dangerously underweight due to difficulty eating/swallowing. There was eventually a barium swallow test. One of the nurses excitedly told sibling after the test revealed clear abnormalities something like "wow, I am sorry, there is something clearly wrong here." The previous attitude having revealed (even if not in so many words) that she believed sibling to be a faker wasting time. I don't know if CFS was even the right label for the cluster of symptoms. Even in infancy there were many more problems with getting sick than the other kids in the household experienced. Infections and a cluster of other symptoms that ended up labeled CFS grew really severe in adolescence through mid 20s, then seemed to (mostly) go away as mysteriously as it had come. It was nearly a decade of misery that never had any clear diagnosis. I've also seen a friend with lingering complications from third degree burns suffered 10+ years ago be treated pretty shabbily as she tries to keep her pain under control. Modern medicine in the US seems pretty darn good at treating acute problems with obvious causes and fixes. It seems to be pretty crappy at treating chronic issues, especially ones that don't have good diagnostic markers. If I ever end up in the hospital again I hope it's for a nice obvious problem like a broken leg.

rendaw 10y ago
I have an unidentified repetitive stress injury (RSI) and doctors have universally tried some treatment, failed, then told me I'm simply working too much. This happened after I stopped all my hobbies and took a 30h/week job (flex time, with frequent breaks). The identifier RSI lends itself to this diagnosis. When the symptoms show signs of improving, the doctors immediately conclude "Well, you're getting better now, so just continue as you are now and we'll consider this resolved." An acquaintance suggested I overwork myself before going to the hospital so I don't risk being dismissed by a temporary improvement in my symptoms. I've had several sprains and a broken wrist that were resolved quickly and without complications. This article and your comments resonated with me.
- muraiki 10y ago
  I have a friend who has struggled with increasingly severe "RSI", for lack of a better diagnosis. He even had carpal tunnel surgery on both hands. In the end he went to Mayo Clinic and they diagnosed him as having fibromyalgia. This was pretty recent so he hasn't had much time to experience the effects of the recommended treatment program, but it may be something for you to look into.
  - dredmorbius 10y ago
    NB, but AFAIU fibromyalgia is a condition that's not ruled in, but is made by exclusion -- symptoms not otherwise explained. Mayo's site gives "widespread pain for more than three months -- with no underlying medical condition that could cause pain". Several of the general / vague symptom conditions are similarly diagnosed.

gfvkdjg 10y ago

I have a chronic pain condition, and the second doctor I saw about it literally said 'given that the first doctor ruled out xxx and yyy, it seems like it's all in your head rather than anything wrong physically; we can offer you an appointment with a psychotherapist if you'd like?'

shakna 10y ago
Me too. Took 9 years, and 4 doctors till someone went, "Huh... Let's get you an MRI." Still not 100% diagnosed, but its in the fibro family. Which has its own issues with doctors disbelieving its existence. I struggle, looking at the medical world. Psychology is a really young science. Yet, a lot of the unknowns get passed to it, rather than an admittal that "we don't know". It might be fear, (getting sued), or arrogance (we know just about everything), or another reason. The result is the same. You have victims who don't have the knowledge required to advocate for themselves, and a tendency for the industry to place the entirety of the responsibility on them. [0]. Its hard. So hard. Where to draw the line, of whose responsible, and what ethical considerations a researcher should take into account, is a hard task. One that I am certainly not capable of... But it needs greater thought. [0] That is my experience, in my town, in my nation. Its anecdotal, and should be taken with a grain of salt.