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Given that we now think that the brain flushes out waste products during sleep [0][1] and that lack of sleep is associated with all kinds of real problems [2][3

Given that we now think that the brain flushes out waste products during sleep [0][1] and that lack of sleep is associated with all kinds of real problems [2][3] (both ideas supporting one another) "psychosomatic" really is something quite physical. As an IT guy who has taken hundreds of hours of medical and several neuroscience courses I can't quite wrap my head around the idea of claiming something is "mental" or "psychological" and mean it as a closing statement. And "stress" is physical. If it was just and "idea" or abstract concept you would not feel anything. It only becomes "stress" when physical things happen inside of you. [0] https://www.nih.gov/news-events/news-releases/brain-may-flush-out-toxins-during-sleep https://www.nih.gov/news-events/news-releases/brain-may-flus... [1] https://news.ycombinator.com/item?id=12153644 https://news.ycombinator.com/item?id=12153644 [2] http://www.npr.org/sections/health-shots/2016/01/04/460620606/lack-of-deep-sleep-may-set-the-stage-for-alzheimers http://www.npr.org/sections/health-shots/2016/01/04/46062060... [3] http://healthysleep.med.harvard.edu/healthy/matters/consequences/sleep-and-disease-risk http://healthysleep.med.harvard.edu/healthy/matters/conseque...

kolinko 10y ago
Not to mention peptic ulcers, which doctors said were stress related until someone [1] discovered a bacteria responsible for it. [1] https://en.wikipedia.org/wiki/Barry_Marshall https://en.wikipedia.org/wiki/Barry_Marshall
- cpncrunch 10y ago
  That's not quite true. 50% of the world's population are infected with H. Pylori, so clearly it isn't the only cause. It is still thought that stress is a major factor in causing peptic ulcer [1]. We know for sure that stress causes increased stomach acid secretion, changes to immunity in the gut, as well as changes to the musocal lining. Any one of these factors could increase the risk of getting a stomach ulcer. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665639/pdf/9501720.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665639/pdf/950...
cpncrunch 10y ago
Firstly, psychosomatic means physical symptoms due to psychological cause, so if there was no physical thing happening inside the body, it wouldn't be psychosomatic. (It would just be psychological). There are many types of stress, e.g. physical (exercise), viral, or psychological, and they all have a similar effect in the brain (i.e. all of those stresses activate the HPA axis). From what I can see, the type of shutdown due to chronic stress that we see in CFS and similar conditions is likely due to the central governor[1] or Boksem's cost-benefit analysis centre[2] (which may actually be the same brain areas) deliberately generating fatigue due to excessive negative stress. So the mechanism isn't "lack of sleep causing damage, resulting in fatigue", it is more along the lines of "central governor sees that we aren't getting enough sleep, and then deliberately generates fatigue to tell us we need to sleep more". So even though it's not a psychological primary cause, it's probably fair to say that the fatigue is psychosomatic because the brain is doing a psychological determination based on a physical input. (The same would apply for excessive exercise resulting in overtraining). If you prefer, you could call it "functional" rather than psychosomatic. I prefer not to get caught up on terminology, and instead concentrate on what's actually happening in the body. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323922/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323922/ [2] https://www.researchgate.net/publication/51426280_Mental_fatigue_Costs_and_benefits https://www.researchgate.net/publication/51426280_Mental_fat...
- collyw 10y ago
  To me this is a bit of a cop out in explaining things. Clearly mental state can affect physiology and vice versa. Placebo effect is a prime example. If doctors or professionals can't explain things, they should admit it rather than trying to claim it is in people's head and ignore it or make it seem like it's below them. Placebo can have as much effect as some medicines and its an aspect of medicine that I feel should be taken far more seriously. I see no reason that mental state shouldn't be taken into account as much as physical (other than the fact that its more difficult to measure).

kolinko 10y ago

Not to mention peptic ulcers, which doctors said were stress related until someone [1] discovered a bacteria responsible for it. [1] https://en.wikipedia.org/wiki/Barry_Marshall https://en.wikipedia.org/wiki/Barry_Marshall

cpncrunch 10y ago
That's not quite true. 50% of the world's population are infected with H. Pylori, so clearly it isn't the only cause. It is still thought that stress is a major factor in causing peptic ulcer [1]. We know for sure that stress causes increased stomach acid secretion, changes to immunity in the gut, as well as changes to the musocal lining. Any one of these factors could increase the risk of getting a stomach ulcer. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665639/pdf/9501720.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665639/pdf/950...

cpncrunch 10y ago

Firstly, psychosomatic means physical symptoms due to psychological cause, so if there was no physical thing happening inside the body, it wouldn't be psychosomatic. (It would just be psychological). There are many types of stress, e.g. physical (exercise), viral, or psychological, and they all have a similar effect in the brain (i.e. all of those stresses activate the HPA axis). From what I can see, the type of shutdown due to chronic stress that we see in CFS and similar conditions is likely due to the central governor[1] or Boksem's cost-benefit analysis centre[2] (which may actually be the same brain areas) deliberately generating fatigue due to excessive negative stress. So the mechanism isn't "lack of sleep causing damage, resulting in fatigue", it is more along the lines of "central governor sees that we aren't getting enough sleep, and then deliberately generates fatigue to tell us we need to sleep more". So even though it's not a psychological primary cause, it's probably fair to say that the fatigue is psychosomatic because the brain is doing a psychological determination based on a physical input. (The same would apply for excessive exercise resulting in overtraining). If you prefer, you could call it "functional" rather than psychosomatic. I prefer not to get caught up on terminology, and instead concentrate on what's actually happening in the body. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323922/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323922/ [2] https://www.researchgate.net/publication/51426280_Mental_fatigue_Costs_and_benefits https://www.researchgate.net/publication/51426280_Mental_fat...

collyw 10y ago
To me this is a bit of a cop out in explaining things. Clearly mental state can affect physiology and vice versa. Placebo effect is a prime example. If doctors or professionals can't explain things, they should admit it rather than trying to claim it is in people's head and ignore it or make it seem like it's below them. Placebo can have as much effect as some medicines and its an aspect of medicine that I feel should be taken far more seriously. I see no reason that mental state shouldn't be taken into account as much as physical (other than the fact that its more difficult to measure).