4 ms·

I am not buying that psychiatry actually helped. With this type of condition, some people get better over time. So those people would have gotten better anyway

I am not buying that psychiatry actually helped. With this type of condition, some people get better over time. So those people would have gotten better anyway without the psychiatry. I also think the medical community should also rethink the notion some symptoms are psychosomatic. Why is that true? Because doctors can't spot the cause, so it must be psychosomatic? Maybe the cause is there but undetectable or not understood yet.

circlefavshape 3y ago
I'm not saying psychiatry helped my wife - it didn't, because she didn't go to a psychiatrist. Eventually she got better, as you say. I think it's unlikely, however, that symptoms are never psychosomatic. If what we think had no effect on how we feel then the placebo effect wouldn't exist
- francisofascii 3y ago
  Agreed. And the placebo effect is a good point.
- pygy_ 3y ago
  Every disiease has a psychological componnent, and a great part of the placebo effect comes from social status and support. Being told you're crazy is a net nocebo.
underdeserver 3y ago
A a few weeks after I had COVID I started having panic attacks. I went up a couple of flights of stairs at work and felt immensely exhausted - way more than I should have, I use the stairs at work all the time. I started feeling like there might be something wrong with me and that turned into a panic attack. (Later, of course, that turned out to be a symptom of long COVID fatigue.) I was 32 at the time. Never had a panic attack before. Sometimes felt something was wrong but clear thinking and a few deep breaths and I was okay. Not this time. In the subsequent couple of months I had a few more random panic attacks - once on a highway; I had to pull over. So I went and saw a therapist. I don't think they actually helped reduce the attacks - the frequency dropped with time, together with the fatigue. Now, two years later, I only have the mildest of attacks (and I'm at around 60-70% of energy). But they did help me calm down, gave me tools to deal with an attack when it happens and reduced my stress around the entire experience. It was definitely money well spent, and as much as I can tell from being my own carer, clinically relevant.
- 7thaccount 3y ago
  I have only anecdotal proof, but I believe there is also a link with caffeine. After getting COVID, I went from being an avid coffee connoisseur to getting extreme anxiety from a cup (I've never had anxiety either). I switched to decaf for 2 years before finally incrementally building my tolerance back up. Several colleagues and random people I've met have had similar issues. It goes away over time, but is very real.
  - touisteur 3y ago
    We're doing anecdotes here, so... I think the post-COVID symptoms made me aware of parts of my body I had never had to 'deal with' or pay serious attention (I'm not into sports...). Feeling your heart doing weird stuff in normal conditions, isn't surprising to trigger anxiety and panic. The first time I felt like keeling over after some mild-the-month-before bicycle effort, I fell not only the heart symptoms but sudden fear and anxiety that compounded the situation. I called 911 a week later because I felt very strong and unusual heart symptoms, feeling like a heart attack. Nothing on either ecg, doppler, blood analysis, heart mri, effort test, absolutely nothing - the EMT said at first 'so many calls these days, most looking like panic attacks, poor people suffering with no physical traces of a problem'. ER doc was 'we didn't find anything but don't hesitate next time, it wasn't nothing and even if it's "just" a panic attack we can help'. The problem went away after 6 months of doing frequent/daily light cardio activity...
    - 7thaccount 3y ago
      Holy cow. I'm fairly young and also had weird heart issues during COVID too. Felt like I could feel my heart slow down and get out of rythem a few times over maybe a month. I went to a cardiologist and did a stress test. Nothing showed up and eventually it also went away. Note, I was a little stressed from work, but nothing unreasonable. Home situation wasn't too bad either.
- zzzeek 3y ago
  I've suffered from nearly lifelong depression and panic attacks. however, about ten years ago my general feeling of anxiety suddenly got much worse. I was able to cope with it using all of my usual anxiety coping skills but it seemed kind of off that everything had shifted. I went onto Lexapro, which helped. But then in 2019 or so things really started getting nutty again, where I'd be up all night with panic, often waking me up in the middle of the night, would be up until 5 am, finally fall asleep, then would have another during-sleep panic attack that would last all day. Turns out I have a node in my thyroid producing thyroid hormone. I now take a very low dose of medication for hyperthyroidism and my panic-esque anxiety levels are kind of lower than they've been for like my entire life (still need the lexapro though, I am sure that my anxiety issues are not strictly the thyroid node). Basically it sucks to have psychiatric illnesses that are standalone, but also compounded by other non-psychiatric pathologies.
cpncrunch 3y ago
>Because doctors can't spot the cause, so it must be psychosomatic? No, because the only replicated findings are that stress (and infections) are triggers, believing in a physical cause is a perpetuating factor, and multi-disciplinary rehabilitation leads to improvement in about 2/3rds and recovery in about 1/3rd of patients.

circlefavshape 3y ago

I'm not saying psychiatry helped my wife - it didn't, because she didn't go to a psychiatrist. Eventually she got better, as you say. I think it's unlikely, however, that symptoms are never psychosomatic. If what we think had no effect on how we feel then the placebo effect wouldn't exist

francisofascii 3y ago
Agreed. And the placebo effect is a good point.
pygy_ 3y ago
Every disiease has a psychological componnent, and a great part of the placebo effect comes from social status and support. Being told you're crazy is a net nocebo.

underdeserver 3y ago

A a few weeks after I had COVID I started having panic attacks. I went up a couple of flights of stairs at work and felt immensely exhausted - way more than I should have, I use the stairs at work all the time. I started feeling like there might be something wrong with me and that turned into a panic attack. (Later, of course, that turned out to be a symptom of long COVID fatigue.) I was 32 at the time. Never had a panic attack before. Sometimes felt something was wrong but clear thinking and a few deep breaths and I was okay. Not this time. In the subsequent couple of months I had a few more random panic attacks - once on a highway; I had to pull over. So I went and saw a therapist. I don't think they actually helped reduce the attacks - the frequency dropped with time, together with the fatigue. Now, two years later, I only have the mildest of attacks (and I'm at around 60-70% of energy). But they did help me calm down, gave me tools to deal with an attack when it happens and reduced my stress around the entire experience. It was definitely money well spent, and as much as I can tell from being my own carer, clinically relevant.

7thaccount 3y ago
I have only anecdotal proof, but I believe there is also a link with caffeine. After getting COVID, I went from being an avid coffee connoisseur to getting extreme anxiety from a cup (I've never had anxiety either). I switched to decaf for 2 years before finally incrementally building my tolerance back up. Several colleagues and random people I've met have had similar issues. It goes away over time, but is very real.
- touisteur 3y ago
  We're doing anecdotes here, so... I think the post-COVID symptoms made me aware of parts of my body I had never had to 'deal with' or pay serious attention (I'm not into sports...). Feeling your heart doing weird stuff in normal conditions, isn't surprising to trigger anxiety and panic. The first time I felt like keeling over after some mild-the-month-before bicycle effort, I fell not only the heart symptoms but sudden fear and anxiety that compounded the situation. I called 911 a week later because I felt very strong and unusual heart symptoms, feeling like a heart attack. Nothing on either ecg, doppler, blood analysis, heart mri, effort test, absolutely nothing - the EMT said at first 'so many calls these days, most looking like panic attacks, poor people suffering with no physical traces of a problem'. ER doc was 'we didn't find anything but don't hesitate next time, it wasn't nothing and even if it's "just" a panic attack we can help'. The problem went away after 6 months of doing frequent/daily light cardio activity...
  - 7thaccount 3y ago
    Holy cow. I'm fairly young and also had weird heart issues during COVID too. Felt like I could feel my heart slow down and get out of rythem a few times over maybe a month. I went to a cardiologist and did a stress test. Nothing showed up and eventually it also went away. Note, I was a little stressed from work, but nothing unreasonable. Home situation wasn't too bad either.
zzzeek 3y ago
I've suffered from nearly lifelong depression and panic attacks. however, about ten years ago my general feeling of anxiety suddenly got much worse. I was able to cope with it using all of my usual anxiety coping skills but it seemed kind of off that everything had shifted. I went onto Lexapro, which helped. But then in 2019 or so things really started getting nutty again, where I'd be up all night with panic, often waking me up in the middle of the night, would be up until 5 am, finally fall asleep, then would have another during-sleep panic attack that would last all day. Turns out I have a node in my thyroid producing thyroid hormone. I now take a very low dose of medication for hyperthyroidism and my panic-esque anxiety levels are kind of lower than they've been for like my entire life (still need the lexapro though, I am sure that my anxiety issues are not strictly the thyroid node). Basically it sucks to have psychiatric illnesses that are standalone, but also compounded by other non-psychiatric pathologies.

cpncrunch 3y ago

>Because doctors can't spot the cause, so it must be psychosomatic? No, because the only replicated findings are that stress (and infections) are triggers, believing in a physical cause is a perpetuating factor, and multi-disciplinary rehabilitation leads to improvement in about 2/3rds and recovery in about 1/3rd of patients.