Doctors often tell patients their conditions are psychosomatic–or just plain imaginary. Very real physical conditions such as erectile dysfunction, chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome get dismissed. Calling them products of the patient’s mind doesn’t make them disappear. It can make them worse.
Chronic Fatigue Syndrome: Decades of Confusion
If you’re old enough, you may remember the “yuppie flu” from the ’80s. That’s what many used to derisively call chronic fatigue syndrome. The condition, also called myalgic encephalomyelitis, is taken somewhat more seriously today, but many sufferers still get dismissed by the healthcare establishment.
Chronic fatigue syndrome (CFS), as the name suggests, is a syndrome, not a disease. Simply put, that means it’s a constellation of symptoms with no identifiable cause. As its name also suggests, those with CFS suffer from persistent, unexplained fatigue. It sometimes mimics flu symptoms, which may have led to the “yuppie flu” slur. Those with the condition go through periods of feeling completely and utterly wiped out.
CFS’s causes are largely unknown, but a 2017 study published in Proceedings of the National Academy of Sciences suggests CFS is an inflammatory disease and that there may soon be a diagnostic blood test.
Fibromyalgia: The Pain is Real
Fibromyalgia is real and affects 10 million Americans–mostly women–each year, according to The National Fibromyalgia Association. It causes pain, fatigue and cognitive difficulties (sometimes called “fibro fog”). In the past, many doctors didn’t take this seriously, pointing out that no physiological basis had been identified. They would blame stress or depression.
The brain is involved; scientists believe that those with fibromyalgia process pain differently, according to the Mayo Clinic. The result is an increased sensitivity to pain. And in Pain Medicine–the journal of the American Academy of Pain Medicine–researchers demonstrated that fibromyalgia may have a biological basis located in the skin.
None of this is to say that mental health isn’t a factor: As with many conditions, stress and anxiety can make fibromyalgia symptoms worse. The mind and the body are connected, after all.
Erectile Dysfunction: Getting to the Root Causes
Women aren’t the only ones to have their physical maladies dismissed. Despite all the research–and the medications on the market–men are often told erectile dysfunction (ED) is purely psychological.
Roughly 90 percent of men with erectile dysfunction have a predominantly physical basis for their condition, according to the Merck Manual. Diabetes is a tremendous risk factor–by some accounts as many as 50 percent of men with diabetes experience erectile dysfunction. Vascular diseases–such as hypertension and atherosclerosis–account for nearly half of all cases of ED in men older than 50.
On the other hand, psychology can play a crucial role. From stress and performance anxiety to guilt and fear of intimacy, the mind can do a number on the body making it even more difficult to achieve or sustain an erection.
But rarely is it all in your head, and there’s a good reason to push back against any doctor who says it is: ED can itself be a symptom of various diseases, perhaps a sign of other trouble, and your healthcare professional needs to find out what that trouble is.
Irritable Bowel Syndrome: A Punch to the Gut
Irritable bowel syndrome (IBS), like fibromyalgia and CFS, affects women more than men. And again, some doctors don’t take it seriously because the cause isn’t known.
IBS is an array of related symptoms that include cramping, abdominal pain, bloating, diarrhea and constipation. Several factors come into play. One possible explanation relates to abnormalities in your gastrointestinal nervous system. Because of poorly coordinated signals between your brain and your gut, your body overreacts to normal digestive processes.
Research published in American Journal of Physiology suggests that changes to microorganisms in the gastrointestinal tract, triggered by what we ingest (especially antibiotics) can affect how those systems communicate with each other
Body and Mind Do Affect Each Other
In saying these conditions have physiological and biological causes, it’s important to remember that all of them–really, most conditions–are affected by our mental state. Behavioral and physical health cannot be cleanly separated from each other. Research published in General Hospital Psychiatry and elsewhere demonstrates that medical conditions may lead to psychological problems, and psychological problems can increase the risk of medical problems.
So don’t worry when your physician talks about biological and psychological problems related to your condition. But if she starts attributing it all to your head, it may be time for a talk. Or another doctor.
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