British National Health Agency Emphasizes Psychology in ME/CFS/FM on Webpage

[Cort]

Without saying that chronic fatigue syndrome and fibromyalgia are psychological disorders and while leaving little loopholes that they may not at heart be one - the UK's National Health Service (NHS) nevertheless emphasizes only one aspect of these diseases (guess which one ) in it's description of them in their Medically Unexplained Symptoms page - http://www.nhs.uk/conditions/medically-unexplained-symptoms/pages/somatisation.aspx

Notice that they're not saying that treating an associated psychological problem will cure these diseases; only that it can help relieve symptoms - which is true. It's the rather numbing repetition and that overt focus on psychology and the down playing of any other aspects of these diseases that is so upsetting.

Many people suffering from medically unexplained symptoms such as exhaustion (fatigue), pain and heart palpitations also have depression or anxiety disorders. Treating an associated psychological problem can often relieve the physical symptoms.

For others, the symptoms may be part of a poorly understood syndrome, such as:

• chronic fatigue syndrome (CFS) – also known as ME, which causes persistent fatigue
• irritable bowel syndrome (IBS) – a common condition affecting the digestive system, which can cause stomach cramps, bloating, diarrhoea and/or constipation
• fibromyalgia – which causes pain all over the body

Note the focus on stress below and the little emphasis given to the most common trigger for ME/CFS (and I believe fibromyalgia - infection.

A psychological or life problem may play a role in these syndromes as well – for example, IBS symptoms can be brought on by stress in some people, and managing the stress can help to relieve the symptoms. However, there may be other triggers (for example, IBS and CFS can occur after infections).

Explaining the symptom pattern of medically unexplained symptoms gives them a chance to re-introduce depression and anxiety again...

Medically unexplained symptoms tend to be quite general problems, such as:

• fatigue
• pain
• headaches
• heart palpitations
• shortness of breath
• dizziness and feeling sick

These are often experienced alongside depression and/or anxiety (see "What's the connection between mental and physical health?" below).

And then again - the NHS adds a mental component....Are they wrong in what they're saying? No...Stress, anxiety, etc. does increase symptom severity...

What's the connection between physical and mental health?

Just as poor physical health can lead to unhappiness and psychological problems, the opposite is also true.

Conditions such as low back pain and IBS are known to be triggered or made worse by psychological problems such as stress, anxiety or depression.

This can lead to a vicious circle – for example, the emotional upset from being in constant physical pain can lead to depression, the depression then worsens the pain, and may trigger other symptoms.

Then they make sure to let you know that your GP will be assessing you for depression or anxiety. Note that depression is the only associated problem mentioned...Thyroid problems? Nope. How about low blood volume? Nope. Gluten or dietary issues? Nope...

How can my GP help?

Your GP will aim to rule out all the possible serious causes of your symptoms. You'll probably have a thorough physical examination and blood tests.

It's important to consider whether the cause of your symptoms may be any medication you are taking.
Your GP should also investigate whether you might have an associated problem, such as depression or anxiety, that may be causing or worsening your symptoms.

You should tell them:

• what the symptoms are like, when they started and what makes them better or worse
• what you think or fear is the cause of your symptoms and your expectations of tests and treatments
• how the symptoms affect what you can do
• how upsetting the symptoms are

There are then a number of things you can do that may help.

You and your GP may need to draw up a personal health plan – this means agreeing some lifestyle changes and goals that you both think will help your symptoms.

You may be referred for a talking therapy such as cognitive behavioural therapy (CBT). CBT aims to help you manage your symptoms by enabling you to understand links between your symptoms, worries, feelings and behaviour.

Medication such as antidepressants can be helpful, even if you're not depressed. However, drugs aren't always the answer – painkillers or sedatives, for example, may lead to dependence. The possible benefits of medication always need to be weighed against the potential side effects.

If you feel your GP isn't taking your complaint seriously, you can get a second opinion.

Then, at the end the emphasis on stress reduction and exercise...

What can I do myself to improve my symptoms?

There are things you can do yourself that can improve or even relieve some physical symptoms, such as regular exercise and stress management.

Regular exercise – say, three 20-minute sessions a week – will at least keep you fit and give you a chance to take a break from other tasks, or just to get out of the house. Many people find that it also boosts their mood (read about exercise for depression). The exact amount of exercise or activity needs to match your current health and capabilities.

Managing stress is very important, as this has been linked to problems such as pain and IBS. Learn some relaxation tips to relieve stress.

They allow you to rate the page, by the way, at the end.

http://www.nhs.uk/conditions/medically-unexplained-symptoms/pages/somatisation.aspx