An Investigation into the Relationship Between ME(CFS) and Obsessive-Compulsive Disorder

[Large Donner]

I have never seen anyone get themselves into such a confused crossed-purposed discussion as you have done, @Large Donner.

I am talking about emotional hypersensitivity, and you bring up allergies?!

If you are struggling to get to grips with something as straightforward as that, I have my doubts that you will ever get a handle on the philosophical concepts behind mental qualia such as color sensation.

Ah just as I suspected as soon as I show you a definition of a word that you aligned with being experienced in the mind (hypersensitivity) you make up a new definition and even add a word (emotional) that at no point did you ever use in this thread together with the word hypersensitivity.

So when you are on a loser your just change the definitions to suit your argument. You still have no explanation of the mechanism that such things go from the brain, as in being neurological to the "mind", which is your exact claim. And then you go on to claim your non proof argument is proof of "mental/psychological symptoms" in ME. Not being satisfied with that you have also used wiki to back up your previous claims and think the NIH study has value and proves a connection cos you found it on google within 60 seconds. Oh boy!!!

Hey, I guess its all logical if you just say what you want, have no explanation, don't define your terms, cant define your terms, and move the goalposts as far away from answering my direct questions by throwing in non sequiturs like the nonsense over the colour red.

I've showed you what we both agree is red now show me an autopsy of the "mind" and when you can do that then explain how hypersensitivity is a psychological symptom, show me how it (however you are going to define it when you reply) jumps out of the brain and into the "mind." When you can then understand the flaws in defining hypersensitivity how you like, who decides its "hyper", the problems with how psychologists "diagnose" "it", particularly in the case of ME where it is often the case they don't believe in the physical illness itself therefore are likely to label any expression of discontent as "emotional hypersensitivity"....when you have done all that come back and we can discuss exactly the same problems with "emotional labiltiy".

When that's all done can I have the photograph, or even your personal mental experience of a photograph of the mind, not even my experience of it....I will even take it in the colour red......When you have done all that and I use you logic back to you over the absence of you showing me such and how it proves your own argument defunct then you can tell us all what you think about OCD being connected to ME.

That will be a real education for us all.

I have never seen anyone get themselves into such a confused crossed-purposed discussion as you have done

Thankyou for pointing out how pointless it was for me to get involved in your confusion. As you have never seen anyone else get into such a confused discussion with you, doesn't anyone else bother?

 

[alex3619]

I agree on this, mental diseases as isolated an well defined entities clearly exists it´s not just "labels", OCD, bipolar disorder, depression, are as real as diabetes and ME.

Actually, the opposite is the case. Even Allen Frances admits this, and there is a disclaimer hidden away somewhere in the DSM that explains it.

Not one single diagnostic entity in the DSM is stable. People have serious symptoms, often disabling, and clearly there is something wrong, but not one single diagnostic entity is proven. Not one. Alzheimers is touted to be the one that will be proven first, and its looking neuro-metabolic and not mental. Schizophrenia is similarly being redefined. Depression, for example, is a highly unstable definition. There is a high failure rate in diagnosis even using DSM simplified test cases during diagnostic validity checking.

Consider also that some with depression improve with changes in diet, vitamins, antivirals, antibiotics and so on. Its a disorder defined by its symptoms. If we did that for headaches then every single disease or problem that might cause a headache could be lumped together. Depression, like most psych disorders, is begging for better quality research.

The subgrouping problem also occurs in CFS by the way. Its a hodgepodge of different things, and with loose definitions like the Oxford definition its no better than defining a disease category on the basis of headache or any other solitary symptom. Symptoms are not diseases. They can be caused by many diseases. There is a strong possibility that even ME is two different diseases, though so far the data does not suggest more than two.

Now there is no doubt that many people with depression, OCD, bipolar and so on have serious symptoms, and something wrong with them. There is also little doubt that doctors love to attribute normal human experiences to OCD, bipolar etc., and overdiagnose and misdiagnose. They are unstable definitions. What we need is to identify the specific cause, using rigorous science, rather than just jumble everybody together and give them broad drugs that are often more placebo than real treatment.

If, for example, recent research in biomarkers in schizophrenia were to identify a specific cause for a subgroup, rather than have generic drugs to placate and poorly treat patients we might be able to develop targeted drugs for treatment or even cure.

Every diagnostic definition in the DSM is just a label. The people who are labelled can have very serious things wrong with them, but its a mistake to think that the label is more than just a pigeonhole. If you look at the history of DSM we find diagnoses appear and disappear. They morph, they merge. These categories are created by small committees. There is huge bias in this process. There is almost no scientific validation of the diagnoses. Validity testing is consistency checking ... how often will a psychiatrist be able to consistently get the definition right. This is not science.

By the way, this is why I constantly warn people about defending ME on the grounds its defined in the ICD. The ICD is just a list of bureaucratic labels and rules. Its not validated science. Most doctors know this. Its the science of ME that supports it, not the ICD.

The science in psychiatry is, sadly, still in its infancy. If we had a time machine and went forward a hundred years we might find that almost none of the diagnoses remain in any form resembling the diagnoses of today. Its still a work in progress, and still near the beginning of that progress.

 

[alex3619]

We all have an irrational fear of exercise too, don't forget that!

What the heck do you do if you have an irrational fear of irrational fear?

 

[TiredSam]

My fear of irrational fear is entirely rational thank you.

 

[alex3619]

My fear of irrational fear is entirely rational thank you.

Which brings up an important point. I have argued, and still argue, that reactive depression, some anxiety, and "exercise phobia" are entirely rational adaptive responses for many ME patients. Who wouldn't be depressed from time to time if they are exhausted, in pain, and their normal life is gone? Who wouldn't be anxious if PEM kept manifesting after doing things, and so they develop entirely justified anxiety? If exercise kept making you worse, and you never recovered in months or years, then why wouldn't you be concerned with exercise?

Fear, like anxiety, depression etc. can be a normal reaction to normal or abnormal situations that are dangerous. It is often the case the fear is normal, its the situation that is abnormal. Which is why I guess many doctors do not get it, its outside their experience, and they may not have time or inclination to even ask.

 

[TiredSam]

I must confess, I do have an irrational fear of having a rational fear of irrational fear.

And who posted that giant green square? It scared the sh*t out of me

 

[Hip]

Who wouldn't be depressed from time to time if they are exhausted, in pain, and their normal life is gone? Who wouldn't be anxious if PEM kept manifesting after doing things, and so they develop entirely justified anxiety?

I really don't think that psychological factors cause generalized anxiety disorder (GAD). I really think GAD is driven by physical organic causes in the brain, and I suspect this is largely true in most mental health conditions.

We all here agree that psychologists looking for psychological causes of ME/CFS have in general got it terribly wrong. And we agree that the money used researching psychological causes for ME/CFS was wasted, and would have been much better spent on biochemical research.

But I also see the very same problem in mental health research: in most cases, I think money spent researching psychological causes of mental disorders would be much better spent on biochemical research into these mental health conditions instead — working out what goes wrong in the brain.


Depression though is a bit different, because most would agree that this can be caused by psychological factors and/or physical dysfunction in the brain. And PTSD is also different, because this has a strong psychological/stress component to it.

However, apart from that, I think most mental health conditions derive from organic dysfunction in the brain.

And this means that the same tragedy that unfolded in ME/CFS (the inappropriate focus on psychological causes) has also taken place in mental health research.

But sadly, as far as I know, there is not a group vociferous mental health patients demanding more biochemical research into mental disorders, and less of the psychobabble.

 

[alex3619]

But I also see the very same problem in mental health research: in most cases, I think money spent researching psychological causes of mental disorders would be much better spent on biochemical research into these mental health conditions instead — working out what goes wrong in the brain.

On this we definitely agree. However I think the current research to develop a biomarker driven nomenclature is much better. The problem of doing research on, for example, depression, is that its a highly heterogeneous condition. So how do you know who you are studying. Wait, that sounds familiar ....

 

[alex3619]

Depression though is a bit different, because most would agree that this can be caused by psychological factors and/or physical dysfunction in the brain.

My take on reactive depression is that experiences trigger it, but the state itself is still a biochemical state of the brain. Its also frequently an entirely normal, human, reaction. Its should only be considered a problem when severity or severity plus duration become an issue, creating additional problems in a person's life.

Primary depression is probably something else again, and probably a whole cluster of different things all jumbled together.

GAD is not specifically what I was referring to. I was referring to regular anxiety, which can be an entirely normal reaction. GAD is not something I have investigated enough to say much about.

 

[Hip]

GAD is not specifically what I was referring to. I was referring to regular anxiety, which can be an entirely normal reaction. GAD is not something I have investigated enough to say much about.

Certainly, anxiety is a normal and in fact often desirable response. When you have an important exam coming up, for example, the anxiety you feel helps focus you to revise for it (usually!).

And at the more extreme level, if you were dragged at into a dark alley and had a gun pointed at your head, your pumping heart and significant anxiety would act as survival responses, to ensure you behaved very carefully, since your life is in danger.

Having GAD is a bit like the feeling of extreme anxiety you would get from have a gun pointed at your head — except that in GAD, there is no gun; there is no external cause for your anxiety. Rather, what seems to happen in GAD is that your brain's anxiety circuits get turned on by some brain dysfunction, so you feel constant anxiety, but for no external reason. I had the unfortunate experience of having severe GAD continuously for 5 years.

 

[alex3619]

I had the unfortunate experience of having severe GAD continuously for 5 years.

I had a friend who had regular severe anxiety attacks. I do understand the experience to some extent. I have never looked hard at the science though. I do appreciate this can be debilitating, and severely degrade quality of life. I still do not know if its one disorder or many though, or on a spectrum, or whatever. That is a big issue with modern psych definitions. Psychiatry needs to be completely reformulated, from scratch.

 

[Scarecrow]

Could you please provide a link to where you read that, because I could not find much info on the CDC 2005 empirical criteria for CFS, and how these criteria are deployed.

On my phone at the moment and still haven't worked how to easily insert links. I believe there was information on the IAMECFS site. I'll post a link this evening if you haven't found it by then. If you search for any one of the questionnaires plus 'CDC empirical', I'm sure you'll find it.

 

[Hip]

I had a friend who had regular severe anxiety attacks.

Panic disorder (PD), which involves anxiety/panic attacks, is similar to GAD, except that in GAD, the anxiety is often more or less continuous; whereas in PD the feelings of anxiety are restricted to short attacks of typically 5 to 20 minutes long.

PD also involves a release of adrenaline during a panic attack, and an activation of the sympathetic nervous system, neither of which you get in GAD.

Other anxiety-spectrum disorders are nicely summarized in this article; they include OCD, PTSD, GAD and PD.


For GAD, there seems to be very little research into it, in spite of the misery and profound disruption to your life it can cause. Severe GAD usually destroys careers, marriages, relationships, your social life, your ability to think even. In my life, GAD was like a bomb that went off without warning and pretty much destroyed everything I had going. (Only 5 years later did I then develop ME/CFS).


Animal studies infusing NMDA receptor antagonists into the amygdala (the main anxiety circuit of the brain) found that these antagonists lower fear and anxiety. So my hunch is that GAD may be caused by high levels of glutamate in the amygdala, probably arising from inflammation and activated microglia which release glutamate.

High levels of glutamate act to amplify neuronal responses to stimuli, which I think may explain why in GAD everything you experience is laden with mental tension or worry. Glutamate I think whacks up the volume/gain control on the amygdala to full, making everything very tense and worrying.

 

[Large Donner]

I must confess, I do have an irrational fear of having a rational fear of irrational fear.

And who posted that giant green square? It scared the sh*t out of me

Giant green square? Its a white and gold dress. :thumbdown:

 

[alex3619]

Giant green square? Its a white and gold dress. :thumbdown:

On a holiday theme, Santa is a square, Santa wears red, clearly its a representation of Santa, maybe in the cubist or abstract traditions. We need to stretch our imaginations and see Santa.

 

[TiredSam]

On a holiday theme, Santa is a square, Santa wears red, clearly its a representation of Santa, maybe in the cubist or abstract traditions. We need to stretch our imaginations and see Santa.

It's a christmas tree.

 

[SOC]

It's a christmas tree.

It's Santa hiding behind a christmas tree... in the dark.

 

[TiredSam]

It's Santa hiding behind a christmas tree... in the dark.

Please don't joke about such things, I've always had an irrational fear of santa jumping out at me from behind a christmas tree.

 

[Hip]

Is there anyone here who actually perceived that dress in the colors of white and gold?

I am happy to report that my brain only perceived the dress in its correct colors, black and blue. But several friends and family members did indeed see the same dress in the white and gold colors.


Some explanations about why this discrepancy in color perception occurs relate to how the brain concocts its own reality out of what the senses observe.

I found it odd that this is the first time (as far as I am aware) anyone has even noticed such a phenomenon. You'd have thought that something like this would have been observed before, since all manner of optical illusions are a well known.

 

[SOC]

Please don't joke about such things, I've always had an irrational fear of santa jumping out at me from behind a christmas tree.

I say this with the utmost concern for your well-being because I really want to help those ungrateful militant ME patients -- CBT is the only evidence-based treatment for false Santa-jumping beliefs. As we all know, Santa never hides behind christmas trees, so your rational fear of the irrational fear of Santa jumping out at you from behind a christmas tree is, in fact, irrational and therefore subject to CBT.

Now me, I have a very rational fear of BPS psychiatrists jumping out at me from behind christmas trees.