I agree with you Firestorm if you are talking about unexplained chronic fatigue (CFS), using Fukuda or British criteria
for diagnosis. No tests are are required to tell someone they have CFS or CFS/ME and thus there is no disease
demonstrated. No argument there at all.
But you can draw a line that divides the physical and mental when talking about disease. So you can have either or Firestorm. If you can't as you propose (can't have either or), then Diabetes is a half mental illness, Cancer is a half mental illness, and Asthma is a half mental illness. Are they? No. They are all potentially fatal and are all worsened by stress. They remain diseases though.
Because ME is a disease, this is important. A disease is either classified as physical.
There is no half mental. A mental illness is so because we don't know the organic aetiology behind the symptoms to elevate them to hallowed disease status.
No one can name a disease that is classified as a 1/2 physical and 1/2 mental disorder.
You can't find one. You could propose one though.
Schizohphrenia is arguably what should be classified as a neurological disease with neuropsychiatric symptoms, but Schizophrenia is not classified as a neurological disease and is not managed by neurologists but psychiatrists.
So we can see no disease is 'half mental' and no 'half mental' illnesses exist when referring to ME either, if you are referring to ME as a disease.
A disease is diagnosed with tests, otherwise it is not classified as as medical disease. No one can be diagnosed with ME unless their abnormal test tally is indicative of an ME likely disease process. In error, many people believe they have ME who haven't had any tests shown to be abnormal in people with ME (organic CFS). But, these people are not all of the ME population, they are some. So some people who say they have ME (believe it in error), will benefit from psychological rehabilitation how could they possibly not!
1. ME is classed as a disease by the WHO.
2. CFS is classed by the UK NHS as an illness, not a disease. As outside the UK.
3. CFS/ME is UK specific. CFS/ME is classed as a collection of fatigue syndromes (symptoms) which are meant to be non organic. Except that is not statistically possible, some will have organic disease, referred to as ME.
We now run into even more confusion because of the accidental mixing with CFS and ME.
CFS/ME is not classed as a mental health illness by the UK department of health, but the treatment is mental health based.
To see if this is appropriate or even dangerous for clients using NHS care services we should contrast ME vs another neurological disease,Parkinsons disease.
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People with neurological disease( MS and Parkinson's) are not refered for CBT unless they have become mentally ill and need their beliefs altering because it limits their potential. A person with newly diagnosed Parkinson's disease who develops an unwarranted negative thought spiral about Parkinsonian symptoms may believe they cannot walk outside the door as they may become trapped somewhere due to an attack of limited 'Parkinsonian gait' and this may cause them great anxiety and fears about mobilizing and keeping independent. That person, for this specific reason, may be referred for CBT and CBT is appropriate.
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In contrast, all people with CFS/ME in the UK are refered for CBT by default unless there is an exclusionary reason they cannot engage or they refuse to. If so, there is no physical treatment at all for people with CFS/ME in the UK and many referals for rehabilitation are medically inappropriate. (Physiotherapy is rehabilitative).
Quite absurdly NHS medical referrals in the UK (if you have ME or CFS) are made irrespective on the beliefs the person with CFS/ME has! Unfortunately many miscarriages of justice happen to people with ME (organic CFS) because well meaning NHS therapists give the care presuming their clients with CFS/ME are all universally mentally ill and all universally have ''faulty illness beliefs'' which of course in contrast with other clients, with other diseases, they don't think this for other neurological diseases.
In practice, people with CFS/ME (who have neurological ME) are not referred for management strategies that ''address the physical and mental'', they are only referred to practitioners who can address the mental that is assumed to be present, and also the cause of 'fatigue', despite their being no scientific evidence for this. With regarding neurological disease in ME, you cannot address the physical if there is no medical treatment on offer to address the physical because the disease is not researched and no drug trials are in place to offer physical treatments.
You will not find one happy customer with a neurological disease having their physical disability ''addressed'' with CBT, GE, Physical therapy or counselling. Neurological diseases are treated with medications tailored for the disease. No medications are on the market for ME and never have been and never will be if ME remains stuck with psychological fatigue syndromes that don't require any tests to prove they even exist outside of the minds of the believer.
Drugs that may help ME, such as anti-viral medications, are listed in the NICE guidelines as not being advisable to prescribe to people with CFS/ME because naturally, many won't have infections. Yet anti viral medications may reduce neurological symptoms in people with chronic viral infections who have ME, such a relieving/reducing headache, and reducing the level of autonomic dysfunction present. (Autonomic dysfunction symptoms are worsened by infections). That is the kind of treatments for ME that really could ''address'' the disease process of ME but are not given the green light because of psychological therapies being the only dominating options, that cannot and do not address the physical symptoms of organic disease based ME.
Why is all this so important? Because people with disease are unfairly told they should go get off their bums and work and that they are free to work as there are 'treatments' such as CBT to make them work. If you have no evidence you are sick and you have psychological chronic fatigue and depression, fine. If you have ME and are clearly organically disabled, not fine.
Either way the DWP and benefits are often cancelled not only for people with ME, but increasingly for people with MS who may not be as disabled as others but too have a fluctuating form of MS that prevents them from working, but official 'assessments' say they can work because of these forms one has to fill in that required people to be practically bed ridden before anyone will accept there is a disablement that is severe and life changing, especially with neurological diseases that affect cognition (thinking).