Letter, Re: Shyness in a child and depression after bereavement could be classed as mental illness in controversial new reforms (Daily Mail, 9 February 2012)
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Daily Mail Letters.
Cc: Jenny Hope, Health Editor
The crucial importance of the name given to an illness. in understanding its cause and improving chances of recovery from it, is illustrated with sufferers of M.E. before and after Psychiatrists have re-labelled them, both since 1988 (Holmes et al.) and as they wish to revise further in their next Diagnostic and Statistical Manual of Mental Disorders, DSM-5. (Shyness in a child and depression after bereavement could be classed as mental illness in controversial new reforms, Daily Mail, 9 February 2012 --
http://www.dailymail.co.uk/news/art...ssion-bereavement-classed-mental-illness.html).
Before: Patient has Myalgic Encephalomyelitis, as recognised in the World Health Organisation Handbook (Issue ICD-10, 2010, Category G93.3, "Other disorders of the brain" NOT a fatigue syndrome. F48.0, in "Neurotic, stress-related and somatoform disorders"), which suggests different treatments for M.E and Chronic Fatigue Syndromes. Onset of M.E. was viral infection OR adverse reaction to vaccination; patient is not malingering, previous good attendance work/school; not hypochondriacal; no previous personal or family history of mental illness. More biomedical research needed. Meantime, treatment options: Patient experience and research evidence (Twisk & Maes, 2009) suggests that Cognitive Behaviour Therapy (CBT) is disappointingly ineffective and Graded Exercise Therapy (GET), makes a majority worse, some irrecoverably so. Alternative and radical, unproven, treatments given by unregulated charlatans are expensive and raise false hopes and even may be the last straw that has led to suicide attempts. Low spirits, due to social isolation, unemployment, poverty and fractured relationships should not be confused with depression; therefore antidepressants will not help and may cause addiction. Best options: treat any symptoms, such as pain, sleep problems etc; demonstrate belief in illness; support in benefits and welfare claims; visit at home when house or bed bound. Encourage patients' enquiries and discussion of latest biomedical research findings. Support blood and tissue bank initiatives. In event of death, encourage post mortem and, especially, call for investigation of inflammation in areas found in others who died after having M.E.
After: Chronic Fatigue Syndrome is now preferred term. Discourage patient using M.E, as if more serious medical condition. Even if onset is organic, illness is maintained by faulty beliefs (somatisation). Treat all with CBT and GET. Encourage patients to try other treatments, suggest can do no harm. Psychological effects are depression, therefore, treat with antidepressants even if addictive. Encourage back to work, even if there are relapses due to trying; do not support for unemployment or disability benefits. Discourage patients' own research and questions. If patient resists voluntary treatments, threaten compulsory; if persistent, send people to break down door and section under Mental Health Act. After death, discourage need for post mortem. Encourage more research into behavioural management of chronic fatigue illnesses and expansion of service to provide above treatments.
Independent journalists may be shocked if they were to enquire into the numbers of people who have been and who are currently affected by these practices. It is why hundreds of thousands of people in the UK, millions around the world, remain ill and neglected with this dreadfully disabling neurological illness, which should be treated discretely as M.E. and not part of a fatigue bundle.
Yours sincerely
drjohngreensmith@mecommunitytrust.org
Dr John H Greensmith
M.E Community Trust.org
