The Psychiatrist's Role In Treating Unseen Diseases

[Never Give Up]

The above titled article showed up on Psychiatry Advisor today, http://www.psychiatryadvisor.com/pr...1&spJobID=622158062&spReportId=NjIyMTU4MDYyS0

Eleanore Stein does a good job parsing out the differences between psychiatric diseases and normal responses to diseases, she even spells out what PWME are dealing with and provides a roadmap to help.

“They are struggling with existential issues and grief. Fear is common because of the uncertainty associated with the course of the illness. Stigma leads to a sense of isolation.”

She also discusses the problem with the new DSM-5 diagnosis of Somatic Symptom Disorder,

Based on DSM-5 criteria, 15% of patients with cancer or heart disease and 26% of those with irritable bowel syndrome (IBS) or fibromyalgia qualify for a diagnosis of somatic symptoms disorder.7 “This is unacceptably high,” said Stein.

I'm pretty sure she, herself, has ME/CFS. At any rate, she's a great advocate.

 

[alex3619]

I met Ellie Stein at an ME/CFS conference in 1999, Sydney, Australia. I still have a lasting and positive impression of her. She has been involved in this for the long haul, and had ongoing discussions with many of the experts, looking for answers. She has also done a lot with pacing therapy, and I think has a booklet on how to pace.

In the email version of this there is an error in that its claimed that ME is the name of choice from the IOM. It isn't. This is also in the article.

 

[Misfit Toy]

When I applied for Social Security Disability....you know who won it for me in a small court room? The psychiatrist! He looked at all of my labs, my thyroid, my adrenal test, Endo surgeries and said...."Of course she's depressed, she's physically sick..anyone can see that." Kazam! I won SSD and for CFS. I've had great help from psychiatrists and my therapist. They are my advocates and have assured my docs and myself at times that I'm not mentally ill and that I'm sick and dealing with too much.

That psychiatrist will forever hold a place in my heart. Validation is a wonderful thing.

 

[alex3619]

Kazam! I won SSD and for CFS.

Wow. The system actually worked the way its supposed to!

 

[Snookum96]

I've found my psychiatrist has been the most helpful with this. He actually listens to me when I tell him about my symptoms.
He's done more relevant bloodwork too, he thought to test things like mercury and zinc, which no other doctor did.

He also suggested some supplements, he's not big on loading me up with prescriptions which I like. He even wants to see my MRI result because he's curious why someone formerly so fit and active could end up like this.

He also knows me well and knows that just because I have a history of depression doesn't mean I'm hysterical or that depression is causing all this weirdness.

 

[ScottTriGuy]

Wow. The system actually worked the way its supposed to!

The exception that proves the rule.

 

[alex3619]

He also knows me well and knows that just because I have a history of depression doesn't mean I'm hysterical or that depression is causing all this weirdness.

Komaroff ran an experiment a few years ago with, I think, spectral coherence EEG. It showed that ME and depression, in women at least (it was not calibrated for men) is differentiable using this cutting edge technology.

 

[Snookum96]

Komaroff ran an experiment a few years ago with, I think, spectral coherence EEG. It showed that ME and depression, in women at least (it was not calibrated for men) is differentiable using this cutting edge technology.

That would be an amazing tool to be able to use. I've no idea what a spectral coherence eeg is but I'll look it up. Providing "proof" to doctors would be a big help.

 

[alex3619]

That would be an amazing tool to be able to use. I've no idea what a spectral coherence eeg is but I'll look it up. Providing "proof" to doctors would be a big help.

You can show them the paper, but most doctors have probably never heard of it, and I have no idea how prevalent the technology is. This was done, I think, at Harvard Medical School.

 

[Dolphin]

Here's a booklet from Dr Eleanor Stein from 2005. I can't recall the details except I thought it was quite good

Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists

http://emerge.org.au/assessment-tre...l-guidelines-psychiatrists-2005/#.Vg8UCxFVhBd

Eleanor Stein MD FRCP(C)

This paper will:

• Define ME/CFS
• Explain why ME/CFS is not a psychiatric disorder despite that a significant subgroup of patients have psychiatric diagnoses.
• Outline how to differentiate the symptoms of ME/CFS from those of depression and anxiety.
• Suggest a treatment approach for common psychiatric symptoms in patients with ME/CFS.
• Summarize psychological treatment issues in patients with ME/CFS.
• Explain issues relevant to children and adolescents with ME/CFS.
• Discuss the treatment issues of drug sensitivity and the utility of Cognitive Behavior Therapy and Graded Exercise in patients with ME/CFS.

POSTED IN: ABOUT ME/CFS, GUIDELINES

Direct link to booklet: http://emerge.org.au/wp-content/uploads/2015/01/Clinical-Guidelines-for-Psychiatrists.pdf