Breaking Through The Fog
I'd much rather collapse the categories in one direction (by seeing psychiatric illnesses as physiological/hormonal/metabolic) than in the other direction, which leads to CFS people being prescribed CBT etc.
Not to say I wholly disagree with all these ideas about neurology, and I want to study the TAAR1 receptor and catecholamines and trace amines a lot more. More that I just think that the findings of metabolic impairment and skeletal muscle impairment will only continue to get more robust.
CBT is pretty much useless in bipolar disorder too since it's a neurologic condition. In fact, other than (maybe) personality disorders, I'm not sure what is a true psychiatric condition would be. Psychiatric conditions are neurologic conditions. When the nervous system isn't working the rest of the body begins to fail too. That's especially true if the neurologic condition involves parts of the brain involved in the autonomic regulation.
The issue you have right now is that you know a lot about CFS but you know little about bipolar disorder which creates bias in your judgment. If you dig deep into bipolar research you will see that there's a ton of subtle metabolomic findings as well. For example such as this:
Blood metabolomics analysis identifies abnormalities in the citric acid cycle, urea cycle, and amino acid metabolism in bipolar disorder