Chronic illness: A mental disorder?

Living with chronic illness such as chronic fatigue syndrome or fibromyalgia (CFS/FM) certainly has its trials! There are a myriad of symptoms which present challenges for people, but even worse than these, for many people, is the disbelief of others about the reality of their conditions.

Despite the opinions of many, CFS/FM are genuine physical illnesses, and it can be quite devastating for patients to be misunderstood by family, friends, co-workers and even medical providers who may not believe the person is actually physically unwell. It is particularly discouraging and demoralising if health professionals are unsympathetic to their patients’ conditions, and treat them as if it’s all in the mind.

Just when I thought that we were progressing well in the health arena in being more accepting of illnesses such as CFS/FM, and other ‘mysterious’ illnesses, the American Psychiatric Association (APA) has introduced a new classification called Somatic Symptom Disorder (SSD) in the forthcoming updated edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), a tool used by psychiatrists and psychologists for diagnosing mental illnesses. For a diagnosis of SSD, a person needs to report a distressing physical symptom that disrupts his/her daily life for at least six months, along with one of the following:

• Disproportionate, persistent thoughts about the seriousness of their symptoms
• Persistently high level of anxiety about his or her health or symptoms
• Excessive time and energy devoted to symptoms or health issues

For those of you with a chronic health condition, spending a lot of time and energy investigating treatments in order to improve functioning and quality of life, you may now also warrant a mental condition of SSD! Those with CFS/FM could soon find that there is even more resistance to having their conditions validated as physical illnesses in the wake of SSD. Certainly, there is a good degree of mental disturbance when a person is chronically unwell. It is impossible not to become depressed and anxious when your life has become severely limited, with little understanding of the condition thrown into the mix.

Fortunately, there are many psychiatrists, psychologists and health practitioners who disagree with the introduction of SSD, however the classification is already set in place. I believe the introduction of SSD is a backward step and in my opinion, it is irresponsible to pass on a diagnosis that may be dismissive of genuine physical illness, whilst adding to the suffering of those who are already struggling to be believed. The fact remains that there are some illnesses that are not well understood at this point in time. Applying a label of mental illness, when it does nothing to improve the condition of a person, ignores the whole-person experience and some feasible healing treatments for improving patients’ conditions.

 What are your thoughts?

Other commentaries on this topic:

Dr. Keith Ablow  http://www.foxnews.com/health/2013/02/14/does-somatic-symptom-disorder-really-exist/

Allen Frances, M.D. http://www.psychologytoday.com/blog/dsm5-in-distress/201301/bad-news-dsm-5-refuses-correct-somatic-symptom-disorder