by Helen Borel,RN,MFA,PhD
As I stated in my 1992 compendium, referencing the terrible mishandling by American government medical "professionals," of the DIRE epidemic CFS/ME, "Major publicity
efforts and strong political actions are going to be necessary before funding for adequate
and competent medical research into etiologies, treatments and preventions can become
a reality".
Severely Compromised Immune Systems: Legacy of a Toxic World?
"Environmental Illness" - multiple allergies, hyperallergicity, multiple toxicities, awful illness relapses upon even minimal exposure to toxins and allergens (toxins and allergens causing no symptoms in immune-competent individuals) - may well be, rather than a separate disorder, but one expression of the severe ultra-hypersensitivity of individuals with damaged immune cells, as in ME, CFS:DIRE. And therefore whose impaired immune function leads to the symptoms which mimic radiation sickness or prolonged chemotherapy (nausea, headache, feverishness not necessarily registered on an oral or rectal thermometer, and prostration) of the relapsing disease known pejoratively as
"chronic fatigue syndrome".
Symptom Severity Must be Taken Seriously by Physicians
Profound Exhaustion, not the trivializing designation "chronic fatigue syndrome," is only one feature of a painful and debilitating cluster of relapsing ME, CFS:DIRE symptoms. These include severe, recurrent secondary respiratory infections (common bacterial and opportunistic), brain fevers, chills, night sweats, headache, nausea, photophobia, and others leading to an aesthenia and sickliness that sharply curtail or arrest normal activity and alters appetite.
Self care grows progressively constricted with poor nutritional status one result, and social isolation the ultimate tragedy, due to an incapacity to live a normal life during relapses and to residual weakness during remissions with little let-up before the next relapse assault. And the suffering inflicted by this illness has been worsened because of how physicians have been dismissing this disorder and its victims for decades. [Note: this description of the suffering patient's experience and of MDs' dismissiveness of these patients' signs and symptoms, was published by me in 1992.]
What has Psychiatry Got to Do with Endorphinization
of the CNS by a Haywire Immune System?
Ill people deserve to be taken seriously by virtue of their illness history. And ME, CFS:DIRE patients experience repeated bacterial respiratory infections, often have high titers of Epstein-Barr Virus (EBV) and Cytomegalovirus (CMV) or other viruses, suffer relapsing low-grade feverishness, chills, sweats, nausea and excessive multiple allergies and environmental sensitivities. None of this constellation of characteristic symptoms or signs appears in any, including the most recent, edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" of psychiatrists. Nor are these signs and symptoms of infection, encephalitis (brain inflammation) and immune system decompensation known in psychiatry to arise from depressive disorders, from anxiety, from hysteria, from personality disorders, or from the psychoses.
Nonetheless, psychiatrists and psychologists too often persist in butting in on the specialties in which they have zero expertise - Immunology, Infectious Diseases, Virology, and Neurology. Arrogantly so, they are frequently as ready, as are too many of their general medical colleagues, to be dismissive of patients whose illnesses are relatively new, or difficult to categorize due to the gap in scientific knowledge at the time suffering patients present themselves for diagnosis and care.
A Delusion of Some Psychiatrists is that Exercise
and Cognitive Behavioral Therapy (CBT)
are appropriate Prescriptions for a
Severe, Relapsing NeuroImmune Disorder
Since when do we treat a progressively worsening autoimmune disorder including cerebral and spinal cord pathologies by revving up the immune-compromised patient's
sick immune system? By revving up the inflammatory (assume febrile, too) process
going on in the brain, during relapse attacks, with "exercise"? Here's where it's the psychiatrists who promote this MIS-treatment who are crazy!
Also, what in the world (other than ineffective "comforting" of distressed physically ill patients) has CBT got to do with turning around an immune system on cytokine overkill? Don't psychiatrists have enough to do with schizophrenia, major depression, bipolar disorder and so forth? They should steer clear of advising immune-compromised/ encephalitis patients to exercise. Hmm. Maybe they're longing to offer CBT to meningitis patients. Or to cerebral Herpes Zoster ("shingles"<-another stupid name for a severe, painful and sometimes deadly disease) patients. Or maybe CBT can treat leukemia? Or maybe they should tell a scleroderma patient to "exercise". How about CBT for an acute appendicitis patient? What about "exercise" prescriptions for a myaesthenia gravis or acute poliomyelitis patient?
Some Psychiatrists Do Grasp Serious Physiologic Pathology
Except for those few mental health professionals acquainted with the research in psychoneuroimmunology, who understand well these interconnections in physiology and biochemistry and can offer support to physically ill patients, psychiatric professionals should steer clear of characterizing or treating ME, CFS:DIRE patients!
ME, CFS:DIRE Heroes must be Immunologists, Neurologists,
Toxicologists, Microbiologists, Infectious Disease Specialists
Which sounds the clarion call to all those specialists who ought to be treating ME, CFS:DIRE patients with regimens that address their signs and symptoms...while we
impatiently await specific etiologies and specific diagnostic tests to pinpoint this illness
at its earliest manifestation in a patient before it progresses to lifelong debility.
(c) 1992 to 2018 by Dr. Helen Borel. All rights reserved.
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