Medically Unexplained Illnesses: It’s not just all in your head!


Having a stigmatized chronic illness can make it more challenging to cope with illness. This is an introduction to CFS, FMS, and MCS, all medically unexplained illnesses. Having compassion and greater understanding for people with these conditions, may help sufferers reduce their stress.


A Brief Introduction to Medically Unexplained Illnesses

Some chronic illnesses have specific titles, treatments and are much more easily understood by medical professionals. They have a consistent set of diagnostic criteria and so they are easy to diagnose, treat, and maintain. More research is done to find drugs and treatments that help with their treatment, and so while they are not curable, they are treatable and people can have a fairly decent quality of life with those illnesses. Some examples are diabetes, thyroid disease, osteoarthritis, and some psychiatric disorders like depression and Bipolar illness.

However, there are some illnesses, like Fibromyalgia (FMS), Chronic Fatigue Syndrome (CFS), and Multiple Chemical Sensitivity (MCS), whose symptoms are not well-understood by medical professionals, and since those symptoms overlap with other disorders and don’t lend themselves well to specific diagnosis, they don’t get as much research funding and effort. Their causes are also not well understood either; hypnotheses include viruses, childhood trauma, injury, psychiatric disorders like depression and PTSD, chemical reactions gone awry, etc. The fact that the disorders are not well-understood does not mean that the disorders are any less distressing to sufferers. It also doesn’t mean that they are simply “psychosomatic” (i.e., psychiatric symptoms masquerading or perceived as physical disorders). There has been a great deal ofstruggle to gain legitimacy in the medical field for people who suffer Medically Unexplained Syndromes (MUPS), as people with these conditions have an added stress of not being believed by family, friends and medical professionals. If they could point to a well-defined diagnostic label like cancer or arthritis, they might have a chance to be believed by others. Some prominent medical researchers have suggested that these disorders are purely psychological, and that if they just got Cognitive Behavioral Therapy, they would be fine. However, as anyone who has coped with fatigue, joint pain, cognitive dysfunction (like poor memory and concentration), or extreme discomfort after chemical exposure can attest, it is not just “all in your head.” Other people demean MUPS symptoms as “just being lazy” or “the yuppy flu.”

Fibromyalgia is perhaps one of the relatively better-researched MUPS and is characterized by joint pain in 11 of 18 tender points on the body, fatigue, insomnia, and at times cognitive dysfunction, like mental “fogginess” that makes it hard to concentrate, focus, or remember things. Many people with Fibromyalgia are limited in what they can do, how they can move, and sometimes their employment opportunities and capacities are severely hampered by their symptoms. Similarly, Chronic Fatigue Syndrome can negatively impact fulfilling social and occupational roles, and sometimes they have to apply for disability as they struggle to even achieve minimal activities of daily living. CFS has many similar symptoms to FMS (fatigue, cognitive problems, joint discomfort) but also have tender lymph nodes, flu-like symptoms, and “post-exertion malaise” which means that if they do too much during the day, they feel even worse for the next day to week. You may be able to see how this could interfere with holding down a job, raising children, having a social life, or running a household. While these disorders usually affect women, men can also be affected. Children and adolescents can become ill with CFS and FMS too, although it’s much rarer.  Most of the studies on CFS and FMS that have been done involve adults from 40-60 years old. It affects all socioeconomic statuses as well as ethnicities.

Multiple Chemical Sensitivities (MCS) is perhaps the most controversial of the MUPS and while it shares a few symptoms with FMS and CFS, it is more focused on negative reactions to exposure to chemicals in every day products. Some of those products include cigarette smoke, gasoline, solvents, perfume, clothing dyes, dryer sheets, cleaning agents, pesticides, and hairspray. People have a range of symptoms when exposed to these types of chemicals, including respiratory problems, skin rashes, headaches, cognitive problems, etc. people with FMS and CFS sometimes have sensitivity to smells, but it is not a defining feature of either of those conditions. Because there’ve been some studies where people failed to show increased sensitivity to certain agents in a laboratory, some medical professionals regard MCS as merely a psychosomatic illness. However, the reactions are real, cause physical and mental distress, and sufferers are not merely imagining what they experience. Instead of invalidating people’s experience, it seems more beneficial when doctors, friends, and workplaces can work with people who are sensitive to smells to make them comfortable, happy and productive. Other people might not perceive the same smells as threatening, because they get no physical reaction. However, there are number of factors that might contribute to some people’s extra sensitive reaction. I will address these factors in the next blog post.

This is been an overview of medically unexplained illnesses, which are often chronic and whose prognosis is often uncertain. Many of these illnesses overlap in symptoms, but the sufferers have very real struggles in meeting their life roles and functioning well. Hopefully, with more understanding, research, and compassion, we can make their experience a little better and a little less stressful. I will be writing about them more in future blog posts, in specific the link between psychological factors and physical symptoms of these illnesses.

Dealing with Rejection


There are few situations that are harder to accept than being rejected by another person, or even organization. Even if we are mentally healthy, we are social animals and want to be liked and loved by others, or to have their approval. After all, when we were more primitive beings long ago, our very survival depended on being accepted by the people in our clan. Perhaps that need to survive is what lingers with us now, in spite of our vastly more complicated social systems and circumstances.

There is also the missed opportunity of being part of a desired activity, whether it is getting a job, hanging out with cool people, having fun, being invited to parties we’d enjoy, etc. That, combined with the sting of not being part of the “in” group, can bring us back to being kids on the school yard when the cool kids didn’t want to play with us. It can hurt even more when the rejection is at the hands of our family members. Nonetheless, rejection is still the same: someone else has determined that there just isn’t a fit between you and them.

Don’t take it personally — “duh!”

The first thing to remember is not to take this personally. Yeah right, you might say. How do I not take this personally? Good question. There are a number of ways to not take it personally. First, remember that you are the same person whether accepted or rejected by others, and that your inherent worth is unchanged. Yes, you might feel cruddy right now in the heat of the moment, but that doesn’t have anything to do with how good or bad you are. Only you can determine your worth in absolute terms.

Just as Good as Anyone Else!

Knowing, liking and accepting yourself is a subject for another post, but basically it boils down to this: you have talents, gifts and limitations like anyone else on the planet. You might shine in one area where I am really not as talented, and vice versa. The more you know and accept these areas within yourself, the easier it is to gauge that against what others are saying (or not saying) about you. Other people might have a different idea of what they want in a friend, lover, employee, etc. that doesn’t make what you have to offer subpar; it’s just not a match.

The Myth of Universal Appeal

Second on your agenda is remembering that not everyone has to like you, just as you don’t like everyone you come across. The idea that you can please everyone uniformly is not only unrealistic, it can make you subservient or angry, neither of which is socially attractive or effective. There are people you will mesh well with, and people who make your tummy turn when you get in their presence. That’s OK! It’s liberating when you think of it. You don’t have to be perfect for them and vice versa.

Who do you Love?

Finally, focus your attention on the people who you do enjoy. You might not have a large circle of close friends yet, but that can change over time. It is vital to remember that relationship-building takes time and effort. You can’t just walk into a room and have an instant friend. I don’t care what Hollywood movies try to portray at times – not very many people have that instant charisma, and if they do, I’m often a little wary of them. There’s nothing wrong with pursuing friendship with people, but don’t let your ego get mangled in the process.

Psychiatrists Versus Psychologists


There’s a lot of confusion about what psychiatrists and what psychologists do. In the beginning of our profession, there was no distinction, really, because psychiatry was invented by a medical doctor, Sigmund Freud. As the years have worn on, however, the functions and duties have become separate. I would like to help clarify some of the differences.

Psychiatrists

Psychiatrists are medical doctors who have specialized training in psychiatry, namely treatment of diseases of the mind. Some psychiatrists still spend time talking to their patients at length about life’s problems and how to cope with them better. However, for whatever reason, they have a lot less time now, especially since managed care has become such a prevalent force in the mental health field. Unfortunately, their time has become more and more valuable and a lot of times they are in a hurry to treat as many people as possible. At is not their fault; it’s just how it is and a lot of communities. As a result, people sometimes go to psychiatrists and feel offended and hurt that the psychiatrist can’t spend a lot of time listening to their problems. This is unfortunate, because sometimes people didn’t want medication in the first place and were hoping to be heard and understood. This doesn’t mean that psychiatrists can hear and understand people, just that there focuses mostly on how the person is doing physically with their mental health condition. Psychiatrists spend most of the time evaluating the symptoms presented to them and how medication can address so symptoms. They can be true lifesavers if a person has a mental health condition that lends itself to medication. For instance, severe depression and bipolar disorder often require medication in order for the person to fully heal. Similarly, psychotic disorders like Schizophrenia require medication in order to have a productive, happy life.

Psychologists

Psychologists are experts in psychology. There are many different types. For instance, forensic psychologists work in the law and criminal justice capacities. They do evaluations, psychological testing, and write reports about their findings, as well as testify in court cases. Health psychologists specialize in helping people with medical conditions and do research on different topics, such as the role of stress and different diseases on mental processes. Clinical psychologists treat emotional and psychological illness by using psychotherapy and often work in conjunction with psychiatrists. This is what I do mostly, and I am very grateful to have the ability to collaborate with medical professionals when there are complex cases of mental disturbance. Not everyone who sees a psychologist needs medication or wants medication; some want to try psychotherapy before resorting to medication, and women who are breast-feeding often want to wait until they are no longer breast-feeding to try medication. I respect the desires and needs of the patient, that in cases where severe mental illness is present, I strongly recommend that people at least be evaluated by a psychiatrist. There are also things that people can do to help themselves feel better that don’t involve medication or talk therapy, and I encourage people to take care themselves as much is possible in order to be empowered and have a full, healthy life. For example, exercise can be and honestly helpful for depression and anxiety. Taking medication is not incompatible with exercise, meditation, yoga, good nutrition, or any other non-pharmacological interventions. If you choose to take the herbs or supplements, however you should check to make sure they don’t interfere with whatever medication you’re taking, whether it be psychiatric meds or medications for physical illness.

I hope this clears up some of the common misconceptions about what I do versus what a psychiatrist does. We still have a long way to educate the general public about how each can help people with emotional and psychiatric illness. However, hopefully this is a step in the right direction.

Healing in The Now


Whether we’re suffering emotionally or physically, no one really likes to suffer for very long. This is natural and normal, and I never would blame anyone for wanting to get better quickly. However, sometimes the desire to get better becomes a permanent stance of impatience that can actually thwart our efforts to get better. If he comes a cool paradox in which we strive so hard to not feel the way were feeling, that we make ourselves more miserable. Living in the future too much distracts us from what we can do in the moment to make ourselves feel better.

I know a lot of people who have emotional or physical problems, both professionally and personally. I have been in that boat, and struggling with a chronic illness is never A fun thing. I have also noticed that the people who live well and feel better quicker, do not get caught up in how fast their healing. They’re not competing against other people who also suffer to see who gets better fastest and in the best way. We have what is called bio individuality, which means that each have a unique body chemistry that interacts with our emotional and spiritual selves, as well as the outside world. What works for one person may not work for another.

There are some things, like alcohol and cigarettes, that probably don’t work for most people to create optimal wellness. However, some people might do very well on them diet with a lot of meat and rich foods, while someone else might feel better if he mostly vegetables and fruit. The point of this is that if we find something that works for us, it doesn’t necessarily work for everyone else who has health problems or mental health issues. We need to be careful about how we talk about our health, not just for others’ sake but also for our own sake.

What do I mean by this, when we think of ourselves as inadequate because we have a mental or physical condition, and we get angry at ourselves for not progressing further, it rarely serves us. If it motivates us to action, such as exercising more, eating better, applying ourselves rigorously to what our doctors recommend, then it can be helpful. However, what I usually see is that people’s impatience and anger at themselves turns into a self-destructive pattern of self- rebuke and low self-esteem, sometimes even depression. It’s natural and as I said before to want to get better. When it turns unhealthy is when we get so bogged down in impatience and anger, that we ignore what we can do in the present moment to improve our well being.

Sometimes there isn’t a lot we can do in the moment, at least from a medical standpoint. They may be taking our medications as prescribed, going to therapy your physical therapy, eating the way we’re supposed to, but the internal work that needs to be done falls by the wayside.

What is this internal work? It’s noticing what’s going on now in our body, mind and spirit. If that sounds to ethereal an abstract, what I mean is that we can observe how were moving, how were thinking, and how we’re feeling emotionally. We can use that data to make decisions about how we care for ourselves. That is a better use of our time and energy than getting angry at ourselves for not being healthier. Anger at ourselves is only useful if it motivates us to protect ourselves order energizes us toward effective solutions. Please keep this in mind next time you find yourself getting frustrated with yourself for not being healthier, happier, more productive, etc.