Psychiatrist Believes It's Somatization Not Dysautonomia That's Our Problem

[dizzyallie]

I can't believe it. After 12 years of CFS, 5 with POTS, I went to ask a psychiatrist what meds are available depression wise for me, should I go backwards. He first started by asking who diagnosed my illnesses because in psychiatry we call it somatic. I'm so offended. He said it's the same, autonomic messages aren't right but the code in psyche talk is somatic. It is not the same thing at all! I came home and read up on it, now I'm just insulted. I called his rooms back today. I said yesterday, no I do not agree with this. But I need to really voice how against I am with this crap. CFS is a real medical illness. Somatic implies you have all these symptoms, no medical basis or diagnosis for it. I'm waiting for a call back. If I get one. What's wrong with these people! my psychologist is fantastic, this one off psychiatrist re meds has no idea.

[MomtoGiuliana]

I'm so sorry you are dealing with this. Many of us have experienced similar responses from doctors, although I am always hoping this is quickly becoming something from the past as information about our class of conditions spreads in the medical community. Unfortunately I do think some specialists are so focused within their narrow specialty that they have a hard time seeing the whole patient and/or are not aware enough of conditions outside of their own specialty.

I hope you can see another psychiatrist. I was sent to a psychiatrist by my general practitioner 12 yrs ago when I was very sick (and undiagnosed). I was hesitant to go b/c I was sure I did not need to see her, however she ended up being helpful. It was actually the psychiatrist who, after evaluating me, concluded that my problem was some unknown physical condition, and not in need of psychiatric treatment.

[Clb75]

I'm sorry this happened to you, unfortunately it's very common for people with rare or undiagnosed illnesses to get this. A lot of people get diagnosed with anxiety before dysautonomia is even considered. Somatic disorders do exist but are rare and hard to diagnose. you have to rule out all physical health conditions and test results and most people have not had a full work up across the board to do that. Somatic disorders tend to have an inconsistent pattern of symptoms compared to someone with a physical basis for their illness, and also wouldn't have abnormal test results. You appear to have several illnesses that can explain your symptoms and I'm guessing you have test or labs that confirm it too. The doctor should have known better.

Maybe he was trying to say that the autonomic system also controls mood symptoms like depression and anxiety but it obviously controls other physical functions as well. Serotonin and norepinephrine contribute to depression, anxiety, poor sleep, appetite changes etc. However, if someone is having a panic attack solely based on anxiety, the symptoms will be consistent, and not only appear when upright then go away when lying back down. Salt, compression socks etc also won't alleviate panic attacks.

Depression is very common and You are being responsible by trying to get help for yourself. He clearly didn't take the time to fully understand your symptoms and how they are different from the presentation of a true mental health symptom or diagnosis. Hopefully you can find someone else who will listen better and be helpful to you.

[gjensen]

He is not qualified to discuss the subject.

[Katybug]

I can only say I'm sorry you had to experience this and please don't let this person fill you with negative feelings for more than a day. He's simply not worth the stress or the additional time.

[xRobin]

ETA: Wait, I reread your post. "Somatic" means bodily, not psychological. That would mean he thinks your symptoms are deriving from illness in your body. Did he say psychosomatic? That means physical symptoms that originate from emotional distress. If so, read my original post below, if not it may just be a misunderstanding!

Original post:

I really encourage you to drop that psychiatrist and get another opinion!

I have CFS and many years ago,when I was first diagnosed, I suffered from a reactive depression. Who wouldn't, after having to drop out of grad school and live a life of extreme debilitation and disability?

I approached psychiatrists with the full expectation of some wanting to label me as a somatizer simply on the basis of reading my diagnosis, so on my first appointment I thought of it as in interview, as in I was interviewing the psychiatrist for the job of treating me. I asked questions to determine their "epistemology" of my illness. I found one who referred me psych nurse/therapist who had chronic illness herself (MS) for talk therapy, while he prescribed medication as needed. It was the best of both worlds and after a while I got a lot better.

So, please don't give up. I'm very sorry that this happened to you and unfortunately it is not uncommon. You're just as worthy of help as any other patient and you certainly don't need it with a side order of inadequacy on the part of the health professional.

If you want to engage this person further, here's a recent journal article about a report made on CFS by the Institute of Medicine, which states clearly that it is not a psychological illness:

http://jama.jamanetwork.com/article.aspx?articleid=2118591

[dizzyallie]

Thank you for all the replies. I am trying to de stress from these comments from this guy but I just can't. He talked about somatic being a problem with cells, cytokines, energy but then says somatoform disorder ... Meaning unexplained medical symptoms. Our medical symptoms are legit. CFS, pots is legit. I have a diagnosis. He even said period pain falls under somatoform. I'm just angry. He didn't mention psychosomatic. I too have reactive depression xrobin, who wouldn't hey.

I have been seeing a psychologist the past year for the depression. This guy was merely an appt to ask about meds. But he still gave his 2 cents on my medical conditions.

I got the impression, to him, CFS, pots etc is all rubbish. Now I'm just hurt. Trying to switch off katybug coz I know how damaging it lol be otherwise. So hard.

Thanks again everyone and for the link xrobin.

[SarahA33]

Hi Allie,

I Wanted to just tell you that I've been in that situation many many years ago, unfortunately, certain people who shouldn't be in the medical profession are, and it results in traumatic situations such as these, however, mine was actually with POTS. It was a long time ago but it still infuriates me if I'm reminded of it. I cant get over how unprofessional and unethical this doctor was with you, This only shows the amount of ignorance he has. That's a really a good link Robin sent you, and also just so you know Allie,I have also included a few others for you.

http://www.washingtonpost.com/news/to-your-health/wp/2015/02/10/chronic-fatigue-syndrome-is-a-real-condition-not-a-psychological-illness-expert-panel-says/

http://www.medscape.com/viewarticle/837577

http://www.apta.org/PTinMotion/News/2015/2/12/ChronicFatigueIOM/

[dizzyallie]

Thanks Sarah for the support, sorry you've had this experience too. So ill informed some docs. Especially psychiatrists. Thank you for the links, I'll look at them. Not all would be like this I know, but when you come across one, as ill as you are, it's just hurtful.

[Goschi]

dizzyallie,

I am really sorry that you had to experience this annoying appointment... It always costs so much energy to deal with - while you are there and afterwards...

I guess everyone here on this Forum has had similar experiences. However, in the english-speaking world, at least the condition "dysautonomia" seems to be accepted in general, as far as I could see. In my country, no doc at all would know what you are talking about when you tell him/her, you have "dysautonomia". "What´s that?", would be the usual answer. If I say, I have POTS, almost everyone gets it immediately, especially the younger docs. Also "PAF" (Pure Autonomic Failure) would be an accepted diagnosis, but "dysautonomia" - no. Besides, I haven´t heard about just one doc here in Austria who "believes" in the existence of CFS... No patient ever would get this diagnosis here!

So, despite your disappointing experience - just know that I can even be worse in other parts of the world... And now simply forget about this doc - he isn´t worth it being angry about him, just go to another one!!

Best wishes!!

[Sunshinegirl]

I feel anger FOR you! This is unacceptable treatment! I too went through all of this but not with a psychiatrist. Other specialists tried to dx me with CFS and Fibro. I know they are real conditions but I refused the dx because I thought it would cloud the bigger issue. Somehow I knew that these syndromes were part of a bigger whole that was not considered a syndrome in the eyes of the medical profession. This is the dx I sought and got many years later. Just yesterday I hugged a dr who told me that if I was crazy, then he was down right nuts. It was such a relief to have someone interact with me in that manner.

I have always avoided psychiatrists for many reasons. Not all are bad or going to treat you like that. I did find one who is also a doctor of osteopathy. He does write prescriptions but offers just as many supplements and life style changes if the person is willing to take that route as well. In some countries and practices, your general dr. can prescribe many psychiatric medications. This can be more advantageous if you have bad reactions to many medications because you can get a sick appt. and not have to wait for a month or more.

[xRobin]

He talked about somatic being a problem with cells, cytokines, energy but then says somatoform disorder ... Meaning unexplained medical symptoms. Our medical symptoms are legit. CFS, pots is legit. I have a diagnosis. He even said period pain falls under somatoform.

That makes absolutely no sense because somatoform disorders by definition have no underlying disease process! He thinks there are problems and then the "mind" magically creates symptoms which match up? Yes, my menstrual cramps, which are well known to be caused by uterine contractions, are just feminine hysteria. (Sarcasm)

Goodness, how do some of these people get through medical school? Don't give him a second thought. (I, however, would give him a menstrual cramp for a day.)

[dizzyallie]

Thank you everyone for your kind thoughtful replies. I've actually written a letter to him, saying how somatisation is used when symptoms are not attributable to a medical illness. CFS and pots are legitimate illnesses. CFS is currently being redefined and renamed as a disease. Yes, the period comment, inside I actually laughed. He was a nice enough man but unfortunately, only aware of conditions within his area of specialty.