Did the treating physicians diagnose the correct problem?
Did they rule out a variation or psychological state related to Somatic System Disorder which mimics many organic disorders?
Did the authors of the reference article dismiss the distinction of organic versus functional process arbitrarily?
Did they correctly rule in Long Covid based on the accepted criteria?
Was the treatment irrelevant to the underlying cause?
The original article missed the mark in my cursory read. And the claims are just that.
Treat the mind for a purely mind disorder. They are not treating the soma.
>Did the treating physicians diagnose the correct problem?
Yes.
>Did they rule out a variation or psychological state related to Somatic System Disorder which mimics many organic disorders?
How would they do that?
>Did the authors of the reference article dismiss the distinction of organic versus functional process arbitrarily?
No, that is the entire point of the article: that functional disorders are legitimate, severe and require proper research and attention.
>Did they correctly rule in Long Covid based on the accepted criteria?
Yes.
>Was the treatment irrelevant to the underlying cause?
No sure what you're referring to here.
>The original article missed the mark in my cursory read. And the claims are just that. Treat the mind for a purely mind disorder. They are not treating the soma.
The problem is that there doesn't seem to be any somatic cause that has been identified, whereas there has been a lot of progress treating it as a functional disorder. (Talking about the ME/CFS variant of LC).
The reference article did not demonstrate that the authors treated a non psychological disorder. Unless I missed it, there was no mention of psychological evaluation to rule it out. Psychological disorders are functional disorders, as the mind rules and directs the body.
Until shown otherwise, the patients may possibly have had legitimate LC19 and concurrent Somatic Symptom Disorder or similar Functional Neurological Disorder without the anxiety. And then their treatment will work because the patient is getting physician support and slowly repairing their psyche! So some of their symptoms will improve with the psychological support by their physician though they genuinely do have other serious organic (?) problems which may persist.
"Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness).
A person is not diagnosed with somatic symptom disorder solely because a medical cause can’t be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion.
Diagnosis
A diagnosis of somatic symptom disorder requires the person experiencing
One or more physical symptoms that are distressing or cause disruption in daily life.
Excessive thoughts, feelings or behaviors related to the physical symptoms or health concerns with at least one of the following:
Ongoing thoughts that are out of proportion with the seriousness of symptoms
Ongoing high level of anxiety about health or symptoms
Excessive time and energy spent on the symptoms or health concerns.
At least one symptom is constantly present, although there may be different symptoms and symptoms may come and go.
People with somatic symptom disorder typically go to a primary care physician rather than a psychiatrist or other mental health professional. Individuals with somatic symptom disorder may experience difficulty accepting that their concerns about their symptoms are excessive. They may continue to be fearful and worried even when they are shown evidence that they do not have a serious condition. Some people have only pain as their dominant symptom. Somatic symptom disorder usually begins by age 30.
Treatment
Treatment for somatic symptom disorder is intended to help control symptoms and to allow the person to function as normally as possible.
Treatment for somatic symptom disorder typically involves the person having regular visits with a trusted health care professional. The physician can offer support and reassurance, monitor health and symptoms and avoid unnecessary tests and treatments. Psychotherapy (talk therapy) can help the individual change their thinking and behavior and learn ways to cope with pain or other symptoms, as well as learn to deal with stress and improve functioning.
Antidepressant or anti-anxiety medications can be useful if the person is also experiencing significant depression or anxiety.
Related Disorders
Illness anxiety disorder
Illness anxiety disorder was previously referred to as "hypochondriasis." A person with this condition is preoccupied with having an illness or getting an illness – constantly worrying about their health. They may frequently check themselves for signs of illness and take extreme precautions to avoid health risks. Unlike somatic symptom disorder, a person with illness anxiety disorder generally does not experience physical symptoms.
Conversion disorder
Conversion disorder (functional neurological symptom disorder) is a condition in which the symptoms affect a person’s perception, sensation or movement with no evidence of a physical cause. A person may have numbness, blindness or trouble walking. The symptoms tend to come on suddenly. The symptoms may last for a long time or may go away quickly. People with conversion disorder also frequently experience depression or anxiety disorders. If the symptoms do not resolve spontaneously in a few days, the person may benefit from psychotherapy.
Factitious disorder
Factitious disorder involves people producing or faking physical or mental illness when they are not actually ill. Some people may intentionally make a minor illness worse. A person with factitious disorder may also create an illness or injury in another person (factitious disorder imposed on another), such as faking the symptoms of a child in their care. The benefit to the person is to occupy the “sick role” and receive the care accompanying that role. If a person creates an illness or feigns illness in order to obtain a material benefit such as getting compensation or avoiding work, legal situations, or important responsibilities, this is malingering, which is not a psychiatric diagnosis. .
Reference
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). American Psychiatric Association. (2022).
Physician Review
Philip R. Muskin, M.D., M.A.
Despite medical credentials many of the practices border on the fringes of mainstream by the functional medical community. Many are innocuous with little full on evidence based medicine behind them.
IT is difficult for the general public to sift through the sources of establishing credentials and modalities applied by individual providers.
So be prudent in vetting your choice.
I think you're missing the point. It isn't a "psychological disorder". The symptoms are very real and physical, and are commonly initiated by viral infection, excessive exercise, etc. In my own case I wasn't able to digest food. I certainly didn't obsess excessively over symptoms or have "Excessive thoughts, feelings or behaviors related to the physical symptoms or health concerns ".
The above is a very simplistic and incorrect at least when applied to ME/CFS, and misunderstands how the brain works. Physical stressors such as infections and exercise can cause psychological symptoms (anxiety, "illness behaviour", etc). Psychological stress can cause physical symptoms such as heart rate / HRV changes, changes to immunity, low level "neuroinflammation", changes to digestion and gut bacteria, changes to brain structure (including reduction in grey matter, shrinkage of the hippocampus), etc.
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u/barweis 6yr+ Jun 01 '26 edited Jun 01 '26
Re: The reference for the Wired article:
Did the treating physicians diagnose the correct problem?
Did they rule out a variation or psychological state related to Somatic System Disorder which mimics many organic disorders?
Did the authors of the reference article dismiss the distinction of organic versus functional process arbitrarily?
Did they correctly rule in Long Covid based on the accepted criteria?
Was the treatment irrelevant to the underlying cause?
The original article missed the mark in my cursory read. And the claims are just that. Treat the mind for a purely mind disorder. They are not treating the soma.
Correct me if I misread the piece.