As you may know, I have two blogs, “Behind the Locked Doors of Inpatient Psychiatry” and “Notes in Passing,” and a strange thing has happened. As I have been writing about fatigue, I have been posting the same pieces to both blogs. The number of viewers on Notes in Passing has dropped by about half; at the same time, the same posts on Behind the Locked Doors approximately have doubled the number of viewers. Hm-m-m, very interesting.
My interpretation of these facts is that the typical reader from the general public is doing okay and doesn’t have much interest in the subject of fatigue. However, people with psychiatric diagnoses are experiencing a type or degree of fatigue that has sent them searching the Internet for explanations. I have two ideas why people with psychiatric diagnoses are particularly interested in fatigue.
The first is that pharmaceuticals cause fatigue. Virtually every drug you take is reported to have side-effects of fatigue, tiredness, lethargy, malaise, weakness or sleepiness. This is because tiredness is the first symptom when the immune system is under stress.
The immune system, according to the National Institutes of Health (NIH), is designed to keep foreign invaders out of your body. To do this, it must first figure out the difference between “self” and “non-self” so it only attacks the foreigners. (Mistakenly attacking the Self creates an autoimmune disease.) The NIH reports “the proper targets of your immune system” are bacteria, fungi, parasites and viruses. The NIH does not countenance the fact that the immune system considers vegetables to be Self but drugs to be Non-Self; drugs are foreigners and therefore the immune system considers them a proper target.
When you take drugs then your immune system knows it and responds by causing fatigue, probably because it’s using up all your energy trying to get rid of the invaders. It is, in its own quiet way, saying “Don’t give me this crap.” Once you’ve taken your first dose of psych meds, you soon find yourself inundated with multiple other drugs because that’s what psychiatrists do: persistent poly-pharmacy. As the drug load gets increasingly heavy, you find yourself overwhelmingly fatigued and sitting at home of a Saturday night reading the Internet in search of an explanation.
If this be your problem, then stop taking psych meds, eat your vegetables, get some exercise, make friends with people with whom you can share your problems, and you’ll feel better.
I have a second theory about why people with psychiatric diagnoses are being drawn to my writings about fatigue: there is a peculiar kind of fatigue that carries with it unstable and atypical emotional activity. You just can’t get a grip on your emotions and somehow, someway, you intuitively think it is because something is wrong with your body.
First of all, there is the brain. The brain’s activity is the mind. The mind thinks. “Meaning occurs in the mind, and the brain obeys the mind. They are not the same thing.” (For a lovely essay on “I love you,” see also http://www.huffingtonpost.com/deepak-chopra/how-the-brain-interprets-meaning_b_981685.html ). Basically, nobody has a clue where emotions come from; they just are. At any rate, I certainly don’t know where love lives. What I am certain of is that the brain and the rest of the central nervous system, along with hormones and the immune system, can totally screw up your existing emotions.
Psychoneuroimmunoendocrinology (PNIE) says that your emotions are connected to the central nervous system, which is connected to the immune system, which is connected to hormone production, which is connected to your emotions. Interrupt the healthy functioning of any part of that cycle and you can expect to mess up your emotions.
I have long been interested in the role the immune system plays in emotional health. For example, chronic fatigue syndrome and chronic hyperglycemia (Uncle John who has diabetes and won’t watch what he eats) both cause depression. So can having a fight with someone you love. We are standing here, loves, on the bridge between mind and body. Your mind and your body each can make you feel depressed.
In addition to chronic fatigue and chronic hyperglycemia, multiple sclerosis causes depression, and lupus frequently is initially diagnosed as psychosis. Chronic Fatigue Immune Deficiency Syndrome (CFIDS) is an illness which messes up the immune system and the brain and, consequently, messes up the emotions.
I think that the readership of my blog is increasing because there are a whole lot of you out there who have CFIDS and don’t know it. What you do know is that you are suffering from emotional dis-ease and fatigue, and you suspect that somehow they are connected, and you’re trying to figure out what’s going on.
You are right: your fatigue and your emotional dis-ease may co-exist under the umbrella of CFIDS. I suspect that there are a heck of a lot of people who are emotionally messed up and they are being blamed—their ego or personality or character—for their instability when, in fact, the blame belongs on their body.
Yeah, hear me? I know your personality is not crazy; your body is sick. That’s the good news.
The bad news is that nobody knows what to do about it. If you read the last three pages posted on this blog then you will know a little more than you did, but not a lot. Nobody knows what causes CFIDS. There are no lab tests to identify it. There’s a little bit about how to treat it, but not much. And there are no doctors—at least not in Central New York.
CFIDS properly belongs in the domain of immunology but there are relatively few physicians who are trained as immunologists (which I don’t understand because I think it is the most important, interesting and provocative field of medical study). Absent immunologists, you might seek a neurologist who knows something about CFIDS. Occasionally a rheumatologist might be helpful, but before you put yourself in the hands of any of these doctors ASK HOW MANY CASES OF CFIDS THE DOCTOR HAS DIAGNOSED OR TREATED.
It is better not to have any physician than to stumble blindly into the hands of a “dinosaur doctor”: “An unhelpful line of thinking among ‘dinosaur doctors’ is to say to a fatigued patient, on receipt of a normal set of blood reports, that there is ‘nothing wrong’.” There really is something wrong; you really are sick. Unfortunately, there are some patients who report having seen 20 doctors before getting correctly diagnosed.
Please write to me about what’s going on with you. Together, we can work this out.