Sunday, December 30, 2007

Musings on “Medical Mysteries”

There are some fictional and nonfictional "medical mysteries" television shows (such as "Mystery Diagnosis") that I have enjoyed watching.

What I find quite revealing in the real-life medical mysteries is that in case after case the people were told that their symptoms were not "real" – i.e. they were "mental".

The people suffered for years without the doctors knowing what was wrong. But, their suffering was compounded by the doctors telling them that it was "mental." By saying that, the patient not only was suffering from their very real symptoms but they did not get the support from others that they would have gotten if they had been diagnosed with a "real" illness.

I was not surprised by the cases which turned out to be Lupus. However I was surprised at the number of cases presented where the illness turned out to be Lyme disease. The reason that they were able to do so many episodes about Lyme disease was that each case presented with vastly different complex symptoms. It turns out that a blood test would be run which would be negative. The doctors then would rule out that diagnosis. However, it turns out that the blood tests run could only rule in the diagnosis if positive, but they could not rule out the diagnosis when negative.  (See here for "Psychiatric Impact of Lyme Disease")

The take home message I got from watching these shows was that time after time if the doctors did not understand what was causing the patient’s symptoms, especially if the patient’s symptoms fluctuated, some doctors would write that patient off as having "mental" or "psychiatric" issues.

One popular fictional show that I especially enjoy is called "House". There have been a few episodes that start with a psychotic patient who for one reason or another ends up in the hospital with Dr. Gregory House and group trying to figure out the cause of the patient’s psychosis. In one show the only symptom the patient initially showed was psychotic hallucinations (it turned out to be mold inhalation--Zygomycosis). I knew very well that in real life that patient most likely would have been sent to a mental hospital, not to a real hospital to try to figure out the source of that patient’s psychosis.

In another episode, a child with hallucinations turned out to have chimeric brain tissue causing the hallucinations.

One very sad episode that hit close to home for me was a mother being cared for by her teenage son. The mother supposedly had, and was being treated for, long term chronic schizophrenia when she started to present with some “physical” symptoms. When they unraveled the patient’s new symptoms they found out that the old symptoms of schizophrenia were actually a part of the patient’s underlying medical problem. The patient did not actually have "schizophrenia" after all. What she had was Wilson’s disease.

Although these episodes of "House" were fictional, they were based on true illnesses.

Meanwhile, real-life "medical mysteries" initially being diagnosed as "mental" are happening all around me to people I know and to friends of the people I know. But is that really surprising? If an illness is not psychological, even though it presents with symptoms affecting the brain, it should not be a surprise that the illness is not "mental". Unfortunately, until the person is diagnosed with something physical it remains "mental".

The problem with giving a patient the "mental" diagnosis when the physical cause is not known, is that because the patient now has a diagnosis, doctors feel there is no longer a mystery. The patient has the diagnosis. Why look further?

From my real life experience it seems that to uncover medical pieces of the puzzle after a person has been given a mental illness diagnosis requires the person, or their family, to have the financial resources, the fortitude, and the education, to move forward in spite of a reticent medical community.

This is a shame. The mind and the body are terrible things to waste. Personally, I would much rather doctors just say "I don’t know" than to give a garbage diagnosis of “mental”.

Here are some problems I have personally known people to have which doctors initially relegated to that garbage can of "mental illness." These were labeled major depressive disorder, anxiety disorder, panic disorder, mood disorder-nos, bipolar disorder, schizophrenia, etc.

Tachycardia (from a congenital heart defect)
Far-sightedness and blurred vision
Adrenal tumor
Hypothalamic Dysfunction
Low progesterone/low cortisol
Side-effect of medication
Intestinal malabsorption
Pain from osteoporosis
Reaction to cow casein (dairy)
Celiac/gluten sensitivity and other food sensitivities
Candidal infection
Viral infection
Kleine-Levin syndrome
Genetic metabolic problem / functional nutritional deficiency
Wilson's Disease

Update: In just the year 2009, I have the following additional diagnoses from friends, families, and acquaintances to add that had been labeled bipolar, schizoaffective and unknown hallucinations:

  • Epilepsy
  • Brain tumor
  • 2 more cases of gluten sensitivity
  • Another case of Central Hypothyroidism
  • Another case of medication side-effect
Update in 2012: In the past few years, here are some more cases of "mental illness" in friends and acquaintances.
Then there is even the label of "hypochondriasis" for problems like Multiple Sclerosis (early stages) and Lyme Disease!

And let's not forget the label "Somatization  Disorder" that used to be given to people with IBS (Irritable Bowel Syndrome) and Chronic Fatigue, and still being given to people with the symptoms of matching those found in people with gut and autoimmune issues!

Makes me wonder when this insanity is going to stop, and by "insanity," I am not referring to the patients!

Unfortunately, once a person does have a mental diagnosis, other doctors seem to chalk up yet more problems they see as part of that mental illness. Unlike the episodes of "House", they don’t see the additional symptoms as being related to the “mental” one and being part of the puzzle of the underlying medical condition.

Some people with a "mental illness" diagnosis end up with 15 other medical diagnoses as well. Seems like when that happens, the doctors are missing something basic, causing all the symptoms, including the mental one that occurred with no underlying psychological etiology.

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Last Updated:
  27 Sep 2012

1 comment:

Anonymous said...

Even a vitamin D deficiency can cause diverse problems resulting in misdiagnoses. It can mimic hypothyroidism, depression and anxiety disorders.

Check out this one man's true-life mystery diagnosis: