“Doctors are men who prescribe medicine of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing”,Voltaire
Those of us with chronic conditions are constantly seeking relief from the myriad of symptoms that make our lives very challenging. Pain, fatigue, lack of physical abilities, sleep disturbances, depression, rashes, to name but a few of the minor to serious struggles with which we are faced lead us to desperately wanting relief in the form of medications. Living with any one of the daily distressing symptoms affects our quality of life and it is little wonder that we seek help in the form of chemicals to help us get through the day. Many, in fact, are essential to our conditions without which we could not survive. Others are prescribed from the sheer frustration of physicians who want to help but medical answers to many perplexing conditions are not yet available to them. Such is the case with fibromyalgia. What to do with a patient who has chronic pain but to prescribe a pain medication, that may or may not help? If the patient cannot sleep there is a solution: sleep medication. Depression and anxiety? Medications for altering moods.The list of medications for all sorts of conditions is limitless. Pharmaceutical companies are big booming businesses whose profits know no bounds.Physicians could not possibly remember the vast array of information that the drug reps tell them about their efficacy or that they learn about on line. More to the point ‘new’ diseases and conditions are constantly being ‘discovered’ for which new drugs must be invented. Read : The Medicalization of Everyday Life by Thomas Szasz, a psychiatrist, whose work in mental illness was compulsory reading for me as a medical sociology student in graduate school, many years ago.
“Nothing in life is to be feared. It is only to be understood”, Marie Curie
I recently heard a presentation from a distinguished scientist speaking about fibromyalgia. The audience seemed to be mostly comprised of people with fibromyalgia. He referred to fibromyalgia as a ‘terrible disease’. My immediate reaction was not very positive as I don’t believe that fibromyalgia is a disease, but rather a syndrome, yet he also referred to pain as a disease, which also surprised me. Language is so important to our understanding of this condition and I prefer to use the word dis-ease. If we feed into this idea of a disease, more and more researchers will continue to search for the elusive and non existent virus or bacteria or continue the search for hormonal issues, without an emphasis on psycho-social causation ! Furthermore, there was much in the presentation on what the brain looks like after prolonged pain, but it seems to me that this is a chicken and egg dilemma. I would prefer that the focus be on what caused these changes rather than to assume that people with fibromyalgia are born with genetic defects. However, the question about whether or not we are born with unusual brain wiring or we acquire it from our early socialization is one which may never be answered.
The term neuroplasticity was only briefly mentioned once. I would have liked to know his thoughts about whether or not a person could acquire this brain defect in wiring because of socio-psychological issues. He emphasized that fear was a big factor in fibromyalgia, a point that I agree with emphatically. If this is so and the ‘fight or flight’ amygdala reaction of the brain is in constant turmoil, it seems to me that this is psycho-socially induced. But of course, once again, I am only speculating.