A Brief Introduction to Medically Unexplained Illnesses

Some chronic illnesses have specific titles, and treatments and are much more easily understood by medical professionals. They have a consistent set of diagnostic criteria, so they are easy to diagnose, treat, and maintain.

More research is done to find drugs and treatments that help with their treatment, and so while they are not curable, they are treatable, and people can have a relatively decent quality of life with those illnesses. Some examples are diabetes, thyroid disease, osteoarthritis, and psychiatric disorders like depression and Bipolar illness.

However, there are some illnesses, like Fibromyalgia (FMS), Chronic Fatigue Syndrome (CFS), and Multiple Chemical Sensitivity (MCS), whose symptoms are not well-understood by medical professionals. Since those symptoms overlap with other disorders and don’t lend themselves well to a specific diagnosis, they don’t get as much research funding and effort. There are efforts to find helpful treatments, like light therapies , but these are often unconventional and with mechanisms of action that may not be readily apparent.

Their causes are also poorly understood either; hypotheses include viruses, childhood trauma, injury, psychiatric disorders like depression and PTSD , chemical reactions that have gone awry, etc. The fact that the conditions are not well-understood does not mean that the diseases are less distressing to sufferers.

It also doesn’t mean they are “psychosomatic” (i.e., psychiatric symptoms masquerading or perceived as physical disorders). There has been a great deal of struggle to gain legitimacy in the medical field for people who suffer from Medically Unexplained Syndromes (MUPS), as people with these conditions have the added stress of not being believed by family, friends and medical professionals.

If they could point to a well-defined diagnostic label like cancer or arthritis, they might have a chance to be believed by others. Some prominent medical researchers have suggested that these disorders are purely psychological and that they would be fine if they just got Cognitive Behavioral Therapy . However, anyone who coped with fatigue, joint pain, cognitive dysfunction (like poor memory and concentration), or extreme discomfort after chemical exposure can attest that it is not just “all in your head.” Other people demean MUPS symptoms as “just being lazy” or “the yuppy flu.”

Fibromyalgia is perhaps one of the relatively better-researched MUPS. It is characterized by joint pain in 11 of 18 tender points on the body, fatigue, insomnia, and cognitive dysfunction, like mental “fogginess” that makes it hard to concentrate, focus, or remember things. Many people with Fibromyalgia are limited in what they can do, how they can move, and sometimes their employment opportunities and capacities are severely hampered by their symptoms.

Similarly, Chronic Fatigue Syndrome can negatively impact fulfilling social and occupational roles, and sometimes they have to apply for disability as they struggle even to achieve minimal activities of daily living. CFS has many similar symptoms to FMS (fatigue, cognitive problems, joint discomfort) but also has tender lymph nodes, flu-like symptoms, and “post-exertion malaise”, which means that if they do too much during the day, they feel even worse for the next day to the whole week or more. You may be able to see how this could interfere with holding down a job, raising children, having a social life, or running a household. While these disorders usually affect women, men can also be affected. Although rarer, children and adolescents can become ill with CFS and FMS. Most of the studies on CFS and FMS that have been done involve adults from 40-60 years old. It affects all socioeconomic statuses as well as ethnicities.

Multiple Chemical Sensitivities (MCS) are perhaps the most controversial MUPS. While it shares a few symptoms with FMS and CFS, it focuses more on adverse reactions to exposure to chemicals in everyday products. Some of those products include cigarette smoke, gasoline, solvents, perfume, clothing dyes, dryer sheets, cleaning agents, pesticides, and hairspray. People have a range of symptoms when exposed to these types of chemicals, including respiratory problems, skin rashes, headaches, cognitive problems, etc. people with FMS and CFS sometimes are sensitive to smells. Still, it is not a defining feature of either of those conditions. Because there’ve been some studies where people failed to show increased sensitivity to specific agents in a laboratory, some medical professionals regard MCS as merely a psychosomatic illness. However, the reactions are natural, cause physical and mental distress, and sufferers are not simply imagining what they experience. Instead of invalidating people’s experience, it seems more beneficial when doctors, friends, and workplaces can work with people sensitive to smells to make them comfortable, happy and productive. Other people might not perceive the same scents as threatening because they get no physical reaction. However, several factors might contribute to some people’s extra-sensitive reactions. I will address these factors in the next blog post.

Medically unexplained illnesses are often chronic, and their prognoses are uncertain. Many of these illnesses overlap in symptoms, but the sufferers struggle to meet their life roles and function well. Hopefully, we can improve their experience and be less stressed with more understanding, research, and compassion. I will write about them in future blog posts, specifically the link between these illnesses’ psychological factors and physical symptoms.