Thankfully, hysteria is no longer considered a viable diagnosis. But there are still so many synonyms for hysteria that are used regularly in the medical world, such as psychosomatic disorder, somataform disorder, functional disorder, and many more.
I’m making a choice to push back against this language around illness. It’s lazy science. It’s harmful medicine.
Once a patient is labeled hysterical, they’re often exiled from most medical specialties. Many specialists refuse to accept new patients with so-called ‘psychosomatic’ illnesses, and further medical investigation, imaging, and blood tests for underlying physiological problems is often denied.
But patients still need help, so they often go it alone on the hunt for a diagnosis and treatment. Then they fall victim to more ridicule from medical professionals for relying on “Doctor Google” or obsessing about their unexplained symptoms.
Some patients are referred to psychiatry or therapy. If they’re lucky enough to be able to access mental health care, that’s a powerful tool, but those providers aren’t trained to treat complex, multi-system illnesses that go beyond just the psyche. They can help with the anxiety, depression, and PTSD that might go hand-in-hand with their other symptoms, but the physical symptoms are usually far outside their scope of practice.
If a patient isn’t able access mental health care, they’re left fighting two difficult battles at once, without any support: The fight against the daily pain and physical decline of an untreated, disabling chronic illness, and a fight against the depression and anxiety which so often accompany the ongoing grief and trauma of a life-altering, unmanaged, chronic illness.
And what is the stereotype for a patient with a psychosomatic illness, exactly? Someone with depression, PTSD, and anxiety who is obsessing about their symptoms in the search for a diagnosis.
There’s a circular logic to it, because who wouldn’t obsess about their disabling, life-altering symptoms? Who wouldn’t struggle with some degree of depression, anxiety, or PTSD when they’re in the middle of such challenging circumstances?
Once they’ve been labeled hysterical, then they’re trapped. How can they argue otherwise, against the doctor’s authority, without fear of seeming even more hysterical? There’s no escape route from this presumed diagnosis unless a patient is able to produce proof of their symptoms, which is hard to do in the course of a 10 minute appointment with a provider who assumes the patient is off their rocker.
This is dangerous because it prevents patients from accessing the care and treatment they need. And quite frankly, I believe that it’s nothing short of gaslighting to tell patients that their lived experience isn’t real.
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