Morgellons Syndrome
Perhaps one of the strangest and most controversial medical
mysteries out there today, Morgellons syndrome involves the
sprouting of inorganic material -- including fibers and crystals --
from the skin.
No solid evidence yet exists for the condition, and many doctors
today say it is likely more a psychological condition than a
physical one. That is, of course, assuming that the individuals who
say they suffer from it do not actually have these objects growing
from their skin.
In 2006, Brandi Koch of Clearwater Beach, Fla.,
told ABC News that she was one of many to suffer from the
condition; she claims she has colored fibers coming out of her
skin.
"The fibers look like hair, and they're different colors," Koch
said.
And while most medical professionals doubt the existence of the
condition, at least one -- pediatrician Dr. Greg Smith of
Gainesville, Ga. -- claims to actually have experienced the
condition firsthand.
"It felt like somebody stuck a pin in my toe and wiggled it and
it just continued to hurt," Smith told ABC News in 2006. "I've
certainly had those crawling sensations, and the fibers which come
out of the skin are really bizarre, and really odd."
However, Dr. Vincent DeLeo, chief of dermatology at New York's
St. Luke's-Roosevelt Medical Center, weighed in on what he'd say to
someone who came to him with this condition: "I don't think this is
any different than many patients I've seen who have excoriations
and believe that there is something in their skin causing
this."
DeLeo says the open lesions are a result of scratching the
skin.
Sibling Rivalry Disorder, Mathematics Disorder and
Caffeine-Related Disorders
Maybe you never got along with your little brother or sister.
Perhaps numbers make your stomach turn, or maybe you drink a bit
too much coffee for your own good.
If you're like most people, none of these situations poses a
real threat to your daily routine. But take any of these situations
and imagine them magnified exponentially. Suddenly, you're dealing
with Sibling Rivalry Disorder, Mathematics Disorder or one of any
number of Caffeine-Related Disorders.
Like some of the other diagnoses on this list, these conditions
appear in one form or another in the DSM. And Kupfer says there is
a good reason for including them; specifically, he says these
collections of symptoms can often cause a certain level of personal
distress or impairment -- the very definition of a disorder.
"In a way, what we are looking for is to diagnose things
reliably to allow individuals to seek treatment," Kupfer says.
With regard to Sibling Rivalry Disorder, treatment can mean
counseling that could solve family problems or prevent future
psychological conditions. Teaching someone to cope with caffeine
abuse may save them from sleep-related problems. It is in these
situations, Kupfer says, that labeling such conditions as disorders
is helpful.
But Hadler cautions that labeling can also have its
downsides.
"A label will always change your self perception," he says.
"Sometimes it elicits a positive change, sometimes a negative
one."
And as far as Mathematics Disorder goes, most are skeptical that
receiving such a diagnosis will get you much pity from your
teachers.
"Would anybody actually say, 'I have math disorder and I'm
getting treatment, and that's why I'm not successful'?" asks Dr.
Dost Ongur, clinical director of the schizophrenia and bipolar
disorder program at Harvard University's McLean Hospital in
Belmont, Mass. "No, you would never get something like that. Math
disorder is not like diabetes."
Oppositional Defiant Disorder (ODD)
Oppositional Defiant Disorder, or ODD for short, is a diagnosis
that is applied to children who display such frequent and
aggressive defiance of their parents that it disrupts the lives of
those within the family.
According to the Mayo Clinic Web site, as many as one in 10
children may have oppositional defiant disorder in a lifetime, and
it is often associated with other childhood behavioral disorders,
such as ADD.
Galynker says the roots of this disorder are most likely
genetic; aggression, he says, is one of the most highly inherited
qualities. And genetic links to the kind of aggression seen in
children with ODD have been proven in twin studies. Based on this,
he says, ODD is likely a very real disorder.
"It's their internal characteristic to argue with their
parents," he says. "Some deal better with this, while others deal
worse."
An official diagnosis of ODD would likely be met first with
counseling, and later with medications to help control a child's
behavior. Parents may also receive counseling in order to learn
more about how to control their children's behavior.
But many would argue that the blame should be more squarely
placed on nurture than nature -- in order words, that parenting
styles are more likely to be responsible for this disorder than
genes. Ongur says it is little surprise that this may be the
commonly held perception.
"For these disorders, I think it makes sense for the lay person
to have that kind of reaction -- not because they are fake
disorders, but because of the way it plays out in society," he
notes.
Hadler, however, has a different take -- that ODD is yet another
example of the medicalization of commonly seen behavior.
"No young child can be a brat anymore," he says. "Now, what
right do we have to do that?"
Dissociative Fugue State
The stories are rare, but they are out there.
A successful lawyer -- a husband and father of two, active in
his community -- disappears, only to be found six months later,
living in a different city under a new name in a homeless
shelter.
A man without an identity walks into a hospital, saying he woke
up on the street with no wallet or identification, and says he has
no idea who he is. His family locates him two weeks later, after
which he returns to normal.
Such cases are examples of dissociative fugue state. In these
cases, an individual will disappear, leaving everything behind --
including their memories and identity. In some cases, the sufferer
even assumes a new identity, which persists until they are reunited
with their old surroundings and allowed to return to their old
persona.
Few psychological disorders have attracted such wonder from the
public -- and sparked so much debate among experts in the field.
Nowadays, most psychological experts agree that such cases are not
simply about individuals running away from their problems, but,
rather, a legitimate condition.
"The thing that people experience as 'fugue state' does happen,"
Ongur says. "There are people who wake up in other cities and don't
know what has happened."
The fugue state is actually part of a larger family of
conditions known as dissociative memory disorders. The trigger for
these conditions is usually a traumatic event -- the death of a
loved one, for example, or an extraordinarily stressful event at
work. It is also more common in those who bear past trauma from
events like natural disasters and war.
Chronic Fatigue Syndrome (CFS)
Chronic Fatigue Syndrome, or CFS, has garnered additional
support as a legitimate diagnosis in recent years. Today, the U.S.
Centers for Disease Control and Prevention (CDC) recognizes it as a
condition that affects between 1 million and 4 million
Americans.
Of these individuals, according to the CDC, only about half have
consulted a physician for their illness -- even though it has been
known to cause serious impairment in some.
As the name implies, CFS is most often associated with severe,
debilitating fatigue. Non-specific pain and other symptoms are also
common hallmarks of the condition, which is disproportionately
experienced by women. As the condition persists, patients will
often become depressed at the current lack of proven treatments to
remedy the problems they experience.
But while the condition is starting to receive more attention
and support, the underlying causes largely remain a mystery. Some
have cited Epstein-Barr virus as a likely culprit. Others point to
anemia, while still others implicate allergies.
Perhaps it is for this reason that the borders of this diagnosis
remain contentious at best. Symptoms run the gamut from
long-lasting flu-like symptoms to memory loss. Treatment can
involve antidepressants, antihistamines or acupuncture.
To Hadler, CFS seems less like an actual condition and more like
a rapidly growing hodge-podge of symptoms associated with a number
of different diagnoses that are becoming increasingly more
prevalent.
"Now it overlaps with post-traumatic stress disorder,
fibromyalgia -- all of these labels include symptoms of fatigue,"
he says.
Still, dozens of studies -- many federally-funded -- are seeking
answers as to the true nature of this condition.
Multiple Personality Disorder
It's been the stuff of horror movies and big-screen comedies.
Yet, the truth behind Multiple Personality Disorder -- or
Dissociative Identity Disorder (DID), as it is known today -- is,
in most cases, a far cry from these dramatic interpretations of
this classic psychological condition.
"Even when a patient says it's a different personality, it's
nothing magical," Ongur says. "When people describe it, it is
really a very extreme version of the more familiar feeling of
disintegration. If you are under extreme stress or have had certain
past experiences, the way the mind functions may actually break
down."
Those who experience DID will create at least one "alter"
personality that manifests itself in certain situations -- in
essence, "taking control" of one's personality. These changes occur
involuntarily, and DID in its most severe forms can limit one's
ability to interact with others.
By the same token, the condition can occasionally go mostly
unrecognized. Football great Herschel Walker is just one example;
in his recently released book, "Breaking Free: My Life with
Dissociative Identity Disorder," Walker says his life was
fragmented by a number of independent "alters" -- at least one of
which led him to attempt suicide.
Ongur says early psychological trauma is one of the most common
underlying causes of the disorder.
"When people describe these things, it is certainly often
associated with a severe history of child abuse," he says. "This
was one way for them to cope."
And, as in Walker's case, psychological treatment involves
unifying the alters into a single personality -- allowing those who
suffer from the condition to regain full control over their
lives.
"The task is to get this person feeling whole again," Ongur
says.
Social Anxiety Disorder (SAD)
If there is a success story among psychological conditions once
considered spurious, it is that of Social Anxiety Disorder (SAD),
psychological experts say.
"The whole issue of social phobias was once considered something
that was not very important," Kupfer says. "As we discovered, this
can cause a tremendous amount of impairment, and there are a whole
lot of issues developmentally which affected coping with it."
In labeling this as a disorder, he says, medical professionals
have been able to help millions of people who otherwise would have
been told that they were simply shy.
Ongur agrees. "It's familiar to people because it's shyness, but
it's really extreme shyness," he says. "It is something that can be
very real and very impairing."
Those who suffer from SAD often find themselves faced with
seemingly insurmountable anxiety when it comes to interacting in
certain social situations. Most common are feelings of being
watched, scrutinized and criticized by others. So intense is this
anxiety that it can sometimes lead to a panic attack.
In most cases, these fears are unreasonable. Counseling can
often help those who live in near-constant fear of being
embarrassed or humiliated in front of others. Coaching in social
skills may also be needed in order to help those with SAD better
integrate themselves into comfortable social circles.
"Social phobia ... is a relatively new diagnosis," Galynker
says. "Many people have difficulty socializing, of course. This is
just a label to help treat people who have it."
And Galynker says the changing perception of SAD and
psychological conditions like it will hopefully help remove the
stigma so often associated with such disorders.
"Everybody has a problem, really," he says. "Nobody does not
have some sort of diagnosis."
Katie Escherich contributed to this story
There are more things between heaven and earth than are dreamt of in our philosophy. I know that's corny, but it's the best I can do.
- Fiona Holding, NORTHWOOD, 20/12/2009 14:49
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