Smithsonian Magazine: For Some Women With Serious Physical Ailments, Mental Illness Has Become a Scapegoat Diagnosis

[SNT Gatchaman]

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Veronika Denner felt like she was dying. She had blood in her stool, an overactive bladder and such severe, debilitating pain that she compared it to barbed wire being cinched around her diaphragm, intestines and pelvis.

The doctor ran the standard tests, checking her complete blood count, inflammatory markers and her abdomen via ultrasound. But when they all came back normal, he said that she was probably just stressed, given her history of childhood trauma and busy college schedule, Denner recalls.

Upset about this dismissal, she sought out doctor after doctor—with little recourse. Denner says a gastroenterologist called her “a drama queen like many women her age,” while another called her a psychopath, making up symptoms to manipulate those around her. “These doctors were getting frustrated that they couldn’t find the answer to my problems,” she says.

In reality, Denner had endometriosis​

 

[Utsikt]

“It’s just easier to label women as emotional or as having some personality flaw that would account for their symptoms,” Bontempo says.

This bias has deep historical roots, harkening back to perceptions of female hysteria. First documented in 1900 B.C.E. in ancient Egypt, hysteria was defined by a “wandering womb” disrupting the body. But from the 18th century onward, it became synonymous with women being “over-emotional” or “deranged”—and a catch-all term for “everything that men found mysterious or unmanageable in the opposite sex,” as medical historian Mark Micale wrote in 1989.

Although female hysteria is no longer recognized as legitimate, its vestiges persist. “We just have different names for it now,” McGregor says. “We have conversion disorder or anxiety. It’s just disguised in different language.”

Since much of this issue stems from how doctors are socialized into their profession, Schwartzstein says change must begin from the ground up.

For one, Bontempo believes that physicians ought to be better trained in diagnosing psychiatric conditions. As an example, there’s a mental health condition—somatic symptom disorder—characterized by excessive focus on physical symptoms. But often, this is diagnosed simply because doctors are not able to identify a physical cause, which Bontempo says is a clear violation of the guidelines. Doctors should be reminded that absence of evidence does not connote a mental illness, she continues.

I think we have to take it a step further and challenge the concept of somatic symptom disorders itself.

 

[rvallee]

It’s just easier to label women as emotional or as having some personality flaw that would account for their symptoms

I don't know who could do that, but I'd really be interested in studies of this "it's easier" and what it means. Because it has so many possible meanings.

Does it mean technically easy? Ethically? Morally? Professionally? Emotionally? Concerning paperwork? What colleagues and employers think of it? How well they sleep about it at night? All of those? And do physicians not get that it's disgustingly immoral? Amoral at best?

I think we have to take it a step further and challenge the concept of somatic symptom disorders itself.

No doubt about that. It serves mainly as a "get out of work" card. Which, like above, is disgustingly immoral.

Although female hysteria is no longer recognized as legitimate, its vestiges persist. “We just have different names for it now,” McGregor says. “We have conversion disorder or anxiety. It’s just disguised in different language.”

Good to see physicians say it plainly. Those are not vestiges. They are not like the husks of downed craft, they are like live ammunition left around and which do regularly, in fact standardly, explode people. It's truly absurd that professionals are aware of this, and yet do nothing. It's like being fully aware that in normal operations for some job, let's say garbage collection, people just randomly get picked up and crushed to death, and no one seems to care. Or something equivalent. It just... gets no reaction.

There is clearly a much deeper, and very disturbing, factor here. As the paper says, related to socialization, to indoctrination that makes, there's a theme here, disgustingly immoral behavior be framed as perfectly normal. Things that a child easily know is wrong.

There are root causes here. No one works on root causes. Almost no one is interested, even when they know some of the consequences. It's so bizarre. The whole point of the job is to help people, and there are entire parts of that job that basically crush people to death. So damn weird.

 

[alktipping]

The whole point of the job is to help people, and there are entire parts of that job that basically crush people to death. So damn weird.

The point of the medical profession has historically been to profit from the sick certainly not to help people That is not to say many individuals do go into the medical world with good intentions .I expect that many become very disillusioned when faced with systems that put budgeting decisions first .