Hi there. Thanks for your post about somatic disorders and RA. Ra Warrior is doing a great job placing a laser beam on RA and bringing the disease out of the shadows. Women have to stop tolerating having their symptoms ascribed to mental health conditions. Rheumatoid Awareness events on FB (with over 25,000 people invited) is having a major impact on informing the public about this disease.
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My primary concern is what I see as the built-in dismissal of legitimate emotional responses to a troubling health situation. I think there's a direct line between the concept of catastrophizing (and the many problems with it) and this new disorder.
These kinds of disorders have been part of the DSM before, but the lack of clarity to the definition of SSD has some serious implications for people living with chronic illnesses. I am also very concerned about the lack of research data backing this up. When I was in university, studying psychology and social work, we had it beaten into us — okay, not literally — that without data, your theory is just an idea with no validity or reliability. It seems to me that SSD is just a theory that needs a lot of testing before it can be determined to be solid.
I'd be very interested in hearing what your psychologist friend has to say about this. Would you mindfollowing up with me after you talk to him?
There is a possible brighter side to this discussion: it might be that, rather than using the diagnosis to dismiss someone's concerns, it will enable them to get treatment for the emotional anxiety and associated preoccupation with illness, rather than saying, "Buck up! You don't know that anything for sure is wrong, so it's YOUR problem to deal with yourself." Even with a known diagnosis, there can be incredible anxiety (as we all know!) and associated stress from lack of sleep (not only because of anxiety but related to the illness). Medication for sleep/anxiety, etc. could be legitimately covered. (Of course, there is always the danger of being OVER-treated, or medication being used where emotional support/counseling, peer-support might be more useful and long-lasting, rather than a stop-gap).
Just as there is a diagnostic code for persons who have same-sex orientation but are distressed by being that way. It's not saying there is anything WRONG with the orientation, but is a recognition that there is a genuine problem to be dealth with an treated, if the patient chooses - because, if there is not a diagnostic code, then insurance has no reason to cooperate. (Not that all insurance covers mental or emotional illness, however!)
Just a thought - not trying to be devil's advocate but just present a different perspective. (having taken a 'psychopathology in counseling' course years ago...)
SSD is an amalgam of previously existing definitions. The problem is not the assumption that people can be upset about their symptoms, the problem is how vague the current definition is, as well as the lack of data supporting the definition.
Hmmmm I didn't know they had combined previous ones (trying to streamline the always-expanding DSM?
I do understand the concern, and you're right, there SHOULD be data, etc. But even considering that - how to quantify? I don't even like the RA questionnairs - except the one from the NIAMSS .... and even that is exasperating to some degree, but if anything they go to the max trying to get exact, explicit date. But I always wonder, how do you match up different people's self-evaluation of This feels like X on a scale of 1 to 10 (at our local hospital, right under the poster for the 1-10, there is a brief, 1 to 5!
Yup. I do get the problem - actually multiple leves..it's only when there is not a stigma when people can freely admit their difficulties and expect help. And even then, it's often hard to admit that we need help, no matter how much it may make sense, even, and be necessary!
I have anxiety and panic disorder with my RA,Srjogens,Graves, osteoarthritis and extreme weakness in my legs, according to my homr health PT like an old lady. I am doing everything they have asked me to..... My family teases me and says my fruitloopy meds! I would be in a nuthouse if I didn't have them. So, from my perspective, there are some RA people with mental issues. My anxiety hits mostly at sundown. kinda like dementia patients.... lol. I worked with them for 14 yrs and it is real,. Iread an article from a doc that said it wasn't..... bologna, he should come visit my former place of employment.... I believe all my issues are related or stem from the RA, it is a systemic disease. Whole body! So why not your mind too? I say it does. I've met others randomly that tell me the same thingbut are afraid to tell the family or docs...Just my thoughts...