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I feel like this misses the case where the "real" and psychosomatic overlap.
There are some conditions that are "real" but rare and their "popularity" far outstrips the rate of the sufferers of the "real"/"physical" condition. Here we have things like various exotic mental disorders/syndromes, pain conditions, digestive disorders, allergies, fatigue conditions (most recently long COVID), auto immune disorders and transexualism.
Also, people who have the conditions likely have some of the conditions that causes psychosomatic symptoms similar to the condition, often because the condition itself causes or encourages behaviour leading to depression, anxiety, inactivity and or isolation.
How does a doctor tell whats going on? How does the social security system? How does the general public? How does the person themself?
As soon as something like this goes mainstream it inevitably gets dragged down in partisan politics.
I don't get paid nearly enough to get dragged into the debate on Fibromyalgia, Long COVID and the like. Especially the latter.*
But, for what it's worth, I have never seen a case of fibromyalgia in India, and even googling for cases here turns about zilch. On the other hand, sequelae after a severe viral illness is quite common, and whether or not COVID deserves a specific carveout is something I don't have a strong opinion on.
Make of that what you will.
*It has come to my attention that I don't get paid at all, but if someone wants to rectify that, Google the BMA rate card. And that does not include the 500% hazard pay rates I demand for trans medical care, or opinions on that.
My suspicion is that this is a trans type situation. Yes there are real trans patients. Yes there are cultural contagion trans patients. Yes there are borderlines (and others) with identity instability manifesting as trans thought character.
Likewise with Long COVD et al you have a mix of those pathologies being rolled together and it really reduces clarity and makes it unclear to what extent it is a real thing. Some people likely do have mangled CNS/PNS as a result of viral illness, others are maybe looking for a more ego syntonic expression of their depressive symptoms.
I know less about fibromyalgia but my understanding is that some physicians are emphatic it's a real thing and more investigation will make real bio markers or whatever abundantly clear.
Not seeing any fibromyalgia in India is interesting but its possible that it's in some way culture-bound, or environment-bound - higher parasite burden, rougher lives may prevent the sensitization or whatever else is going on under the hood.
There was a study done of "long COVID" which demonstrated that the only symptom of long COVID patients that was correlated with actually having tested positive for COVID at some point was loss of taste and smell. So yes, there are real and there are fake, but there's a whole lot more fake than real. And I suspect the same is true of trans patients. A few have a mental illness specific to that (call it "gender dysphoria" or whatever), a large number have cluster B personality disorders, and an even large number are pure social contagion.
I don't know if I believe in such a thing as long COVID, I do think that some people have gone online to make a whole condition out of post-viral syndrome and the like.
But Trinity College Dublin is at least half-assed respectable, and their eggheads are claiming that something is going on with leaky blood vessels?
Newspaper report here, link to published paper here. Again, I have no idea if Nature Neuroscience is a reputable journal or one of those 'you pay, and we'll publish any old rubbish" efforts. But the bit about serum from patients with (alleged) long COVID producing inflammatory markers in cultured cells would seem to indicate that there is indeed something there:
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Identity instability is a literal symptom of borderline. Not surprising if these people (when unstable) have trans thought content. If you throw the long COVID equivalent into your research studies, it's going to give you a ton of junk data and hide whatever thing is really going on.
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Great, a comment refresh ate everything.
But here's two screenshots of my Google results, I suspect yours would look very different.
https://ibb.co/cwqnt5K https://ibb.co/Bcxb3Jr
It's not that there's precisely zero fibromyalgia here, but I've never seen it diagnosed and don't know of a diagnosis through at least two degrees of separation. Old research papers, legitimate and more sketchy clinics advertising, pure puff pieces. One article from 2014.
I also can't recall formal diagnosis of Long COVID here either, and believe me I've treated more than my fair share of COVID patients, and everyone and their dog has caught it. I have seen symptoms that could be attributed to it, or at least COVID serves as the best proximate cause.
I would guess a culture of "toughing it out" and "oh god we have tons of real health problems" limits the role for these softer diseases.
Also thank you for introducing me to "crore."
Trust an American to show appreciation for non-standard and awkward methods of counting! I'll take millions any day, as a matter of fact I mentally convert from those to crore rather than vice versa.
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