The Doctor's Have the Delusions
and Not the Patients?
Paula walked into the office with a small limp, and obvious pain. She had marked rashes on her shins, for arms and the top of her head. The rashes had many shapes, some were nodular, some were weeping clear fluid and others had blood clots on the top of them. Simply, she had about 50 lesions on her skin covering about 20% of her body.
"What did the dermatologist's say these were?" I asked
"They either said they were 'nothing' or 'they did not know.'" She says
"And other physician's said I was delusional and picking at these and making them." She added. "I have been so hopeless and desolate—you go to respected doctors and they tell you are psychotic with delusions."
When I first started treating patients with Morgellons syndrome, I could not believe that any physician would consider this a psychiatric disorder. I had seen people pick their skin before, and these marks and rashes looked NOTHING like people picking their skin. Calling them delusional seemed analogous to calling a burn victim with burns, as someone delusional about their burns.
Sure most were restless, agitated and overly talkative. So what? That describes most of the Type A personalities running most of corporate America. Any medical problem(s) with the obvious inflammation found on their skin would cause the type of agitation they showed. This is psychiatry 101 and apparently many physicians missed this class. It is real simple. Burn someone and they will be restless, agitated and overly talkative. Infect or inflame the skin and the same response.
But then I would read evaluation summaries and see expressions like Delusional Parasitosis for these patients in their records. I was stunned. I wanted to make a new rule for physicians. They could not use a psychiatric diagnosis without ten years of psychiatric training. Why? Because it seems everyone has become a star in a Woody Allen movie and they casually and effortlessly toss out psychiatric labels like hands filled with seed at planting time.
Why Morgellons is not a Delusion Disorder
While this issue could fill a book, so lets just hit the simple basics. First, delusions of any type are very rare. If you walked down your street today, how many folks you greet would have delusions? Extremely few, and it would be a huge walk to meet even one. Bring two sets of shoes.
The prevalence of ANY TYPE of delusional disorder is 0.03%. The incidence of first admissions for delusion disorder into a psychiatric hospital 0.001 and 0.003% (www.emedicine.com/med/topic3351.htm). Not sure what these zero's mean before the period? It means many folks will never meet a delusional disordered person in their lifetime. These are not people with hallucinations and other things that get attention. Further, we have still not finalized a definition for this disorder and because most delusional folks do not believe they have a problem, research is hard to do with them. Their memory and thinking processes are normal, and they are alert and able to focus normally.
Delusional Symptom Clusters and the Discovery of Lyme
While many physicians designing vaccines and getting grants and patents have taken credit for the discovery of modern Lyme disease. But it was really Polly Murray, the mother and artist, who wrote The Widening Circle: A Lyme Disease Pioneer Tells Her Story. She noted a number of children were getting arthritis in her community. She did not think they were delusional for being agitated and complaining of pain. She reasoned that a medical problem in a select community was a medical problem that was not yet discovered. She was right. She discovered modern Lyme disease.
The same thing is going on with Morgellons disease. A number of patients primarily in the southern United States are getting Morgellons symptoms. When I test them with extensive labs, mostly at a top USA lab used by many physicians, I find clear and certain findings of systemic inflammation, hormone abnormalities, peptide abnormalities, blood abnormalities and other findings. Generally, I also find 7-20 abnormal results that are consistent with a medical problem and not simply a belief problem. So far, we have found that Morgellons patients have between 5-20 medical issues and most have a number of Morgellons causes which when combined cause their problems.
Could Morgellons be a Delusion?
One reason why I do not believe Morgellons is a medical delusion is because they have abnormal labs, if you know which labs to order.
Further, medical delusions are very diverse, and do not fall into one type. For example, I have treated those with medical delusions. One believed she had snakes in her belly and no MRI or exam would convince her otherwise. Another was certain she was infested in her head with flies Again it was had to convince her otherwise. Another was certain he had birds in his stomach, and each belly flutter or eccentric sensation was the movement of the birds. Morgellons are not this way. They generally mention the same medical troubles--about 75% offer the same complaints. Further, they are pointing to and discussing very real and obvious skin damage.
The problem here is that in a delusional person, like a person who thinks snakes are all over their stomach, they have little insight and they have impaired judgment regarding their pathology.
Now enter the Morgellons patient. They have been seen by a number of doctors—usually for 7 minutes at a time. They are describing something that is found by many people in many southern states, but is not researched except by small articles in the mental health field. These rushed evaluating physicians do not do aggressive lab work, so all the signs of systemic inflammation and/or infection are not done—merely a few tubes of basic organ failure labs that would only be positive if the patient was half dead.
In conclusion, patients could have 10,000 possible medical troubles, but these folks all have virtually the same story. If it was a delusion problem, we should not have independent people with the same medical complaints and similar rashes. Morgellons patients show many clear and certain blood test abnormalities that are not part of the normal range for these labs—the results show they are ill and sick.