The Physical / Mental Dilema

Changes at the beginning of January 2013 mean that points will only be awarded for the mental health part of the questionnaire, for problems that can be directly attributed to a mental health problem or a learning difficulty. Similarly, points will only be awarded for the physical part of the questionnaire, for problems that can be directly attributed to a physical health problem.

Physical symptoms caused by your health condition will (should) be taken into consideration. For example, Post Exertional Malaise should be taken into consideration.

Physical symptoms caused by medication for a physical condition may be taken into consideration. For example, diarrhoea as a result of (too much) thyroid medication should be taken into consideration.

Physical symptoms caused by medication for a mental health condition will not be taken into consideration. For example, Urinary Hesitation caused by anti-depressants will not be taken into consideration.

Mental health symptoms caused by your health condition will (should) be taken into consideration. For example, people with M.E. often suffer a symptom called Acquired Dyslexia; this should be taken into consideration.

Mental health symptoms caused by medication taken for a mental health condition may be taken into consideration. For example, depression caused by anxiety medication should be taken into consideration.

Mental health symptoms caused by medication taken for a physical condition will not be taken into consideration. For example, cognitive dysfunction (brainfog) caused by pain medication will not be taken into account.

The last time I read the guidelines for assessors on Chronic Fatigue Syndrome (2010) it gave them the choice of whether they could assess people with CFS / M.E. as:

• having a mental health condition.
• having a physical condition.
• having a combination of the two.

As such, I personally advise that you fill in both parts of the questionnaire as fully as you are able, in the hope that the person assessing you will assess M.E. as being both a physical and a mental health condition (even if you do not agree that it is).

Be very careful how you phrase what you say, making sure you explain clearly how each symptom is attributed to M.E.. Remember that they have a list of your medications towards the beginning of the form, and are likely to be familiar with common side effects.

 

This isn't reasonable is it? Some symptoms that you suffer as side effects of medication are not taken into account. Yet, if you do not take the medication your abilities are totally different. As such, I make the following suggestion:

• state clearly which symptoms are caused by your illness.
• also state clearly which symptoms are caused by your medication.
• if both your illness and medication cause one symptom, make sure that it is understood that the illness does cause it too.
• state how much you suffer / how much worse your abilities are, without that medication.

For example,
"M.E., pain medication and sleeping medication cause severe concentration impairment. I can barely concentrate for five minutes without being distracted or becoming fatigued. Eliminating pain medication and sleeping medication does not improve concentration."  

Then in the pain and sleeping parts of the form  

"Without sleeping medication I sleep approximately three hours a night at most, and it is unrefreshing sleep" 

and  

"Without pain medication I am in continuous discomfort and pain that I cannot bare."

It may, or may not, be taken into account by the assessor / Decision Maker, but it simply cannot be taken into consideration if you do not include it.