The Great Contradiction in ME/CFS and Long Covid Care 🚨 Why Are We Using ‘Psychiatric’ Drugs but Still Shunning Psychiatry? Lamotrigine.
Stimulants.
Memantine.
Guanfacine.
Fluvoxamine.
Clonidine.
Naltrexone.
NAC. Benzodiazepines ….. Why do so many medications used to target symptoms in ME/CFS and Long Covid overlap with everyday psychiatric prescribing… yet the very mention of psychiatry is shunned? Before a psychiatrist even sees them, many patients are already on layers of “medical” treatments: 
antihistamines, beta blockers, ivabradine, supplements, sleep agents, pain agents…… As a clinician treating these conditions what is striking for me is so many modifiable targets remain untouched because each specialty keeps viewing the problem through its own silo. Several things can be true at once: 1. Brain-body dualism is dead. 2. Many psychiatric medications have immunomodulatory, anti-inflammatory, autonomic, cognitive, and central regulatory effects. 3. Once illness becomes chronic, the brain’s predictive processing changes around that state. Expectation, salience, threat signalling, effort regulation, sleep, reward, and interoception all become part of the illness. 4. Excluding psychiatry because of past conceptual errors leaves multiple treatable targets untouched. 5. And a message for Psychiatrists - We should stop seeing ME/CFS and Long Covid as “not ours”.
 These conditions sit directly within our skill set, if we are willing to build the expertise. Clinicians who preserve the mind-body split only reinforce the very dualism these illnesses expose; our role is to integrate, provide clear psychoeducation about brain-body regulation.

People are dying of Long Covid, after years of fighting and trying and waiting and fucking hoping. We need real treatments.

😡😡Let’s be brutally honest: The leading anti-vaxx grifters aren’t fighting for your health, they’re farming your fear to line their pockets. Supplements, “detox” kits, books, Substacks, blogs, and ad revenue. That’s the entire business model. Direct or indirect, your actual health is irrelevant to them. Meanwhile, the data/science keeps coming: a large JAMA Internal Medicine study of over a million veterans found that the COVID vaccine cut major cardiovascular events linked to the virus (heart attacks, strokes, and heart-disease hospitalizations) by roughly 40%. I don’t only disagree with the anti-vaxx crowd. I pity the people they’ve conned into throwing away that protection. Pure stupidity is filling our waiting rooms today. (General warning: finger hovering over the block button.)

The twenty minutes after you overdo it decide how long the flare lasts. Spend them wrong and a single afternoon becomes three days in bed.

Concerning story about #COVID, #LongCOVID and cancer risk. Dovetails with the work we have been been doing with @drmfreire's team showing that persistent SARS-CoV-2 antigen found in the GI tract of pwLC is pro-inflammatory and oncogenic: biorxiv.org/content/10.64898… Stay safe 🙏

These operations are quite 'vibey' with staff creating an atmosphere of excitement. The client may express doubt but there is strong encouragement (pressure) to go through with the jump. This creates a distraction from the careful process necessary to control risk.

My kids did one when quite young. I was unimpressed that the 'safety' was a climbing harness with no shoulder straps - so if the ankle tether failed the harness could potentially slide over the hips. People were never that good at thinking things though. Add SARS2 dementia ...

You take an antihistamine for MCAS and half your symptoms do not move. The drug is not wrong. It is covering less than half the receptor map.

It's days of preparation. Of adjusting sleep schedule to the correct hours, to preparing clothes, washing hair, showering, a bunch of other small things, none of it is doable during a single day with ME/LC.