Yes, I completely agree. It would be better to talk about anxiety, chronic itching, etc. and offer the patient some potential treatments. CFS, fibromyalgia and IBS patients are in a similar situation.
How do you offer a patient a treatment for something they don't believe they have?
The patient believes they have a parasite, or nanotechnology.
Medicine suggests they may have a psychological disorder.
Asking the patient to see a psychologist is not going to work because the patient isn't going to go and is going to feel (perhaps correctly?) they are being fobbed off.
I think you have to either get the patient before they get sucked into the delusional illness belief, or concentrate on the patients who are open to the treatment option. I had CFS myself, and I was very open to the idea that it was caused by stress. I've also have IBS. Doctors didn't have any useful suggestions, but I was able to eventually figure it out by myself. I think one of the problems is that doctors don't really have the time necessary to deal with conditions like these. Certainly for conditions like CFS and IBS there are a lot of patients like me who are interested in finding the actual cause of their illness. I've never talked to any Morgellon's patients, so I'm not sure what the ratio of open-minded to nutty patients is for that condition.
The last time I saw this story come up (if I recall correctly it was on 60 minutes a few years back), it was mentioned that antipsychotics worked to alleviating the symptoms; the real problem is that most of the patients experiencing these symptoms didn't _want_ to be told that it was mental, and would refuse to take antipsychotics as a potential solution.
How else could the doctors informing the patients of the real problem, and pointing them at a real solution to the problem?
It would be better to talk about anxiety, chronic itching, etc. and offer the patient some potential treatments. CFS, fibromyalgia and IBS patients are in a similar situation.
There's a disease called Hallucinogen Persisting Perception Disorder (HPPD) that some people get after heavy use of psychedelics. The theory I subscribe to is that they're actually overreacting (almost obsessively) to the defects in perception that we all have. For example, if you stare at a bright white screen, especially when tired, you'll eventually see "static" due to retinal fatigue happening at uneven rates. The brain filters out a lot, but when that filter is weakened or challenged, it can let "hallucinations" in. Most of us aren't bothered by "white screen static" and hardly notice it. For some people (such as those with HPPD, who may have strong emotional associations with "tripping") that can be very distressing. In extreme cases, they can't go out at night because they're bothered by (again) scotopic vision defects that all of us have, but that (due to their anxiety) they can't tune out.
What I've noticed with anxiety is that there are things that are hard to un-notice. For example, after reading that article, I itched like hell. I knew why, so I didn't need other explanations (I basically know that reading any article about health problems is going to be a bit masochistic) but there are some distressing thoughts that are just very hard to banish, especially in a state of fatigue (which is not uncommon in our overworked, bizarre society). None of us is fully in control of our focus, and sometimes it's possible to get into a feedback loop of anxiety producing weird symptoms (panic attacks, for example, can throw all kinds of shit... even phantom smells) that produce more intense focus and anxiety.
I suspect that it might be low GABA that is causing the itching, as that is the neurotransmitter that is reduced in alcohol withdrawal (actually, it's a downregulation of GABA receptors), and it's GABA that reduces anxiety. As you say, it's probably just a removal of the normal "anti itch" filter that causes you to notice the itching.
I usually start itching when I read about fleas. There is an actual thing called "contagious itching":
So there can definitely be a psychological trigger for itching. Add in some anxiety and/or withdrawal and it's easy to see how something like Morgellons could happen.
That's funny, now that you mention it I realize that if I had read this article a year ago I would have started itching and spent hours hallucinating an infestation in my skin - as it is I read it, was intrigued, then moved on. My combination of SSRIs and intense self-care is working. There is hope :)
