How Important is it for Your Doctor to Believe You?

In this article, Dr. Richard Fogoros examines the past and present of dysautonomia while also offering some hope for the future.

Among his observations: the condition is far from new, but the way it’s viewed has changed considerably over the centuries… and not necessarily for the better.

Back in the 1800s, dysautonomia was known as neurasthenia.

That was the scientific way of saying that those who experienced some of the symptoms – like inexplicable weakness, fatigue, pain, and occasional loss of consciousness (among others) – had a “weak nervous system.”

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In other words, they just assumed women acted like this. Source:

Diagnoses were lopsided across genders, because centuries ago men couldn’t be weak.

Not knowing how else to treat it, the women who were diagnosed with neurasthenia were prescribed bed rest for extended periods of time. And because it’s not good to go long periods without using and moving your body, their conditions worsened and sometimes even led to death.

So how could this approach to dysautonomia possibly get any worse?

As Dr. Fogoros points out, medical professionals of the 1800s may not have known how to treat the condition, but at least they took it seriously. They recognized that it could be debilitating and used their best misguided judgment to be accommodating of those living with it.

Now look at the present, where doctor’s offices are bursting at the seams with patients, providing less and less of an opportunity for doctors to get to know their patients.

What doctors probably think their waiting rooms look like. Source:

Rather than listening to anecdotes and appreciating how disruptive dysautonomic symptoms can be, doctors instead search for objective findings: something that can be felt on the body or looked at under a microscope.

Here’s the thing though:

People with dysautonomia
are usually normal
in every other way

That means objective findings that can lead to a diagnosis and possible treatment are hard to come by. And THAT means people living with dysautonomia are too-often written off as being hypochondriacs whose symptoms exist solely in their own minds.

To be clear, dysautonomia is real and has been linked to genetic predisposition as well as environmental triggers, such as viral infections, exposure to toxins, and physical trauma.

Whereas the way in which healthcare providers initially view people with dysautonomia may have taken a hit since the 1800s, treatment and prognosis (once a diagnosis is made) seems to have improved.

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The modern era’s got some good things going on. Source:

Rather than being prescribed bed rest, people may be given treatments to address specific symptoms and are encouraged to stay as active as their condition allows.

The search for better, more comprehensive treatments continues, but there’s more than that to take solace in.

According to Dr. Fogoros, the symptoms of dysautonomia seem to go away in time, at least to the point where people are able to live relatively normal lives.

James Ernest Cassady

James Ernest Cassady

Though "Ernest" is a family name that's been passed down for generations, James truly earned his middle moniker when, at the age of five, he told his mother that "laughing is stupid unless EVERYBODY is happy." Since then, the serious little bastard has been on a mission to highlight the world's shortcomings (and hopefully correct them). In addition to his volunteer work at hospitals and animal shelters, James also enjoys documentaries and the work of William Faulkner. He is originally from Oklahoma.

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