Are too many Americans being "over-diagnosed?"

Too many people becoming patients?

Excerpt: "When I meet a patient with a complicated medical history, I often start by asking when they were last perfectly well. Darcie couldn’t remember ever being truly well.

Darcie is 20 years old. She was referred to me because she was having regular seizures, but her illness began long before. It began with headaches as a child, which a neurologist diagnosed as migraine when she was 13. By the time she reached my office, her referral letter included hypermobile Ehlers Danlos syndrome (hEDS), anorexia, irritable bowel syndrome, postural orthostatic tachycardia syndrome (PoTS), autism, ADHD, depression and anxiety. She had also started having seizures every day, which was why she was in my clinic.

Darcie was clearly sick. She had barely been out of her own home for a year. Yet I came to believe that most of her symptoms, including her seizures and faints, were psychosomatic.

Every measure we took of Darcie’s brain waves, heart rate and blood pressure was entirely normal. When Darcie felt dizzy and fainted, her blood pressure and heart rate were normal. This left only one explanation for why these normal measures contradicted Darcie’s experience of her body: A psychological process rather than a disease process was making her collapse.

Most doctors who see a large volume of patients will regularly see young people with various mixes of Darcie’s diagnoses. Other diagnoses in this pile include Tourette’s syndrome, dyslexia and dyspraxia, mast cell activation syndrome (an immune disorder) and Chiari malformation (a developmental difference in the base of the skull).

What all of these diagnoses have in common is that they all have a severe form with a demonstrable pathology, like a genetic or biochemical abnormality, that’s been recognized for decades, but have expanded in the past 20 to 30 years to include mild cases with no proven pathology. While there has been no real change in the share of people suffering from the severe form of these diseases, sufferers with the milder form have shot up dramatically. For example autism diagnoses in the U.K., where I work, rose by 787% between 1998 and 2018."