Why Dysautonomia Is Often Misdiagnosed


In the 19th century, there was a common condition called neurasthenia. Previously healthy people were suddenly unable to function due to many unexplained symptoms.

These often included fatigue , weakness, unusual pain that came and went and moved from place to place, dizziness , various gastrointestinal symptoms, and fainting (fainting). Doctors found nothing to explain these symptoms, so they were classified as "weak nervous system" or neurasthenia .

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Women with neurasthenia (men were generally not diagnosed with this diagnosis) were often bedridden, where they recovered or eventually died (as prolonged forced bed rest is very unhealthy). And although no one knew what caused this condition, everyone, doctors and non-specialists alike, took it very seriously.

Although neurasthenia could not be scientifically explained, it was considered a serious disease and its victims were treated with compassion and respect. Most modern doctors who learn of this mysterious condition simply shake their heads in surprise. What, they wonder, happened to this neurasthenia?

Few people seem to think that neurasthenia is still with us. Consequently, they are less able to recognize the manifestations of this condition than their older counterparts and tend to have much less empathy for the people who suffer from it.

People who were called neurasthenia a century ago are now diagnosed with a multitude of diagnoses. These include (but are not limited to):

Unfortunately, many people with these conditions consider themselves insane. They are not crazy. (Or, if so, it's a coincidence.) People with these conditions tend to experience imbalances and, most of the time, extreme instability of the autonomic nervous system. This imbalance, which explains its strange symptoms, is called dysautonomia .

What is de-autonomy?

Dysautonomia is a general term for a disorder in which the autonomic nervous system (ANS), which unconsciously regulates bodily functions such as breathing and digestion, is out of balance and does not function normally.

Autonomic nervous system

The autonomic nervous system controls the unconscious functions of the body, such as heart rate, digestion, and breathing patterns. It consists of two parts: the sympathetic system and the parasympathetic system.

It's best to think of the sympathetic nervous system controlling the body's fight or flight response, causing heart palpitations, rapid breathing, and increased blood flow to the muscles to avoid danger or deal with stress.

The parasympathetic nervous system controls "silent" bodily functions, such as the digestive system . The sympathetic system prepares us for action and the parasympathetic system prepares us for relaxation.

Usually the parasympathetic and sympathetic components of the autonomic nervous system are in perfect balance, from time to time, depending on the immediate needs of the body.

In people with dysautonomia, the autonomic nervous system loses its balance, and at different times the parasympathetic or sympathetic systems prevail inappropriately.

Symptoms of dysautonomia

Symptoms may include frequent, vague but bothersome pain, fainting (or fainting spells), fatigue and sluggishness, severe anxiety attacks, tachycardia (heart palpitations), hypotension (low blood pressure), poor exercise tolerance, gastrointestinal symptoms, sweating, dizziness. . , blurred vision, numbness and tingling , pain, anxiety and depression.

People with dysautonomia may experience all or just some of these symptoms. They may experience one set of symptoms at one time and a different set of symptoms at another time.

Symptoms are usually fleeting and unpredictable, but on the other hand, they can be triggered by specific situations or actions. (For some people, symptoms occur, for example, when exercising, standing up, or after eating certain foods.)

Because people with dysautonomia are generally normal in all other respects, when a doctor performs a physical examination, they often do not show any objective abnormalities.

Because physical examinations and laboratory tests are usually quite normal, physicians (scientifically trained and therefore trained to expect objective evidence of disease) tend to view people with dysautonomia as mentally unstable (or, more often, as people with an anxiety disorder).

What causes the lack of autonomy?

Dysautonomia can be due to many different reasons; there is no universal reason. Dysautonomia can occur as a primary condition or in relation to degenerative neurological diseases such as Parkinson's disease .

It seems clear that some people inherit a predisposition to develop dysautonomia syndromes, as variations in dysautonomia are often inherited.

Viral diseases can cause dysautonomia syndrome. Chronic fatigue syndrome usually begins after a typical viral illness (sore throat, fever, and muscle aches), but any of the dysautonomia syndromes can have a similar onset.

Another trigger is exposure to chemicals. Gulf War syndrome is essentially dysautonomia with symptoms of low blood pressure , tachycardia, fatigue, and other symptoms that, in addition to government denial, appear to have been caused by toxin exposure.

Dysautonomia can result from various types of injuries, especially head and chest injuries, including surgical trauma. This has been reported to occur after breast implant surgery.

Dysautonomia caused by viral infections, toxicities, or trauma often occurs suddenly.


There is no cure for dysautonomia, but fortunately the prognosis is much better than in the days when the disease was called neurasthenia. This is likely due to the fact that bed rest is no longer considered the method of choice.

Most people with dysautonomia eventually find that their symptoms disappear or diminish to the point where they can lead almost normal lives. Sometimes, in fact, the likelihood that something will eventually improve on its own may be the only thing supporting some of these people.

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Dysautonomia syndromes can have a very negative impact on people's lives. While symptoms improve over time in most cases, many people with dysautonomia experience life-altering symptoms, and all too often competent medical care is difficult to find.

If you think you may have dysautonomia, you should learn as much as possible about the various forms of the condition, and especially about the treatments that have been shown to be effective.

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