I had intended to write on a completely different subject today, something much more seasonal and light-hearted. Unfortunately I found myself on a website reading a rather heated debate between multiple chemical sensitivity (MCS) sufferers and those who believe (or portain to believe) that MCS is a psychiatric disorder. As a result I felt compelled to write about MCS skeptics and analyse

their arguments and motivations.

Now, as an (ex-) MCS sufferer myself my viewpoint is clearly coloured by my own experiences (as is anybody's) but this does not necessarily mean I cannot analyse various points objectively. I, as the skeptics always claim to be, am a strong advocate of the scientific process, which leads me into my first point.

Having read a lot of online debates on scientific subjects I think it is safe to say that a common tactic people employ in an attempt to add weight to their argument is that science is on their side. They will often say things like "the science is in and MCS is a psychiatric disorder". This is clearly an intimidatory tactic as it makes the poster sound as if they know more than they probably do. Unfortunately for MCS skeptics the science is most definitely "not in" as of this moment and is not likely to be for the foreseeable future. There remains much that is not known, however, according to a list compiled by MCS Referral & Resources, from 1952 to September 1999 there were 609 references to MCS in the mainstream medical literature (not including journals specialzing in MCS). Of these, there were 311 papers presenting study findings or describing hypotheses relating to MCS being of organic/physical origin. In contrast there were only 137 articles published which presented findings or hypotheses suggestive of a psychiatric basis for the condition. So, if as the skeptics say, the science is in, we have 69% of scientific evidence pointing to MCS being a physical illness and only 31% suggesting it might be psychiatric.

Skeptics, with heavy use of the "science" card, imply that they are more intelligent than MCS sufferers. What they are saying is that they have science on their side so anybody who disagrees with them and feels that MCS is a physical illness is automatically unscientific and therefore a little intellectually challenged so to speak. This is obviously akin to verbal bullying and as we have seen, has no basis in fact since the weight of scientific evidence is actually on the side of the MCS sufferer arguing that it is a physical illness.

Researchers have found a host of biochemical abnormalitites in people with MCS and in animal models including:

- Abnormal cerebral blood flow (SPECT scans)
- Increased resting alpha brain waves (EEG)
- Limbic system hypersensitivity (mouse model)
- Impaired detoxification (e.g. low glutathione & sulphation, impaired phase I and II pathways)
- Abnormal porphyrin metabolism
- Hormonal abnormalities (especially thyroid and adrenals/HPA axis)
- Immune abnormalities (e.g. low natural killer cells, chronic T-cell activation)
- Increased allergies (incress risk of IgE respiratory allergies)
- Gastrointestinal problems (e.g. increased intestinal permeability, small bowel bacterial overgrowth)
- Evidence of toxicity (e.g. heavy metal and pesticide poisoning)

For an extensive and fully referenced list visit MCSRR (biomarkers page)

In the debate I was reading today the MCS skeptics claimed that people with MCS often complain of depression and that this is clear evidence that the condition is psychiatric in nature. I have a problem with this on many levels. First of all, are skeptics unable to appreciate that someone may become depressed if they have a frightening medical condition that produces multiple destressing symptoms. Then on top of that they lose their jobs, their social life, their marriage, and are then told that it is all in their head and that they aren't eligible for social security benefits. Finally people (with no personal experience of MCS) in internet forums insist that they are mentally ill, deluded, hypochondriacs, stupid etc. Is there anyone that would not be a little down when subjected to this? Secondly, there is no reason to believe that MCS sufferers cannot also suffer from depression. Depression is a symptom of numerous physical diseases including but not limited to multiple sclerosis (MS), diabetes, coronary heart disease (CHD), and HIV/AIDS. As we have seen there is ample evidence of biochemical abnormalities such as reduced blood flow to the brain, altered brainwave activity, and hormonal abnormalities which could all have a profound influence on a patient's mood. Finally, one MCS skeptic posted the abstract of a study that found that a man with MCS was cured after being given an anti-depressant drug (a selective serotonin reuptake inhibitor (SSRI) like Prozac). The skeptic gleefully presented this as evidence that MCS patients are actually suffering from depression (as did the articles authors). Let me explain why this proves absolutely NOTHING. First of all anybody with the slightest knowledge of the scientific process and medical research knows that a study involving ONE person is scientifically worthless. For a finding to be accepted as solid evidence a study needs to involve a significant number of participants on which to test a hypothesis or treatment. In this particular case the MCS skeptic and the paper's authors themselves have wrongly concluded that because the man got better after being given an anti-depressant drug that he was therefore suffering from depression and not a physical illness known as MCS. All this proves is that one MCS patient got better when given anti-depressant treatment, it does not tell us WHY he got better. He may well have been suffering from depression and been wrongly diagnosed with MCS. On the other hand he may genuinely have been suffering from MCS and the anti-depressant drug actually treated the underlying mechanism of MCS. We know from the scientific evidence that MCS sufferers have multiple abnormalities in brain function and hormone levels. The way in which anti-depressant drugs work is still not fully understood but we know they alter brain function and levels of a whole host of brain chemicals. For example anti-depressants are thought to affect cortisol function and we have seen that MCS patients have dysfunction of the HPA axis which regulates cortisol. It is therefore perfectly reasonable to assume that anti-depressants may be a possible treatment for MCS. I am open to all avenues of research into MCS so if anti-depressant drugs have helped people with MCS I would like to find out WHY.

Another argument that MCS skeptics always seem to use is that they are actually taking MCS very seriously and want to help us by telling us it is a psychiatric condition. They say MCS is like panic disorder and tell us to stop resisting and just accept that we are mentally ill. In a post I read today a skeptic went so far as to accuse an MCS sufferer of having a dim view of people with mental illness and suggesting that is why they wouldn't accept that they themselves were mentally ill. I really have to laugh at comments like that! If MCS sufferers were genuinely mentally ill I am sure the majority would be happy to accept medical treatment and feel relief at the prospect of getting well. The reason people with MCS won't accept being labelled as mentally ill is because they are NOT mentally ill, simple as that. If I were to tell someone with a broken leg that they were actually mentally ill and should just get up and start walking around, do you think they would accept that? (A rather silly example but you get my point!). People suffering from MCS know that they are not simply mentally ill, just as someone with the flu recognises that they are physically rather than mentally ill. THIS is the reason why MCS sufferers so strongly oppose being labelled as mentally ill, not because they are deluded or because they feel being mentally ill is something to be ashamed of.

So, that final passage explains why MCS sufferers so strongly resist the mental illness label. The question now is: why do MCS skeptics argue so strongly that MCS sufferers are actually suffering from a psychiatric condition? They often go so far as personally insulting and abusing sufferers. What could possibly motivate someone to behaviour such as this? There is no way they can be truly certain that MCS is not a physical illness so what makes them exhaust so much effort trying to convince people they do? To be honest, I do get the impression that some people just like arguing for the sake of it. It's like a sport to them, something they do for entertainment. It makes them feel good, powerful, clever. I'm sure there are those who genuinely believe that MCS is psychiatric in nature and they do have good (if misguided) intentions. This does not explain however why they try to assert their belief with such vitriol, mainly at people who are obviously suffering greatly (whether MCS is psychiaric or not!). Finally, at the risk of sounding like a conspiracy theorist it cannot be denied that certain individuals and organizations would have an interest in descrediting MCS sufferers and MCS as a medical reality.

I am all for open debate on MCS, I just wish the skeptics would play fairly and honestly.  

The online discussion that got me started on this: http://www.medkb.com/Uwe/Forum.aspx/alternative/25327/The-MCS-Opponents