Illnesses with no known medical cause were common in the 19th century. Modern complaints have an eerie similarity, writes Kate Holmquist
During the industrial revolution, there were "epidemics" of medically unexplained illnesses that seem quaint in retrospect. Mothers who were depressed and overworked had the "vapours", while young, affluent, single, urban women with chronic pain were diagnosed with "spinal irritation" and confined to health spas for years on end.
It was a well-known phenomenon that tuberculosis seemed most likely to hit young people thwarted in love, and people struggling to come to terms with the vast changes in society brought about by the industrial revolution often developed "neurasthenia," the 19th century equivalent of Chronic Fatigue Syndrome (CFS).
Currently, society is experiencing "the third wave", a shift from the life brought about by the industrial revolution into a post-modern life in which the individual can be everywhere all the time through the internet and global communications, yet at the same time seems to count for nothing without becoming a celebrity. And with this social change - we have seemingly new illnesses that are eerily like their 19th century counterparts.
Irritable Bowel Syndrome, CFS, food allergies, fibromyalgia and breathing problems are on the increase. Complementary practitioners may blame mercury in tooth fillings, additives in foods, viral infections, environmental pollution and sugar - but the truth is that there is no known medical cause for these new "epidemics".
Across the EU, as many as 45 per cent of people claim to suffer from a chronic illness and the number of young adults claiming long-standing illness has doubled since 1972, according to Eurostat. Figures from the EU National Statistical office, show that in Nordic countries, the proportion of children with chronic complaints grew from 8 to 15 per cent between 1984 and 1996.
The number of Americans with ill-defined malaise has grown from 30 to 45 per cent in the past 25 years, according to US national health surveys.
By contrast, the Irish - whose economic success is more recent - have remained an almost ludicrously happy and optimistic lot considering that Irish life expectancy is the lowest in Europe. No less than 49 per cent of the Irish described their health as "very good" in 2003, compared with only 9.3 per cent of the French, who are more typical of Europeans, according to Eurostat.
Only 3 per cent of Irish people claim to be in poor health, compared with more than 14 per cent in Germany, where 65 per cent of people use complementary healing methods and health supplements.
As the Irish lifestyle becomes more like that of Europe and the US, GPs report that they are seeing increasing numbers of Irish people, especially young women, who feel sick and tired all the time. General malaise and fatigue with no specific cause is a frustrating one for GP and patient alike, as there is no proven medical cure.
What we're seeing, writes physician and psychotherapist Dr Nick Read in his new book, Sick and Tired: Healing the Illnesses Doctors Cannot Cure, is an epidemic of illness caused not by bacteria, viruses, heart disease and cancers, but by modern life itself.
Heart disease, cancer and so on are "organic" illnesses with medically proven treatments or cures. The epidemic of non-specific complaints affecting the sick and tired is a panoply of "functional illnesses" - conditions that the patient finds debilitating, but which have no organic source.
An entire industry of complementary healers may have theories, such as the mythical candidiasis, and people may buy into these explanations out of desperation when what they should really be looking at is their emotions, Read writes.
"The kind of people who are likely to succumb to chronic fatigue are the supermen or more often the superwomen, who have struggled to conform to the cultural imperative to 'do it all'. Such people often sleep poorly and seem to work themselves to a standstill, but instead of being able to negotiate some help or relief in some of their roles, they let the illness do the negotiation for them," Read writes.
But what it is about western culture that makes people push themselves so hard?
Medical anthropologist Arthur Kleinman has suggested that CFS might be seen as a cultural illness. He writes that sufferers are driven individuals, keen to make their mark in an increasingly anonymous society, who devote up to 80 hours per week to their work, combining it with child-rearing and caring for ill parents.
Read believes that the physical collapse that accompanies CFS is "more than a state of exhaustion; it is more a state of despair, a depletion of will". It is a way of saying "no" to the pressure, but far from blaming sufferers of such "functional" illnesses, Read argues that society is to blame.
"People need a true health service that helps them to cope emotionally with the isolation and demands of 21st century life, not an institution that inculcates fear and dependency by treating them as if they might have an incurable disease."
Curing such complaints is fruitless anyway. Illness is so much a part of the human condition, that all attempts to eliminate it are futile, Read argues. Even when "organic" illnesses like cancer and heart disease are prevented and treated, people who at some profound level need to be ill will find ways to become so.
Read argues that an individual's illness carries a meaning that a person needs to find out through psychotherapy. For example, Irritable Bowel Syndrome can literally be the emotional body's inability to regulate itself, so that periods of constipation - holding in feelings - alternate with periods of excessive emotional expression, or diarrhea.
Many people turn to acupuncture, reflexology and other complementary disciplines to ease such "functional illnesses". There may be no scientific evidence to support that these methods work in western medical terms - yet they can and often do make people feel better.
This is likely to be a result of the healing relationship between practitioner and patient, in which the patient is listened to and comforted through touch, Read believes.
His conclusion: So what if there's no medical proof of the therapy? If it helps, then the health service should provide it. He would like to see GP practices in which the GP is just one part of a team including psychotherapists, nurse practitioners and complementary healers.
"Human beings are social animals. And social animals always get ill if they are cut off from their community," Read says. He believes that we need to shift focus away from narcissistic individual achievement, towards a "collective identity that transcends the morbid obsession with the self".
• Sick and Tired: Healing the Illnesses Doctors Cannot Cure, by Nick Read, published by Weidenfeld and Nicolson, price £16.99 sterling.