Ella ~ Medical illustrator

Medical & Scientific illustrator | MSc MA | interested in sciart 💀🧠🫀✍🏻 & mecfs/pots | Dutch & English

[Ella ~ Medical illustrator @ella_nitters]

Not so active on here for the moment, feel free to check my insta https://t.co/7k9GUrUl0E to see more of my work :)

[Ella ~ Medical illustrator @ella_nitters]

@surf4children Why nothing? "Mild" is still very limiting? Not sure I understand what exceptions you mean?

[Manuel Ruiz @manruipa]

‼️⚠️Please read this until the end.

A widely shared article has presented a deeply misleading view of Long COVID, suggesting once again that cognitive behavioral therapy, exercise, and “mind-body” approaches may be the uncomfortable truth patients refuse to accept.

This needs to be challenged.

Not because the nervous system does not matter.
Not because psychological support cannot help.
But because confusing support with cure, physiology with psychology, and heterogeneity with “it might be in your head” is exactly how medicine has harmed post-infectious patients for decades.

There are articles about Long COVID that look like science journalism, but in reality they repackage, in modern language, a very old idea: if we do not fully understand a disease, maybe the problem is in the patient’s mind.

And that is not science. That is repeating history.

The article begins with a striking sentence:

“There isn’t a single approved pharmaceutical treatment, not even a test to verify the presence of the illness.”

This may sound forceful, but it is a very misleading way of presenting the problem.

The fact that there is still no drug specifically approved for Long COVID, or a single diagnostic test, does not mean that “nothing has been found.” It means that we are dealing with a heterogeneous disease, probably with several biological subgroups, and that medicine has not yet converted those findings into validated clinical tools.

“No single diagnostic biomarker” is not the same as “no biology.”

In just a few years, immunological, vascular, neurological, endocrine, and metabolic abnormalities have been described in subgroups of Long COVID patients: autonomic dysfunction, herpesvirus reactivations such as EBV/HHV-6, alterations in the cortisol axis, autoantibodies against GPCR receptors — including adrenergic and muscarinic receptors — persistent viral antigens, endothelial damage, muscle abnormalities after exertion, mitochondrial dysfunction, persistent inflammation, and differential immune changes.

Is everything settled? No.

Does that mean it is psychological? Also no.

Science does not work like that. Multiple sclerosis did not stop existing before we had MRI. Many autoimmune diseases do not show up in routine blood tests. If a complete blood count, a basic biochemistry panel, or an X-ray comes back “normal, normal, normal,” that does not prove the absence of disease. It only proves that you are looking with inadequate tools.

One of the article’s most serious mistakes is this: it confuses the absence of a simple clinical test with the absence of organic disease.

And that mistake has caused harm for decades.

The article also says:

“Almost $2 billion and half a decade of international effort have yielded little more than hypotheses about micro blood clots and spike proteins and mitochondrial dysfunction.”

No. That is not correct.

A hypothesis is a provisional explanation. But when you compare patients and controls and find significant differences in muscle tissue, metabolism, response to exertion, immune biomarkers, viral antigens, autoantibodies, or vascular dysfunction, you are no longer talking about “little more than hypotheses.” You are talking about lines of biomedical evidence that still need to be organized, replicated, stratified, and translated into treatments.

That is not scientific failure. That is research into a complex and new disease.

🔵Continued in the next post.👇🏻
(1/6)

[Om Prakash, MD @ompsychiatrist]

Dr. Moncrieff, your post is sparking a vital debate, but as a psychiatrist seeing patients climb out of severe depression every single week, I can’t stay silent on the one-sided narrative.

Here’s my perspective point by point:
1. On harms like severe withdrawal and PSSD: Withdrawal is real and can be tough. We urgently need better & slower tapering protocols. PSSD is a rare but acknowledged risk, and we discuss it openly in consent. With careful, patient-led tapering, the vast majority stop without lasting issues.

2. On effectiveness (“not very effective at best”): Large meta-analyses (Cipriani Lancet 2018 and later network studies) show clear & meaningful benefits over placebo for moderate-to-severe depression i.e. real symptom relief, fewer relapses and better daily functioning for many. They shine brightest alongside with therapy.

3. On not targeting an underlying biological abnormality: The old “chemical imbalance” line is a strawman we’ve moved past. Depression involves complex biology involving genetics, stress responses, inflammation and neuroplasticity. Antidepressants help modulate those pathways, much like treatments for other multifactorial conditions.

4. On growing patient voices describing treatment as misleading or disabling: Every voice matters, especially the painful ones. In clinic, however, the majority of patients report getting their lives back i.e. work, relationships & hope. Untreated depression carries its own heavy costs. Online spaces can sometimes amplify one side.

5. On working together to help the harmed and prevent more harm: I am 100% with you on better surveillance, tapering clinics and more research into alternatives. Real collaboration would be powerful. At the same time, broad discouragement risks leaving many who could benefit stuck in suffering.

Thank you for kind attention
@joannamoncrieff

[Ella ~ Medical illustrator @ella_nitters]

@riendebock Zat ik mij ook af te vragen, maar helaas niet

[Ella ~ Medical illustrator @ella_nitters]

@surf4children Thank you, will check it out, very interesting (as I believe I personally have experience with this unfortunately)

[Todd Davenport @sunsopeningband]

Just because it seems unbelievable that exercise can harm something, doesn’t mean it merits disbelief.

Follow the evidence. It will set you (and our patients and research participants) free.

[Rien de Böck @riendebock]

8 jaar geleden adviseerde de gezondheidsraad multidisciplinaire poliklinieken voor de chronische ziekte ME 👇

Nu is er nog altijd 0 regulier medisch zorgaanbod voor ME, niks.

Dat is een medisch schandaal, maar het ontstijgt dat niveau ook: het is een politiek schandaal. Het is veel te makkelijk om verzekeraars en artsen de schuld te geven, als het volledige zorgstelsel bepaalde ziektes meedogenloos weigert.

In het beschaafde land wat Nederland pretendeert te zijn, laat je niet al decennia tienduizenden ernstig zieke patiënten zonder enige zorg creperen.

En nog altijd zijn er institutionele "platte-aarde gelovers" die stapels bewijs negeren en deze ziekte als psychosomatisch duiden, met ziekmakende "behandelingen" en medische gaslighting tot gevolg.

Deze wanpraktijken zijn het voorbeeld waarop de schandalen van Long Covid en andere PAIS zijn geënt.

En voor alle duidelijkheid: nee, ME patiënten hebben, vanuit de opzet al, geen toegang tot de zorg in de zeer tijdelijke Long Covid expertisecentra.

12 mei is ME awareness dag. Wees bewust van dit medische schandaal wat zich al decennia afspeelt.

[Dr Terry Simpson @drterrysimpson]

I don’t sneer at people harmed by side effects. That is real medicine, and it deserves to be taken seriously. SSRIs can help many people, but they can also cause weight gain, sexual dysfunction, emotional blunting, withdrawal symptoms, and difficult discontinuation syndromes in some patients. Pretending otherwise is dishonest.

What I push back against is the idea that because a medication has risks, it is therefore useless, evil, or part of a conspiracy. Medicine is rarely that simple. Antibiotics save lives and also cause side effects. Chemotherapy saves lives and also harms healthy cells. The question is always risk versus benefit for an individual patient.

Where I agree with critics is that medicine has often done a poor job warning patients about discontinuation symptoms and tapering. Too many people were told “just stop taking it,” only to discover dizziness, anxiety, insomnia, brain zaps, and rebound symptoms. That failure damaged trust.

At the same time, I have also seen patients whose depression lifted enough on these medications that they stopped drinking, returned to work, repaired marriages, or simply survived long enough to get through a terrible period of life.

Both things can be true:

Some people are harmed by SSRIs.
Some people are helped profoundly by SSRIs.

.

[Anil van der Zee © @AnilvanderZee]

Het artikel over de tentoonstelling "Ongebroken" die vandaag opent, en mijn digitale knutselwerkjes, ook nog even in de vorm zoals ie in de krant komt te staan.

“Ongebroken” is t/m 5 mei te zien in het Treehouse op het NDSM-terrein in Amsterdam. Zie ook https://t.co/ooqLLMiMw1

[Ntisec 𓆣 🏴 @ntisec]

In Frankrijk komen #longcovid patiënten in aktie tijdens een lezing van een kliek wetenschappers die LongCovid proberen te #psychologiseren.

Patiënten zijn klaar met de gaslighting en het bagatelliseren van LongCovid.

Nu biomedisch onderzoek en tzt echte behandelmogelijkheden!

[Danilo.Buonsenso_Surf4Children @surf4children]

recent long covid or mecfs might be an exception, what you think?

[TheDisabilityEnthusiast @twitchyspoonie]

Doctors: you don't know what it's like to deal with these ridiculous patients?

Me, a ridiculous patient: my symptoms get worse every time I exercise or exert myself.

Doctors: my recommendation of exercise didn't work? Well, if it isn't doctor google making up diseases again.

[Bert @Bert_with_ME]

I find myself being repeatedly sucked into the dumb arguments about ME/CFS, Long Covid, POTS & related conditions being psychosomatic/biopsychosocial.

I keep naively thinking that if I respond with a good comment/study/statistic, that maybe I'll change their mind or at least the mind of somebody reading the comments.

But that's just completely wrong and dumb. The idea that there isn't already enough evidence of real biological explanations for the widespread suffering caused by these diseases is dumb. The idea that the US govt committed $1.8B to the RECOVER initiative to study a psychosomatic illness is dumb. The idea that people with successful careers, vibrant social lives, and beautiful families one day just stopped doing those things in favor of a disabled/housebound life is dumb.

Those who believe these things are a lost cause. It is impossible to attribute their position to anything but intentional disregard of the existing body of research. In the vast majority of cases, they are either engagement farming or grifting or both.

I'm making a promise to myself to stop engaging with these conversations entirely. Progress will not be made by attempting to convince bad faith actors to behave rationally. Rather, find the people who are doing good work and fan their flame - they do exist and they need as much support as we can give.

[Naomi Harvey “PhD Witch” #WearAMask @Naomi_D_Harvey]

Ok, new ask for Anna in 🇦🇺

Pls RT

Does anyone in the Melbourne area have land they could let Anna live on in a trailer/caravan?

See replies for info, she needs to escape abuse but is severely disabled & can’t use shelters etc.

[Todd Davenport @sunsopeningband]

Recreating medical misogyny from first principles. I'll just point out that a culture of care and intellectual rigor are not and should not be mutually exclusive.

[Danilo.Buonsenso_Surf4Children @surf4children]

I want to raise 100 million dollars for a free for all center for post infectious complex chronic conditions.
Am I a dreamer or a stupid?

#longcovid
#mecfs
#Pais

[Ella ~ Medical illustrator @ella_nitters]

@surf4children Ah yes, I understand, thank you!