State fixation disorders

In an article about COVID-induced anosmia (loss of sense of smell), Scott Alexander also describe a class of problems:

This makes me wonder if persistent COVID-induced anosmia fits into a class of problems which don’t ‘t have an official name, but which I think of as “state fixation disorders”. This will be easier if I just give examples:

– Mal de debarquement: you know how if you go on a boat, you might get seasick and nauseous for a few hours/days until you get your “sea legs”, and then you’re fine? And you know how, once you get off the boat, you might feel sick and nauseous for a few hours/days until you get your “land legs” again, and then you’re fine? In some extremely small percent of cases, you never get your land legs and you feel sick and nauseous forever. You can take one boat trip, get off it, something goes wrong, and you feel nauseous for the rest of your life. This is the purest example of what I mean by “state fixation disorder” – you have a state (like seasickness) that you ought to adjust away from quickly, and somehow it becomes fixed and lasts forever for unclear reasons.

[he then writes about “Hallucinogen persisting perceptual disorder“, “Post-acute withdrawal syndrome“, to continue with:]

– Chronic pain: what, you thought this was all going to be cool exotic syndromes you’ve never heard of? Chronic pain is exactly like this. You have some acute injury – maybe you fall and break your leg. It predictably causes leg pain. After a few months, your leg is completely healed. But maybe the pain continues anyway for the rest of your life. It’s tempting to think that there’s some microscopic injury that persists even after everything else looks normal, and for all I know maybe some chronic pain is like this. But studies find that the risk factors for chronic pain are less about the kind of injury and more about psychological factors like depression and trauma. My guess is this is another state fixation disorder; a state of pain which is temporarily appropriate for a limited injury somehow gets hard-coded in and becomes the new set point.

Chronic pain is by far the best-studied of these, and the going theory is “central sensitization” aka “nociplastic pain”.
— Astral Codex Ten, “What Should We Make Of Sasha Chapin’s Claim That Taking LSD Restored His Sense Of Smell After COVID?

I had thought that the loss of sense of smell had to do with the damage caused by lack of oxygen due to damages to the lungs, but apparently I am completely wrong about that. I still think it’s possible that it may be part of the cause of some of the symptoms that are harder to explain, when we know that SARS-CoV-2 can’t attack nerves or neuron. Like those symptoms examined in “Cognitive deficits in people who have recovered from COVID-19“; might cognitive deficits be explained by having lacked sufficient oxygen for an extended period of time?












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