Imagine waking up one day with a throbbing headache, a racing heart and a sense of overwhelming fatigue. You visit your doctor, but after several rounds of tests and exams, they can’t find anything wrong. You feel frustrated and confused, and people around you might even suggest that you’re making up your symptoms.
This can feel isolating, but it’s unfortunately common. If diagnosed properly, you may find that you share something in common with this percentage — you may have a psychosomatic illness that can affect your long-term health and well-being.
What is psychosomatic illness?
In plain terms, a psychosomatic illness occurs when physical symptoms are caused or exacerbated by psychological factors like stress or anxiety. It is often difficult to diagnose these symptoms, as the cause is unclear. In some cases, patients may undergo unnecessary medical treatments to identify and treat a physical cause when in reality, the cause is psychological.
Psychological causes like stress can greatly impact all of the systems in the body — from your respiratory system to your endocrine and reproductive systems and beyond. Mainly, stress and anxiety have been linked to changes in hormones, immune function and inflammation.
Your automatic nervous system — which controls both physical functions like your breathing and heart rate along with psychological functions such as stress hormones — proves even further the interconnection between psychological and physical processes. Changes in one can affect the other, leading to a range of physical symptoms.
Psychosomatic illnesses are not “all in a person’s head” or a sign of weakness. They are real conditions that require appropriate diagnosis and treatment, which may include both psychological and medical interventions.
Potential symptoms of psychosomatic illness
Psychosomatic illnesses can present themselves in many ways, and you must look for signs in both your mental and physical health. From here, you can receive timely and appropriate treatment, which can improve your chances of recovery.
Here are some possible symptoms of psychosomatic illness:
- Chronic pain or discomfort in the back, neck or stomach.
- Digestive issues, such as bloating, diarrhea or constipation.
- Shortness of breath or difficulty breathing.
- Chest pain or heart palpitations.
- Headaches or migraines.
- Fatigue or weakness.
- Skin rashes or other dermatological issues.
- Sexual dysfunction or loss of libido.
- Muscle tension or spasms.
These symptoms can also be indicative of other conditions, so you should work with a healthcare professional to determine the underlying cause and appropriate treatment. Additionally, prioritize self-care and stress-reduction techniques to prevent psychosomatic illness from developing or worsening.
Causes of psychosomatic illness
As mentioned, psychosomatic illness is a very real condition, and like any condition, it typically has a cause or range of causes, including:
- Stress and anxiety, particularly chronic or long-term stress.
- Trauma or unresolved emotional issues.
- Depression or other mood disorders.
- Poor coping skills or lack of social support.
- A history of physical or sexual abuse.
- Additional chronic or serious medical conditions, particularly those that have a significant impact on daily life.
- Certain medications or medical treatments, which can cause physical symptoms as a side effect or lead to stress or anxiety.
Getting to the root of the cause can help you feel faster and prevent future psychosomatic symptoms from occurring.
Potential effects of psychosomatic illness
To spot a psychosomatic illness, look for the following effects:
- Physical symptoms that interfere with daily life and functioning.
- Increased stress and anxiety.
- Reduced quality of life and ability to participate in daily activities.
- Increased healthcare costs and use of medical services.
- Difficulty managing symptoms and finding an effective treatment.
If these short-term effects are left untreated or the cause behind these effects is undiagnosed, you may expect a range of long-term effects, including:
- Chronic physical symptoms that can persist even after treatment of the underlying psychological issue.
- Development of other physical or mental health conditions.
- Impaired immune system functioning and increased risk of illness.
- Reduced life expectancy.
- Social isolation and difficulty maintaining relationships.
- Impaired work or academic performance and decreased career opportunities.
Why psychosomatic illness can be difficult to diagnose
Despite the varied effects a psychosomatic illness can have on a person, it’s often misdiagnosed among medical professionals. There are a variety of reasons for this, including:
- Stigma and lack of awareness among healthcare professionals.
- Limited time and resources available for medical appointments.
- Overreliance on medical tests and imaging.
- Patient reluctance to disclose emotional or psychological symptoms or history.
- Difficulty distinguishing between psychosomatic illness and other conditions with similar symptoms.
- Lack of standardized diagnostic criteria and assessment tools for psychosomatic illness.
There has also been disagreement among medical professionals on how to properly diagnose and treat psychosomatic illnesses. Some believe that psychosomatic illnesses should be treated for purely psychological causes and others believe it should only be treated for physical causes when it should be treated for both.
What is Munchausen syndrome?
Psychosomatic illnesses may be misdiagnosed as Munchausen Syndrome because the physical symptoms of psychosomatic illness can be difficult to explain or diagnose. What’s more, there’s a tendency to seek out unnecessary medical interventions, which can also be misconstrued as Munchausen Syndrome.
Munchausen Syndrome, also known as a factitious disorder, is a mental illness in which a person intentionally fakes or exaggerates physical or psychological symptoms to receive medical attention or sympathy.
While psychosomatic illness is a physical and psychological condition, Munchausen Syndrome is a mental illness that involves intentional deception.
The potential impacts of disbelief from medical providers and others
Misdiagnosis caused by a provider’s disbelief, although common, can affect a patient in a variety of ways, including:
- Delayed diagnosis and treatment of underlying medical conditions.
- Worsening physical symptoms.
- Increased anxiety and stress.
- Feelings of frustration, anger, and hopelessness.
- Decreased quality of life.
Providers that discredit their patients may also cause long-term effects, including:
- Chronic pain and fatigue.
- The development of mental health disorders, such as depression and anxiety.
- Impaired immune system function.
- Social isolation and difficulty maintaining relationships.
- Decreased ability to perform daily activities and maintain employment.
What to do if your doctor doesn’t believe you
Imagine experiencing persistent physical symptoms such as fatigue, dizziness and stomach pain for several months. You’ve visited your primary care physician multiple times, but your doctor has been dismissive and hasn’t ordered any diagnostic tests. In this situation, it’s completely normal to feel lost, invalidated and unsure. Don’t be fooled though — you can prevent a misdiagnosis by taking several actions in the short and long term.
In the short-term:
- Be an advocate for yourself.
- Seek a second opinion elsewhere.
- Keep a symptom diary to provide more detailed information to your doctor.
- Ask for referrals to a specialist who can provide more targeted diagnostic tests and treatment.
In the long-term:
- Educate yourself on your symptoms and their potential causes.
- Join a support group of people experiencing similar symptoms.
Taking charge of your health can be an empowering step toward finding the right team of doctors and providers.
Managing a long journey to diagnosis and treatment
Once you find a doctor who supports you and seeks to treat your symptoms, diagnosis can still be elusive. Gaining a proper diagnosis is a journey, and like any journey, it isn’t stagnant. You’ll constantly need to seek out new doctors and new treatments. To see any kind of improvement in your diagnosis and treatment, you must consider the following:
- Be open and honest with your medical provider about your symptoms.
- Seek out a mental health professional such as a therapist or psychiatrist.
- Stay persistent in your suspected diagnosis, but also stay open to the idea that the cause of your symptoms may be unclear.
- Try different treatments and therapies, including medication, massage therapy, talk therapy, cognitive-behavioral therapy, and complementary therapies such as acupuncture or mindfulness practices.
- Take care of yourself both physically and emotionally.
Even though finding a diagnosis and proper treatment may be a journey, there is still hope that you’ll find an ending worth waiting for.