It is estimated that 50% of visits to the doctor for physical ailments end up being rooted in psychiatric causes.
Does this mean that half of a doctor’s patients are imagining their symptoms, or faking it?
No. No, not at all.
As you know, the brain is the “control centre” for the entire body. There are hormones, receptors for hormones, proteins involved in making these hormones and receptors…it is all quite complex, and I’m not going to pretend I know how to explain it. The main idea here though is your brain, along with your endocrine system (hormone system) controls your whole physiology. So, when something is not quite right with hormones, or hormone receptors, or the inticrate pathways these things take throughout your brain and entire body, you are going to experience physiological symptoms: mental, emotional, and physical.
The mind-body connection is a strong one. Not because we have vivid imaginations. Not due to the power of the placebo effect. The mind-body connection is a strong one that is based on real, live, scientifically observed biochemistry.
You awaken to the sound of your baby’s hearty grunting. Normally, this would make you laugh, but your head is pounding. You feel like you can’t move. Cramps squeeze hard on your lower spine. Pain radiates into your pelvic bone. Your sheets are soaked with sweat once again. Taking deep breaths, you carefully roll your body over, wincing at the back pain. You just need to relax a bit, and the pain will ease. The same thing has happened each morning lately.
You loosen up enough to move just as your baby starts crying for you. Standing up makes your head spin, so you sit back down, take more deep breaths.
It’s Okay. You can do this.
You sigh with relief and feel grateful your baby’s bassinet is right beside the bed as you sink back into your pillow and hold her close. You nurse her, and feel comforted, despite the pain in your head. Your mind wanders. Every time you start thinking of what might be wrong with your health, you desperately try to shake it off. Tears sting your eyes when you picture your two sweet little girls trying to make it in this world without their mother.
No. No. No. You do not have a spinal tumour. You do not have ovarian cancer. You do not have leukaemia. You are not dying.
A sharp burning prickles over the skin on your left upper chest. It slowly fades into numbness. Shingles. Your defences are down, your body is tired, your immune system is weak. The chicken pox virus you had as a kid has jumped on the opportunity and come back with a vengeance. You have been enduring it now for 2 months, which you know is a lot longer than normal for a person your age.
Shingles is for weak, old people, isn’t it?
Why did you get it?
Why won’t it go away?
You gently burp your baby, being careful to keep her against your right side. You bend your fingers and notice your hands are slightly swollen.
Maybe it’s your kidneys. That would explain the back pain. Maybe your electrolytes are out of balance. That can cause heart failure.
A wave of nausea crashes over you. Your heart thunders. Your body is rubber. Your bedding feels like it has been stuffed with massive lead bars as it rests upon you. You see black spots rimmed with twinkling light in front of you.
You are going to pass out. Frantically you call to your husband. He needs to wake up and take the baby! When she is safe in his arms, you roll onto the floor. Remembering your lifeguard days, you put yourself into the recovery position. Your frail body rocks back and forth. You suck in air, trying not to pass out. Your stomach churns. You tingle all over.
Your husband has rushed to bring you some juice. He asks if he should call an ambulance.
“I don’t know.” You cry.
You press yourself into the cool floor and will yourself to stay conscious. You take deep breaths, and sip the juice. Your husband kneels beside you, cradles the baby in one arm and rubs your back. Slowly you start to feel better. You stand up, feel an urgent need to visit the washroom, pass loose stools. This has been an increasingly common health concern for you.
You wash your hands and gaze into the mirror. You look green. You lift up your shirt and examine your stomach. At least the hives that covered you the night before are gone now. You step on the scale: 95.8lbs. You have lost all of your baby weight, plus at least 10 extra pounds in only a few months.
Just add it to the list of reasons you think you are dying.
In the living room your children lie on the baby’s play mat and giggle.
Your husband pulls you into a tight hug.
“What’s wrong with me, Lovey?”
You apologize for wetting his shirt and look up at his concerned expression.
“I don’t know, Cutie, but you need to make an appointment with the doctor. No more putting it off.”
When you first walked into the examining room, your blood pressure was through the roof. 180 over something. You could hardly speak without your voice breaking.
Now, you’ve been waiting for a while, you feel a bit better. You grab your purse tightly. You mutter prayers repeatedly.
The door opens, and you jump. The familiar sight of your competent doctor, his warm greeting threaten to unravel you. You smile weakly. This is it.
Your doctor produces the paperwork from the extensive testing he had ordered for you.
Abdominal and pelvic ultrasound: normal
Chest x-Ray: normal
2 pages of blood work: all normal
Urine test: normal
Tears stream down your face and you sigh heavily.
You aren’t dying. According to the tests completed, you are perfectly healthy.
But why have you been feeling so awful?
You expect your doctor to reassure you and dismiss you, but he doesn’t.
He asks you if you have a personal and / or family history of anxiety and depression.
Yes. Yes, you have both.
“How has your mood been lately?” He asks gently.
Then, you unravel. Your kind doctor passes you the box of Kleenex and waits.
You’ve been feeling scared. Scared for no reason, almost all of the time. You are tired beyond words, but can’t catch a good sleep. You have trouble focusing when talking on the phone, when getting groceries. You get irritated very easily, and take it out on your husband. Never your daughters though, never. You are so worried that your days with them are limited that you try to pack a lifetime worth of love into each day you have. You read to them as your vision blurs. You take them to the park as your limbs tremble. You hold them close in the night, and cry.
You picture your own death far too often. You’ve even gone as far as sprinting home from the park, looking over your shoulder, convinced the man in the white van was coming for you.
Your doctor listens attentively. When you finish, he produces more paper. Information on the emotional, cognitive and physical symptoms of anxiety and depression.
You read and realize you have been having almost all of them.
“This is not your fault. It is nothing you have done or not done. Things are imbalanced in your brain, but I can help you. It is going to be alright. ”
Tears spill onto your cheeks once again. You dab them with a mascara streaked tissue.
You listen as he discusses medication and counselling, and sigh deeply.
Humans have a great ability to lie. They can also tend to attention-seek, exaggerate, and be self absorbed.
I think it’s because of these things people often have trouble completely trusting someone when they say they feel sick, anxious, depressed, or are experiencing pain.
“Oh, it is just in your head.”
“Just stop dwelling on it, and you’ll feel better.”
“Some fresh air and exercise will shape you up in no time.”
They might say.
Although saying these things may be well intentioned, they are quite harmful. The person who has confided starts to doubt themselves, to blame themselves, to feel ashamed.
And they stop talking.
The best thing a person who suffers mental illness can do for themselves, is talk.
The best thing a person who listens can do, is say,
“I believe you.”
Be Brave, and Talk.
Be Brave, and Believe.
** stat on number of doctor visits obtained at http://www.nursingassistancentral.com