a guest post by David D. Clarke, MD

(www.livelywomen.com) — Do you have an illness but your health care professional can⿿t find the cause? The usual, and still essential, approach to this problem is to keep working with your doctor or obtain another opinion (possibly from a specialist). But it is also important to recognize that in up to half of people who go to a doctor, the symptoms are caused by one or more hidden stresses in the patient⿿s life. Complicating the situation is the fact that few clinicians have had much formal training in how to diagnose these. This article will help you understand this often overlooked problem.

There are five kinds of hidden stresses capable of causing real physical illness.

The first is stress is your life at the moment. Here are two ideas to evaluate for this:

1. Make a list of everything in your life that causes stress, tension, worry, anger or fear. Ask yourself if you would feel sorry if a friend was coping with the same list.
2. Ask yourself (or a loved one) if you are the kind of person who takes care of everyone else in your world before getting around to caring for yourself.

If the answer to either of these questions is ⿿yes⿿ then it is possible these sources of stress are contributing to your illness.

The second hidden stress is prolonged effects of difficulty in childhood. Childhood stress survivors often answer the second question above with a ⿿yes.⿿ Other possible indications that your early years were difficult enough to cause problems are that you:

• Would never want an innocent child to grow up experiencing what you did as a child.
• Have poor self-esteem and/or often find yourself in relationships where you are treated disrespectfully.
• Have an addiction (drugs, alcohol, nicotine, sex, food, shopping, work, exercise) or an eating disorder (anorexia nervosa or bulimia).
• Cut, burn or otherwise deliberately injure yourself.

The third hidden stress is depression. Surprisingly, many people with this disease don⿿t feel particularly depressed and so don⿿t recognize what is happening to them. Instead they may have one or more of the following:

• Have lost interest or pleasure in activity they previously enjoyed.
• Have a low general energy level.
• Cry easily or for no obvious reason.
• Have diminished appetite or eat because they should not because they want to.

Fourth is stress from a traumatic event. Often the event is recent but traumas from many years in the past are also capable of causing physical illness. You might have this problem if you:

• Are bothered by unwanted memories from a traumatic, terrifying or horrifying personal experience.
• Avoid certain situations or types of people because they remind you of the trauma.
• Have nightmares about the traumatic event.

Finally, the group of conditions known as the anxiety disorders can sometimes manifest in your life primarily as physical symptoms. Here are some clues:

• You are unable to control or stop feeling anxious, worried, on edge or nervous.
• You often feel that others are judging you.
• You often fear embarrassment, particularly in social situations such as public speaking, eating with others or simply being around large numbers of people.
• You suffer from panic attacks, which are sudden episodes of overwhelming fear often accompanied by shortness of breath or pounding heart.
• Your physical symptoms never occur when you are in a place you consider safe.

If some of these ideas seem to apply, you should bring them to the attention of your health care professional. The good news is that there is usually excellent treatment available for all of these issues. For example, if you are taking care of everyone but yourself, try adding yourself to the list of those for whom you care by taking 4-5 hours every week just for your own enjoyment. It may take you a few months to overcome your guilt and get skilled at this, but keep at it and you will see results.

When illness improves as a result of attention to hidden stresses, this provides good evidence that the diagnosis is correct and that you are on the right track.

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David D. Clarke, MD, is a Clinical Assistant Professor of Medicine at Oregon Health and Science University, a Clinical Instructor at Pacific University, and a member of the Academy of Psychosomatic Medicine. He is board-certified in Gastroenterology and Internal Medicine, and has practiced in Portland, Oregon, since 1984. For more information, see the book They Can’t Find Anything Wrong!: 7 Keys to Understanding, Treating, and Healing Stress Illness or the web site www.stressillness.com.

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