The only thing worse than feeling lousy is being told that your symptoms are all in your mind. Joni Mitchell recently made the news when, after being found unconscious at home, stories circulated about her battle with Morgellons disease, a mysterious illness—which includes symptoms like the feeling of bugs crawling on you—that many researchers don’t believe exists.
There are plenty more commonly known diseases and disorders that also present with symptoms that can lead doctors to mistakenly declare them psychosomatic or attribute them to a different illness altogether. And the harder an illness is to determine, the more likely you are to get that incredibly frustrating “all in your head” diagnosis. Read on for the 9 most common.
Widespread pain, sleep problems, fatigue, headache, tingling of the hands and feet, along with cognitive issues such as memory loss can all be symptoms of fibromyalgia, says Navid Farahmand, MD, a board-certified pain management physician with the Brain and Spine Institute of California in Newport Beach, CA. “There is no single spinal nerve, muscle, bone, or other definable source that can explain the variety of symptoms patients can experience,” he says, which makes it tough to diagnose. Plus, since depression and/or anxiety may also accompany these vague symptoms, doctors sometimes conclude that it’s all in your head. In addition to ruling out other diseases, confirming a diagnosis is determined by a widespread pain index, which rates and catalogs where you’ve been experiencing pain. (If you’re dealing with fibromyalgia, these diet tweaks can help control symptoms.)
Caused by the bite of an infected tick, Lyme disease starts with vague symptoms including fever, headache and fatigue, along with a skin rash. Left untreated, the infection can spread to the joints, heart, and nervous system. “It’s often hard to diagnose due to the ambiguous symptoms,” says Sachin Jain, MD, chief medical officer of CareMore, a medical group in Cerritos, CA. “Most people who have Lyme see a doctor when symptoms worsen and they have joint pain or neurological issues like foggy brain or forgetfulness. By then the doctor may want to explore a whole host of causes, so the work up may take time as other conditions are dismissed.” A proper diagnosis requires laboratory testing.
Also known as painful bladder syndrome, interstitial cystitis is a chronic condition characterized by bladder pressure and, sometimes, pelvic pain, which may range from mild to severe, along with a persistent, urgent need to urinate. It mimics a urinary tract infection (UTI) in some ways, yet your urine culture will contain no bacteria and the pain goes away after urinating. “Because the pelvic pain gets worse during your period, it’s often misdiagnosed as menstrual cramps,” says Sherry Thomas, MD, a urogynecologist in Agoura Hills, Calif. Diagnosis involves ruling out other issues, says Thomas. Treatment varies but usually includes medication, physical therapy to relieve the pelvic spasms, and avoiding triggers such as spicy foods.
This painful condition occurs when the lining that normally grows inside the uterus grows outside of it. It’s tough to diagnose in its early stages because growth can’t yet be seen, says Thomas. And symptoms may be simply perceived as bad menstrual cramps. “Endometriosis also produces severe pain with your periods,” says Thomas, which may be mistaken for menstrual cramps. An accurate diagnosis can be made by an ultrasound to rule out a mass or anything else that may be causing the pain, and a urinalysis to rule out a UTI
Lupus is an autoimmune disease that affects multiple organ systems. It can manifest by affecting your lungs, heart, kidneys, brain, skin, joints, blood cells, tear glands, salivary glands, and general health (feeling tired or having fevers) in various ways, says Delphine Lee, MD, director of translational immunology at the John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA. “Lupus can be confusing to diagnose because it requires a specific set of criteria to be met to make the diagnosis—it’s not just one symptom, like how shortness of breath would indicate a lung problem, but the combination of symptoms that leads to the diagnosis.”
Multiple sclerosis (MS)
In MS, the immune system attacks the myelin sheath, a protective covering around nerves, disrupting communication between the brain and body. The result can be a wide variety of signs and symptoms that don’t lend themselves to a clear-cut diagnosis. “MS can affect any part of the brain or spinal cord,” says S. Ausim Azizi, MD, PhD, chairperson of the department of neurology at Temple University School of Medicine in Philadelphia. “Therefore, symptoms can be varied and can change frequently.” Neurological symptoms (issues with seeing, reaching, feeling) lasting for weeks should be checked with a neurologist or MS specialist, says Azizi.
An overactive thyroid speeds up your metabolism and may trigger panic attacks and a pounding heart, common symptoms of anxiety. “Although an overactive thyroid is more commonly associated with triggering anxiety than an underactive thyroid, either condition may be involved,” says Joseph J. Colella, MD, author of The Appetite Solution. Though it can be an easy symptom to dismiss, feeling anxious all the time is never normal, and while there are many potential causes, it’s almost always treatable. Ask your physician to perform a thyroid panel of blood tests to be sure that the organ is operating at peak efficiency, says Colella.
Irritable bowel syndrome (IBS)
This gastrointestinal disorder, characterized by bouts of recurrent abdominal pain and diarrhea, has no known cause but is often triggered by anxiety and stress. It also involves a miscommunication between the brain and gut regulation, which is why it’s sometimes believed to be all in your head, says James Lee, MD, gastroenterologist with St. Joseph Hospital, Orange, CA. “Although psychological factors are not the primary cause of IBS, they can affect how a person manages and copes with its symptoms, such as becoming fearful of having an attack in social situations.” (These 11 highly effective solutions for IBS can help.)
A symptom rather than a specific disorder, chronic pain refers to pain that keeps up for weeks, months, and even years, sometimes with no known cause. “Every injury has an expected period of time to recovery,” says Farahmand. “If pain lasts for longer than what seems normal, further evaluation is necessary.” Common chronic pains include headache, low back pain, arthritis pain, and neurogenic pain, which is pain resulting from damage to the peripheral nerves or the central nervous system itself. Treatment may include oral medications, ointments or a patch applied to the skin, injections or more invasive procedures.
Published: May 4, 2015. By Linda Melone
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