Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab
+923211439754
Lahore & Gujranwala
Dr. Zahid QutabDr. Zahid QutabDr. Zahid Qutab

Medically Unexplained Symptoms

medical
This information will help anyone with physical symptoms without any physical illness. It will also explain what you can do to help yourself and others( your friends or relatives) with such symptoms. We all experience physical symptoms – painful or uncomfortable feelings in the body – at some times in our lives. Mostly , they get better on their own or without any treatment. If they don’t settle down with time, we may need to ask a doctor about them. Usually a physical cause is found but sometimes you don’t find anything , even when blood tests and x-rays / scans have been done repeatedly. Such symptoms are common. They are called “medically unexplained symptoms”, because they are not because of any physical illness .

What is a symptom?

We all experience aches, pains and odd sensations in our bodies. Most of the time we know that they will go away on their own, and we tend to ignore them. If these changes become painful or uncomfortable, or unusual, we may think they may be signs of an illness and we call them symptoms.

How often these symptoms occur in polulation :

  • About 1 in 4 people who see their GP have such symptoms.
  • In a neurological setup, it is 1 in 3 patients or even more.

Diagnosis;

The common ones include:
These can range from experiencing sensory symptoms pain in head , back or joints, tingling or numbing sensations , feeling of extreme cold or heat in hands or feet or any other part of body , onset usually is sudden but it may or may not be associated with a stressful event e.g, death of loved one, severe arguments with friends or spouse , financial crisis.
They can also includes motor symptoms like severe body movements mimicking fit of epilepsy or possession like symptoms (in our culture, usually mistaken for Black Magic or Devil’s possession ), this includes bending of hands or feet , fainting , difficulty in breathing, tongue bite or growling loud sounds, unable to speak or communicate with others or apparent paralysis , these symptoms can last, usually from more than 2 minutes to even hours. But a person has to be evaluated by a psychiatrist either he is having a real epileptic fit or unexplained medical symptoms.
It usually happen In episodic manner , mostly associated with stressful times/events.

What causes medically unexplained symptoms?

When we don’t feel right, mostly there is a ‘physical’ cause – stomach problems may occur due to an infection, or palpitations due to a heart problem. What if there is no physical explanation for your physical symptoms? Also these symptoms aren’t present “all in the mind”, but neither are they all in the body.To understand this we have to know the mind body link.

What causes medically unexplained symptoms?

When we don’t feel right, mostly there is a ‘physical’ cause – stomach problems may occur due to an infection, or palpitations due to a heart problem. What if there is no physical explanation for your physical symptoms? Also these symptoms aren’t present “all in the mind”, but neither are they all in the body.To understand this we have to know the mind body link

How are the mind and body linked?

Main Body

We think of  minds and bodies as two separate things.  In fact, they work together and have an impact on each other.
There is a  two way communication between our brains and bodies. This happens because :  

  • Signals travel down the nerves from our brain to the body and then  back again from the body to the brain.
  • Natural body regulating chemicals, called ‘hormones’, circulate in the bloodstream. 
    Every day feelings and thoughts , we experience make changes in our bodies .for example:
  • When we feel embarrassed, we usually blush
  • Feeling worried or frightened can cause an uncomfortable feeling of “butterflies in the stomach or palpitations”.
  • when we get very  upset , we feel our throat tighten – “choking feeling or chest tightness ”.
    We also know this,  the way we think and feel can make us physically ill.  For example:
  • long-term stress can contribute to high blood pressure or a  heart attack.

Is there a diagnosis for my symptoms?

We can give a name or a “diagnosis” for symptoms when:

  • they occur together in a particular pattern in many people, or
  • when they share a similar cause.

Examples of diagnoses that may be made because of possible causes of these symptoms include:

  • Somatization disorder and somatoform disorder – where stress is a major cause of the symptoms that involves complaining a lot about body pains etc . And these symptoms are going on for a long period with any physical cause.
  • Dissociative disorder (also called ‘conversion disorder’ or ‘dissociative-disorder’) It is thought that symptoms that look like they are caused by a disease of  nervous system (e.g. fits, paralysis, loss of memory or unable to speak ) but are in fact caused by long term or sudden severe  stress.
  • Health anxiety: when symptoms are less severe and someone gets anxious a lot and thinks , they are not well.(Hypochondriasis )But if this grows to over concern,  when someone worries a lot that their symptoms mean they have a serious physical illness like cancer, or any venereal disease like HIV, or AIDS  ,despite repeated la  reports reassurance that they are not physically ill.

Body dysmorphic disorder –  when someone is so overly concerned about any aspect of their appearance and causes them considerable distress which gets in the way of everyday life.

Treatment:

Both Psychotherapy and Medications
Antidepressants drugs

Antidepressants are used to treat a wide range of  problems, not just depression, and can help in  treating medically unexplained symptoms in a number of ways.

  • A vicious circle  sets up between symptoms  such as pain and depression. Antidepressants can be helpful to break this vicious circle and both the depression and the symptoms can improve.
  • Some antidepressants act as pain-killers and can be prescribed for chronic pain. People with medically unexplained symptoms can notice more side-effects than others  because they are always looking out for bodily symptoms.

Talking therapies

There are  many different types of talking therapies that can help. The choice of therapy depends upon the sort of problem. These therapies commonly help you to:

  • Start recognising what seems to make your symptoms worse
  • managing stresses that might contribute to the symptoms
  • develop ways of coping with the symptoms.

Some of the most commonly used talking therapies to treat medically unexplained symptoms are described below.

Cognitive behavioral therapy (CBT)

CBT can  be very helpful to identify unhelpful thoughts about yourself and your health, which can make symptoms worse. 

For example, someone may worry that, because people in the family have got a serious illness like cancer , they are bound to get ill too. 

CBT helps people,  first  to recognise and tackle these unhelpful thoughts and to develop ways to change the way they think which can improve their symptoms.

Psychodynamic therapy

This can become particularly helpful when early life  experiences negatively affect the way we think, feel and act. 
For example, people who have experienced difficulties as children are more likely to have medically unexplained symptoms as an adult. 

The therapy helps people to understand how and why their symptoms occur and develop ways of coping.

Problem-solving therapy and solution-focused therapy

These therapies first help you identify and tackle specific problems in your life that seem to make  symptoms worse.