Truth Needed for Proper Mental Health Diagnosis
When people are under significant stress, the mental burden can be overwhelming.
In our society, it is somewhat difficult to seek help for mental health issues, but physical symptoms get the most attention of health care providers. It is therefore not uncommon that people with mental stress seek medical help for physical symptoms.
For example, instead of seeking help for anxiety and depression a patient may perceive the mental stress as a burden in the chest and call it chest tightness or chest pain. When the patient first seeks medical attention for the problem, they secretly hope that the doctor would recognize the symptom and tell them that they have depression and give treatment for that.
If you have read my articles about evaluation of chest pain, you probably understand that doctors take any chest pain very seriously. As a result, this particular hypothetical patient will initially be surprised when they get a lot of medical attention for chest pain. They will wonder why they are unable to detect the lie with the array of sophisticated and high tech medical equipments. What they do not understand is that our medical system relies heavily on subjective information provided by the patient.
When the patient is "producing" a symptom to get attention, there is no equipment that can detect that lie. Most medical tests can only be interpreted in the context of the symptom that the patient is having. There is not a single medical test that can be absolutely called a positive or negative on its own without the context of the symptom for which the test was ordered.
In view of the patient having persistent chest pain, a seemingly negative test will only warrant further testing with even more invasive and riskier medical tests and procedures.
As a result, the patient's thought process starts to change. After being subjected to multiple tests, they still are not seeing the reaction from the doctors that was expected. Instead, the doctors are still concerned about the chest pain. At this point, the patient begins to think something must be wrong with their heart. They begin to believe their own lie. This gives them a sense of relief that they had a physical illness to begin with, not a mental one. Unfortunately, some patients who go down this path develop an actual physical illness from complication and side effects of the tests and procedures.
This example underscores the importance of being completely honest with your doctor about your symptoms. Medical diagnosis relies heavily on how you describe your symptoms to the doctor. Lying or exaggerating to the doctor only causes harm. There is help available for mental stress and depression.
If you honestly tell your family doctor about your true symptoms, you will not only get appropriate help but also avoid the complications that could arise from a made up physical symptom.
In medical terminology the type of patient I just described is labeled as having a diagnosis of "Munchausen Syndrome" or fictitious disorder but the diagnosis is seldom made in practice because there is no reliable way of knowing when a patient is making up any physical symptom in the first place.
Nabin Sapkota, MD, is board certified in internal medicine and is a hospitalist with the Inpatient Physician Associates of Columbus and is a physician with the hospitalist program at Columbus Community Hospital. His book, "The Secrets of Modern Medicine Revealed" can be purchased online at www.medicinerevealed.com/medicine-revealed.html.
Learn more at: www.medicinerevealed.com
Story by: Dr. Nabin Sapkota of the Columbus Telegram
