HEALTH : Psychosomatic Disorders

Every doctor working in any hospital encounters about 30% of patients with unexplained symptoms. That is, symptoms which are vague and do not fall in any known disease pattern, or the patient may have symptoms of some disease but physical examination and tests reveal no ailment in the body. Psychosomatic disorders are where a person presents complaints pertaining to some part of the body but in reality has no physical problem. With World Mental Health Day around, it is meaningful to generate awareness about such problems. There are many well defined psychosomatic conditions where clinical examination and all investigations are negative and complaints are maintained and perpetuated due to anxiety and mental tension. Common psychosomatic symptoms are palpitations, abdominal pain, hiccoughs, body pain and unconsciousness. In hysteria, one pretends to be ill for some personal gain. Chronic pelvic pain in women when tests are negative for infection is also categorized as a psychosomatic condition. Though women are said to suffer more from these conditions, men are not immune. Irritable bowel syndrome in young men is one such condition. In this condition, one has chronic recurrent diarrhoea. Fibromyalgia is yet another condition commonly encountered in young men, where they complain of vague muscular pains. Typical chest pains mimicking heart a problem is also a psychosomatic problem. Hyperventilation syndrome where an individual hyperventilates voluntarily is yet another psychosomatic disorder. In chronic fatigue syndrome, the person complains of excess fatigue which is unexplained. Tension headaches occurring both in men and women are psychosomatic in nature. Conversion disorders, where there is loss of function of one or more limbs, is an extreme form of psychosomatic condition. A psychosomatic condition is diagnosed by excluding physical illness by means of relevant exams. They have to be differentiated from organic psychiatric problems like schizophrenia and maniac depressive illness which need treatment. These psychosomatic disorders may be due to anxiety or mental stress. It is common to see students falling ‘sick” around examination times. Depression is the underlying cause of the sickness of some people though reasons for depression may be imaginary. Hypochondriac people are sick with anxiety related to imaginary disease. They are so anxious as to not suffer from some malady that they also start getting ill. Some persons may have psychosomatic problems one or two times as a result of some stress. In many people, psychosomatic problems are recurrent or chronically present. Whatever type of psychosomatic disorder one may have, it always indicates a weak mind. Alcohol and other addictions add to the problem. Such individuals spend a lot of time visiting hospitals to seek treatment. It is not an individual problem but affects the society as a whole and therefore concerns all. With any member being affected by a psychosomatic problem, entire family is disturbed. All members become anxious, cannot have a good time, because someone in the family is repeatedly falling sick. It also burdens the family financially. In hospitals, they add on the number of patients and workload of hospital staff. With the limited number of working hands available in the hospital, these individuals divert the focus of health personnel which is essential for really sick people. In institutions, such people avoid their share of work due to the supposed sickness. This reduces the entire productivity of that institute. Employers also remain in a dilemma as to what to do with the employee? Interestingly, majority of these people are aware of the true nature of their sickness. But they do not realize that being in the hospital is not going to solve any problem for them. Rather they expose themselves to nosocomial infections from other patients. Instead of attention and medicines, these people need good counselling. It is better to face the world bravely and find solutions for stressful situations, instead of getting sick. They need to learn and practice techniques for mental relaxation. The author is a specialist in Internal Medicine E-mail – rachna212002@yahoo.co.uk