Why the diagnosis of a psychosomatic illness is often a misdiagnosis
To change the language click on the British flag first

Many patients with chronic symptoms that are difficult or impossible to explain are regarded by their doctors as suffering from psychosomatic illnesses.

The diagnosis is often made after an inadequate diagnosis of the symptoms.

The symptoms of vascular compression syndromes are particularly varied and difficult to interpret. Patients with these conditions are therefore often misdiagnosed as suffering from a psychosomatic illness.

After an inconclusive routine diagnosis, it is often claimed that “Your symptoms originate in your head!”, “You have nothing, your complaints have purely psychological causes!”, “You are healthy, all examinations are negative, your complaints are imaginary.”.

Psychosomatic treatment is then often recommended, after which the patient continues to suffer from the original symptoms. Both the treating doctor and the patient are then disappointed, as no relief can be achieved.

Patients often feel abandoned, frustrated, devalued and become melancholic, sometimes even suicidal.

How do such misjudgements come about?

There are no generally recognized criteria for the primary diagnosis of psychosomatic illnesses! As a rule, organic illnesses are “ruled out”. If the corresponding examinations fail to produce results, it is simply claimed that the illness is a mental illness or that the physical complaints have purely mental or essentially mental causes.

In many cases, however, this approach, which is common in psychosomatics, is at best a helpless attempt to calm a situation, to alleviate the accompanying psychological complaints of a patient with an underlying serious organic illness or even, in some cases, to simply get rid of the patient. On closer inspection, this widespread approach proves to be completely illogical.

You don’t need to have studied medicine to understand this.

If I don’t know something, I shouldn’t claim that I know it. Instead, I should admit that I don’t know and not try to fill the gap with unfounded claims or explanations. Unfortunately, it is often assumed that what cannot be explained somatically can be explained psychologically. This view overlooks the fact that although the human being can be seen as a unity of psyche and body, the whole is more than the sum of its parts. Modern medicine, however, has divided itself into many specializations and subspecializations, rarely looking beyond the boundaries of its own field. For example, interactions between organ systems, long-distance effects through the transport of substances in the blood and the transmission of nerve signals, and the physical effects of gravity on various organ systems are examples of the causes of complaints that cannot be identified if limited to a single specialty.

The fact that human knowledge is generally limited and that it is therefore not possible to find an answer to every question must be accepted by both the doctor and the patient. However, this realization is difficult to bear. Therefore, esoteric, untested alternative medical or psychological, spiritual or freely invented connections are often invoked as the cause.

Even in seemingly hopeless cases, there are often starting points for further diagnostics. To do this, it is often necessary to go beyond the boundaries of a specialist field or to consult the basic subjects of medicine such as physiology, anatomy, biochemistry, biophysics, genetics and others. Often, even in seemingly hopeless cases, a path to knowledge can be found from which help can be derived. There are certainly also cases of severe psychological stress that have physical consequences, for example due to prolonged immobilization with reduced physical activity as a result of depression, self-harming behaviour with self-esteem problems and the like.

However, most patients who are assumed to have a psychosomatic diagnosis deny psychological impairments at the beginning of their illness and essentially suffer from their physical symptoms. Of course, there is always an interaction between physical and mental health. However, it cannot be concluded from this that physical symptoms can be traced back to a mental disorder if this mental disorder cannot be proven and if the physical symptoms do not diminish when the mental disorder is treated. Apart from this, the causal link between certain psychological stress factors and certain physical symptoms cannot usually be established.

A doctor admitting his/her own helplessness would help the patient much more. At best, the doctor whose knowledge has reached its limit would seek advice from other colleagues or educate himself. It is not unusual to get stuck with one’s knowledge. However, doctors have a commitment to help their patients, i.e. to alleviate their complaints. It is not easy for them to have to admit to themselves that their skills are not sufficient in many cases. If they then localize the problem exclusively to the patient by blaming their physical symptoms on a mental disorder, they are harming the patient and relieving themselves in the process. It is not uncommon for irrational so-called alternative healing methods to be recommended as a last resort.

A better way would be to look for a solution together with the patient, organize accompanying help (which is often done), contact specialized colleagues and researchers (which is already used much less frequently), use the resources of the Internet for diagnosis (which many doctors even advise patients not to do!) and support the patient as a fellow human being and develop compassion.

If you are a patient suffering from severe physical symptoms for which no cause has yet been found, do not be satisfied with the diagnosis of a psychosomatic illness. Seek help from other sufferers in patient support groups, exchange ideas and consult the Internet. However, when seeking help on the Internet, make sure that the solutions offered there are logically comprehensible to you. Make sure that the claims are backed up by facts. Check what you read on the internet and base it on scientific literature. Good sources are Pubmed, OMIM and Google Scholar.

Vascular compression syndromes are an example of a serious organic disease that is often misinterpreted as psychosomatic. The reason for this are the numerous and varied symptoms that can be spread over the whole body, often affecting different organ systems and depending on posture, food intake or the sleep-wake rhythm.

Compare your symptoms with those on the list of symptoms of vascular compression syndromes. If you find frequent similarities there, investigate this suspected diagnosis further. Do not be discouraged! Vascular compression syndromes can often be treated with medication, physical training and surgery with good to very good results. Numerous successfully treated patients are proof of this!



How useful was this post?

Click on a star to rate it!

We are sorry that this post was not useful for you!

Let us improve this post!

Tell us how we can improve this post?