1. Health

What to Do If Your Doctor Tells You "It's All in Your Head"

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Updated June 18, 2014

When you suffer symptoms, and your doctor can't seem to diagnose you accurately, he may tell you that your problem is "all in your head."

Or worse - he won't tell you, but he'll tell others. So often, doctors who behave this way do so because they want to make it a problem with you, not a problem with their own inability to find answers. Such is the practice of an arrogant doctor, one who thinks he is never wrong or incapable.

Yet, despite your doctor trying to blame your mental status, you'll continue to experience those physical symptoms. You know something is not right. You know you need a diagnosis because you need a treatment that will work. You know there is something wrong that needs fixing.

Here are some steps to take if your doctor tells you that your problem is all in your head:

1. Don't assume "all in your head" is a negative judgment.

"All in your head" may not mean your doctor is dismissing your symptoms. What it may mean is that your doctor wants to explore the possibility that your physical symptoms have a cause that's rooted in your brain, and not the body system that seems affected.

For example, we all know that dizziness can upset our stomachs, even cause us to vomit. We know that stress may cause us to break out in hives, or cause other blemishes on our skin. Fear or embarrassment causes us to blush or even begin to perspire.

Modern medical science every day finds new ways our thought processes affect us physically. They call this the mind-body connection. That connection is also what makes placebo medicines work.

When the mind-body connection creates problematic symptoms, doctors call the results psychosomatic illnesses or somatoform disorders. If you have been under stress or you believe it's possible your symptoms may be attributable to recent stressful experiences or emotional trauma, consider that "all in your head" may be exactly what the problem is, and work with your doctor to sort it out.

2. Understand Your Doctor's Inability to Diagnose You

The truth is, it is not possible for every doctor to know every answer, or to be able to diagnose every illness. We patients should not expect any given doctor to have that capability, nor should doctors expect that of themselves. Arrogant or not, no doctor should have the weight of that expectation on his shoulders.

There are several reasons we can't have that expectation.

Instead, what we patients should expect is that a doctor will give it a good, objective try, and then, if she can't solve the challenge, that she will help us find the resources to get the right answers from someone, or somewhere, else, and not to merely blame the problem on our mental health.

3. Work with your doctor in partnership to figure out what's wrong.

Work through the process of differential diagnosis with your doctor, which may help you determine what all the possibilities are.

You may also want to consider possibilities that your doctor isn't familiar with, or doesn't diagnose often. For example, dysautonomia is a good explanation and diagnosis for a host of symptoms that are tough to put a finger on, and can't be tested.

4. Get a second or third opinion.

This is best done independently, not through a referral from your current, unable-to-diagnose-you doctor. Follow the guidelines for getting an objective second opinion.

5. Ask for a referral to a psychologist or psychiatrist. (Yes - seriously!)

This is the step that most of us miss, but may be the most vital and important step. Here's why:

If your doctor tells you that your problem is all in your head - then it will likely make you frustrated and angry. The best revenge, once you know for sure the problem is not psychosomatic or a somatoform disorder (see #1 above) is to prove he is wrong. If the best he can do is tell you the problem is all in your head, then that's where you'll go with it. Ask for that referral.

Either he will provide the referral (see below for outcomes.) Or he won't - at which point you will have called his bluff.

If he does provide the referral, and you meet with the psychologist or psychiatrist, then you have two possible outcomes, and both can be helpful to you. One outcome will be that you will be deemed mentally stable, with no hypochondria or cyberchondria. Now you know the non-diagnosing doctor was wrong - and he will, too.

The other possible outcome is that the psychologist or psychiatrist will determine you do have a mental problem that needs addressing.

If the counselor does tell you the problem is in your head, then by all means, get a second psychological opinion, too. Take great pains to find a second mental health opinion from someone totally unaffiliated from your original "all in your head" doctor. You don't want the doctors' friendships impacting your ability to get the right diagnosis.

6. Once you have pursued those options, you'll have choices to make about moving forward.

You can choose to work with whichever doctors you believe have the right answers for you.

One caveat: the right opinion is not necessarily the opinion you like better. Be sure your choice of which doctor to work with is the one with the correct answers, and not just the answers you find the easiest to cope with.

You can review these tactics for uncovering every piece of information possible to help you determine what your diagnosis might really be.

7. Work with a patient advocate.

Sometimes the best answers come from someone with no stake in the outcome except your success. A private patient advocate can help you take a step backward, track and record the important pieces of your puzzle, and help you determine where to go from there. Here is how to find, interview and choose a patient advocate.

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