The Biggest Shock of My Medical Career..

by David D. Clarke, MD

...was learning that stress, particularly when not fully recognized, is responsible for physical illness in millions of people. Symptoms can occur anywhere in the body and are severe enough that many of the thousands I have treated were in the hospital.

One of these patients was Ellen, aged 50. Every month or two for fifteen years she suffered attacks of extreme nausea and dizziness that would last for days. She was so discouraged when we met that she barely looked up from her hospital bed to say, "don't waste your time with me."

She then told me about being admitted sixty times to one of the best university medical centers in the western U.S. with no diagnosis and no successful treatment.

Fortunately, I had learned that when tests show nothing wrong it is time to look for stresses that can be linked to the symptoms. I inquire in five different areas. The first is the most obvious: stress that is ongoing at the moment. This might be a personal crisis, family issue or problem in the workplace.
Ellen believed she had none of these. I also look for signs of Depression that are more subtle than the obvious symptom of feeling depressed. These include poor sleep, loss of interest in previously enjoyable activities, lack of energy, poor appetite, crying for little or no reason and lack of hope.

Next I ask about anxiety, worry, nervousness or fear. These are particularly common when physical symptoms are worse away from a safe environment (such as the home) or when around large
numbers of people.

The fourth type of stress comes from having had a traumatic experience such as a motor vehicle accident, an assault or military combat. In some people, illness begins a long time after the trauma following a triggering event connected to the trauma.

Ellen did not have those problems. What she did have was a history of abuse by her mother as a child, mostly verbal and emotional. Unfortunately, this was still happening five decades later. After a long discussion I found clear links between the abuse and Ellen's symptoms.

For example, many of her attacks occurred after phone calls from her mother or when driving to visit her. Ellen was aware of the tension in this relationship, but not its enormous power. But that day everything became clear. She looked up at the ceiling and said, "Oh my God, I can't believe it."
he never had another attack. In many other people the links between stress and illness are not so obvious and complete relief may involve months or even years of counseling. But the path to improvement always begins with uncovering the hidden sources of stress.

David D. Clarke, MD
Clinical Assistant Professor of Gastroenterology Emeritus
Oregon Health & Science University, Portland, OR

Dr Clarke is the author of They Can't Find Anything Wrong!: 7 Keys to Understanding, Treating, and Healing Stress Illness

Terri's Response: Thanks Dr. Clark. Being aware of stress and making lifestyle changes is so important. If we can get rid of stress and dehydration, my belief it that wellness would be the norm.

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