“Doctors (and other presumably well-meaning people) dismiss them as being ‘all in your head’ – by which they mean fake”George Hodan

For years, I suffered from inexplicable bouts of illness where I would feel nauseous and unable to eat for days on end, but I would have no temperature or visible signs of the cause. These almost always coincided with periods of stress. I wasn’t diagnosed with an anxiety disorder until I was in sixth form and suffering from panic attacks, but I remember these stomach problems occurring from about the age of 11. I can’t help but think that if somebody had connected my genuine stomach aches with a psychological cause, my anxiety might have been identified before it became so severe.

The trouble is that since these physical symptoms are often invisible and have no provable cause, doctors (and other presumably well-meaning people) dismiss them as being ‘all in your head’ – by which they mean fake. I can’t speak for anyone else, but trying not to vomit in Victoria Station because unfamiliar journeys and crowds made me anxious felt all too real. Moreover, just because that nausea was caused by thinking doesn’t mean I can think my way out of it: positivity and ‘trying not to worry’ have so far failed to produce miraculous results. Besides, if my anxiety were logical it wouldn’t be an anxiety disorder.

What needs to be acknowledged is that physical problems with a mental cause are just as real as those caused by a virus or other physical trigger.

“Chronic pain is still chronic pain if it’s caused by anxiety, and learning to manage it would have helped regardless of the cause”

There is a flip side, however: some doctors take the correlation between mental health and physical symptoms to an extreme. I have hypermobility syndrome, which causes chronic pain due to frequent dislocations and other joint trouble. When I went to a rheumatologist, seeking a referral to a pain clinic so I could learn to manage this better, she stopped listening to me after she heard I had an anxiety disorder. I’m not pretending: she literally didn’t let me finish my sentence when she asked me about symptoms. I was told that I didn’t need the referral, because pain clinics were ‘for people with actual chronic pain’, and that if I had CBT for my anxiety, the pain would go away.

Funnily enough, a psychosomatic dislocation is just as painful as a ‘real’ one. If only I’d known sooner that my anxiety had caused my shoulders to slip out of place, I might have stopped my various injuries and pain crises from ever happening. Oh, enlightenment!

Not only did she refuse to refer me to the pain clinic, but I was also discharged from the rheumatology department, so I couldn’t seek further treatment. Ironically, had I not been so anxious in my appointment I could have spoken up and presented her with proof that my pain was indeed caused by actual physical issues. Instead, I was on the edge of tears. I shouldn’t have needed to, though – chronic pain is still chronic pain if it’s caused by anxiety, and learning to manage it would have helped regardless of the cause.

Suffering from both physical and mental health conditions can make it impossible to identify the cause of a symptom. Have I ‘glutened’ myself (I’m coeliac, so even a crumb can make me ill), or is my stomach ache because I’m anxious? Am I fatigued because of hypermobility or because of depression, and will getting out of bed help or make it worse? Sometimes it feels like a game of ‘pin the tail on the disorder’, but there’s no way of knowing whether I’ve got it right. Most of these aren’t solvable problems: whether mental or physical, when it comes to chronic illness, learning to manage it is as good as it gets.

But if doctors and peers would take the intersection between mental and physical health more seriously, that would be a start.