Posts Tagged ‘medical interview’

Stress Illness Brochure (2)

Wednesday, December 16th, 2009

Continuing with Part 2 of the Stress Illness brochure:

How Can You Find Out If Stress is Causing Your Illness?


Stress Illness Brochure (1)

Monday, December 14th, 2009

My first “best-seller” was a brochure for patients titled “Is Stress Making You Ill?”  Clinicians in my medical group ordered thousands every year to put in examination rooms.  I found that if a patient was reading one as I entered the room, it usually turned out that stress was causing their symptoms.  The brochure often triggered discussions that helped me with diagnosis.


Mental Health Professionals and Physicians (Letter)

Friday, December 4th, 2009

Building referral pathways from medical to mental health professionals will be a key part of relieving stress illness.  Here is an example of a letter written by a mental health professional  to a medical clinician offering ideas that could help.  (The references below will be discussed in more detail in a future post.)


Mental Health Professionals and Physicians (Intro)

Thursday, December 3rd, 2009

Millions of people who could benefit significantly from a few visits with a mental health professional never get the chance.  This is because the psychosocial stresses they are coping with manifest primarily as physical symptoms.  When they go to a medical office, diagnostic tests are normal because the stress causes no visible damage to the body.  Most of the time, neither the physician nor the patient knows what to do next.


Nathaniel Hawthorne’s Doctor

Tuesday, November 17th, 2009

In The Scarlet Letter (1850), Nathaniel Hawthorne describes the physician Roger Chillingworth as he evaluates his patient, the Reverend Arthur Dimmesdale. His approach is a model for health care professionals who seek to help patients understand and cope with hidden stresses.


The Stress History

Monday, November 16th, 2009

Negative life events that persist for more than a short time sometimes can cause physical symptoms.  We can divide the wide range of issues that can do this into five major categories, which simplifies the diagnostic process considerably.  In evaluating medically unexplained symptoms, I inquire into each category in a process called taking the Stress History.  I do this after having acquired a clear chronology of the patient’s illness.  I know when and where symptoms began and their pattern over time.  This often enables me to find links between symptoms and stresses.  For example, I often ask if anything stressful occurred just prior to the onset of the illness.  When I find these connections in timing, it increases the likelihood that the stress is responsible for the symptom.