[Medical Q&A] I always feel unwell, but the test results are always normal. What’s wrong?

Planner: Chinese Medical Association

Reviewer: Tian Jinzhou, Chief Physician, Dongzhimen Hospital, Beijing University of Chinese Medicine

This may be a somatic symptom disorder. Somatic symptom disorder is a disease in which an individual has one or more physical discomforts and is overly concerned about his or her own discomfort or health, causing obvious physical and mental pain. It is also a common disease in psychiatry. Such patients can often be seen in every department of major hospitals. The physical discomforts of such patients are as follows.

(1) Nervous system: dizziness, headache, tingling of scalp, tingling of hands and feet, and general weakness, etc.

(2) Cardiovascular system: palpitations, chest tightness, chest pain, and unstable blood pressure, etc.

(3) Digestive system: abdominal pain, bloating, constipation, diarrhea, nausea, vomiting and repeated hiccups, etc.

(4) Respiratory system: foreign body sensation, burning sensation, obstruction and shortness of breath in the throat, etc.

(5) Pain in multiple parts of the body: headache, pain in the shoulders and neck, pain in the waist and back, muscle twitching and stiffness, etc.

(6) Autonomic nervous system dysfunction: dry and bitter mouth, alternating hot and cold sensations, hot flashes, sweating, and frequent urination, etc.

The occurrence of the above symptoms may be related to a variety of factors: a large number of negative life events, including excessive work and/or study pressure, emotional and/or career setbacks, family disharmony and lack of care, etc.; having certain anxious traits, such patients are usually impatient and pursue perfection, or hesitant and calculative; unable to express negative emotions, such patients can not find an outlet for emotions, and have no way to vent negative emotions normally through language, expression, behavior and action, so they use the body as a carrier to vent through various physical symptoms such as palpitations, shortness of breath, abdominal pain, bloating, muscle pain and tension. Patients with somatic symptom disorder usually do not notice that there are problems with their emotions, or they know but are unwilling to express them. After psychotherapy and further discussion, doctors will find that there are a lot of negative life events and social and psychological factors around the patients.

As social pressure increases, mental illnesses are becoming more and more common in clinical practice. If an individual exhibits the above symptoms and is unable to carry out normal work and study, in addition to repeatedly ruling out physical illness, it is also necessary to pay attention to somatic symptom disorders, receive timely diagnosis and treatment, and rediscover the beauty of life.