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All in the Head

Mar 25, 2008 - 4 comments

Anxiety sufferers and others will frequently say either that the physical symptoms we suffer can't be in the head, or else that they are all in the head. The idea is that either:

1. This can't possibly be "just" anxiety -there must be something "really" wrong -meaning an independent cause of pain or anxiety or discomfort which is unrelated to feeling anxious. Therefore, it is NOT anxiety -there is something ELSE going on. New anxiety patients in particular go through this phase because they are not accustomed to the mechanisms at work with anxiety. And so, many tests are done to rule out those independent causes, heart tests, oxygen absorbtion, digestive tests, etc. Once all the "other" causes are ruled out, THEN anxiety is about all that remains.

2. Or, the symptoms are COMPLETELY imagined. They are ALL in the head and no where else. Unfortunately, people who don't understand the disorder believe that someone can just be "talked out of" the problem, or that they are deliberately "making it up."

So, what's really going on?

To begin with, it is fair to say that every ache and pain -and every pleasure and comfort; be it large, small or in between, is IN THE HEAD. If you had NO brain, you would feel no pain. That ingrown toe nail? Yes, it hurts at the toe, because your nervous system, at the brain's direction, registers the pain in that place. But it could just as well register the sensation somewhere else, including places that no longer exist at all. This is why amputees feel pain in an arm they don't have anymore. By the same token, if we receive a sudden, castastrophic injury (think auto wreck) we may feel no pain whatsoever for a time -because the brain closes down the nerve pathways for a bit. Then, 5 days later we're getting an Xray that shows a cracked collar bone -because we feel a pain in the BACK.

In what we regard as the normal course of events, we expect pain or discomfort to exist at the site of the problem because this is our experience, and it helps us resolve the problem. But in reality, the sensation exists in the brain -and is displayed or presented at the problem site. Most of the time, the portrayal is correct.

In the case of panic or anxiety which do not appear to have an immediate external cause, however, the symptoms may be presented at various places and in various ways. The brain is doing the work in these cases, as well. What you feel is no more and no less "in the head" than an actual whack upside the head. And so, to say that your symptoms are "all in your head" is the same as saying that a diamond is "just a rock." True, but meaningless and unhelpful.

Medications can help interrupt the triggering of symptoms by the brain, and this gives us a measure of relief and may help us focus on figuring out what the real cause of those symptoms is. But they no more get "rid" of the anxiety than an aspirin gets rid of a broken leg. The healing occurs when the cause or causes is discovered, and we can get to work at making whatever mental adjustments are required to relieve the problem.

So, when you hear the "all in your head" thing, don't take it to mean that the problem is somehow not as significant as some external or independent cause: the effect is the SAME. Rather, it is the treatment that differs, once we have ddtermined that the source is, in fact, in the brain as opposed to the foot.

What's going on in the brain? For some, there really is some organic, functional, physical issue involved which has arisen independently of the thinking process. Surgery or medication may be indicated, together with whatever behavior modification or therapeutic approaches are appropriate.

For many of us -most of the folks on the forum, I believe- the causes of that "out of the blue" panic or anxiety for "no reason" are rooted in emotional conflicts and psychological challenges of long-standing. As we grow older, the defenses and adjustments which once worked no longer do so -and we have a swallowing problem, or some other strange sensation. The meds may help us interrupt to triggering, but it is therapy that allows us to do the emotional archaeology and discover the causes. And there really is no reason to think of this as being any more fundamentally different than finding that tiny splinter on your finger and digging it out, after a week of feeling "something hurt" somewhere on your finger.

For more on digging out the problems, please see the "Smoking Guns and Puzzles" post.

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404682 tn?1324579818
by Jerzeegal, Mar 25, 2008
JS  you hit the nail on the head :-)  It's interesting with some of the posts I have read and even people in my life wondering if anxiety is all in their head or if their symptoms are physical.  Many folks have trouble connecting the fact that the physical symptoms we feel are very real regardless of the fact they are caused by anxiety.  Putting it very simply,a headache still hurts whether it's caused by stress of by a sinus infection and for me in doesn't much matter what causes it... the pain is still the same and the root problem needs to be fixed.

Have a great day

82861 tn?1333453911
by Jaybay, Mar 25, 2008
What a fabuous and informative post!  You described exactly what my younger brother went through from the time he hit puberty until he was in his forties.  Anxiety manifested as severe diarrhea several times a day.  Multiple colonoscopies and other tests revealed nothing physical was wrong.  He just could not believe he had a "mental problem."  Mental problems just aren't acknowledged in our family.  I am the oddball for finally dealing with my lifelong depression a few years ago. You wouldn't believe the flak I got from that!  "You shouldn't need a pill to solve your problems.  Suck it up and deal with it!"  Typical attitude, huh?  But I digress.  It wasn't until my brother's son became seriously ill that he finally listened to me and told his doctor about his depression and anxiety.  Lexapro has given him back his life.  I have my brother back; his wife has her husband back; and his boys have their father back.  

You are so right that anxiety causes physical symptoms.  The shame is not in having anxiety diagnosed, but rather in refusing to consider that is the root cause and not treating it.

By the way, I'm so jealous of your little Eden!  You're living the life I picture for me and my husband in another 20 years.  Good for you!  :-)

Avatar universal
by suzi-q, Mar 25, 2008
Yes, you hit the nail on the head.  Thank you for taking the time to piece together what everyone is "trying to say" and saying it so well.  

432009 tn?1304749841
by xanweaner, Mar 25, 2008
You're so right about getting to the "root" - I'll use an analogy when I had a cyst in my arm as a little child. We had to soak my arm each night in warm water to drain it.....and had to continue to do this....soak/drain......soak/drain.......the cyst was not eliminated until we finally uncovered the "root", which finally expelled itself into the water. Our Dr. told us that the cyst would not be healed until we located the "root" and removed it.

There's the psychotherapy that we need so desperately......we have to drain out our emotions, issues, and keep uncovering, peeling, expelling them....and hopefully, we get to the root...

Your post is pushing me to finally get back into psychotherapy....this time around is taking longer in my recovery as I'm not getting to the root with a guide. It's time now for me to take that step, I know....
Thank you for taking the time to share this with us....

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