Patient
Ellen was hospitalized at a university sixty times in fifteen years with no diagnosis and no relief. Then she had a Stress Check-Up and, in a little over an hour, the hidden stress that was responsible for her condition was uncovered and followed with treatment that was a complete success.
Ellen is not alone (though most patients take longer to fully recover). Every year in the United States, millions of people who seek medical care are left undiagnosed or inadequately treated because examinations and tests can’t find the cause of their symptoms. The diagnosis in many of these patients is Psychophysiologic Disorder (PPD) and the symptoms they suffer are perfectly real. (The word psychophysiologic means only that the brain and body interact to produce the symptoms, which are not due to mental illness and not self-inflicted.)
When diagnostic tests are normal, illnesses can be baffling until hidden stresses are uncovered and treated. Here is a list of symptoms that can be linked to hidden stresses in some patients:
- Pain such as headache, back pain, chest pain, muscle or joint pain and abdominal or pelvic pain
- Abnormal swallowing, digestion or bowel function including constipation, diarrhea, bloating, nausea and vomiting
- Discomfort in the bladder or during urination
- Respiratory symptoms including difficulty breathing, cough, throat and vocal changes
- Heart palpitations
- Pelvic and vaginal irritation, premenstrual or menstrual pain
- Fatigue; abnormal sleeping or eating
- Symptoms related to nerve function such as blurred vision, dizziness, ringing in the ears, itching of the skin, sweating, numbness or tingling
Remember, the same symptoms can also result from diseases that can be diagnosed through tests, so it is essential to have a medical evaluation to be sure none of these diseases is present.
Below is a brief questionnaire that can uncover clues that you might be suffering from a hidden stress. It will not find all hidden stresses, but does point the way toward many of them.
Hidden Stress Screening Test
1. How much stress have you experienced in your life recently? (Choose one answer)
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None Score = 0 |
Mild Score = 1 |
Moderate Score = 2 |
Severe Score = 3 |
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2. How often do you neglect your own needs because you are taking care of others? (Choose one answer)
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Rarely Score = 0 |
Occasionally Score = 1 |
Frequently Score = 2 |
Nearly Always Score = 3 |
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3. Over the last two weeks, how often have you been bothered by the following problems? (For each row, choose the one box that applies best to you)
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Not at All Score = 0 |
Several Days Score = 1 |
More than Half the Days Score = 2 |
Nearly Every Day Score = 3 |
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A.Feeling nervous, anxious or on edge. |
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B.Not being able to stop or control worrying. |
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C.Feeling down, depressed or hopeless. |
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D.Little interest or pleasure in doing things. |
4. In the past month, how much have you been bothered by repeated, disturbing memories, thoughts, images or dreams of a stressful experience? (Choose one answer)
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Not at All Score = 0 |
A little Bit Score = 1 |
Moderately Score = 2 |
Quite a Bit Score = 3 |
Extremely Score = 4 |
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5. In the past month, how much have you been bothered by feeling very upset when something reminded you of a stressful experience? (Choose one answer)
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Not at All Score = 0 |
A little Bit Score = 1 |
Moderately Score = 2 |
Quite a Bit Score = 3 |
Extremely Score = 4 |
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6. How would you feel if you discovered that a child you care about was experiencing everything you did as a child? (Choose one answer)
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Happy Score = 0 |
Neutral Score = 1 |
Sad or Angry Score = 2 |
Very Sad or Very Angry Score = 3 |
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Total Hidden Stress Score __________ (range 0 - 29)
Interpreting the Hidden Stress Screening Test
A word of caution: This test is too short to provide more than a screen for hidden stresses. It will not detect all the stresses capable of causing physical illness nor is it capable of reliable diagnosis. If you have concerns about a score greater than zero on any question, a discussion with a medical or mental health professional would be a good next step.
No score proves or disproves the presence of hidden stress. People with higher scores are more likely to have hidden stresses but even some people with scores in the 2-5 range will have issues they could beneficially review with a health care professional.
Here are a few additional basic suggestions about what to do for scores greater than zero for each question.
Question 1: Make a list of every stress in your life. Keep the list with you and add to it as new ideas come up. Then, see if you can reduce the stress from some of the listed items.
Question 2: If possible, take several hours each week for self-indulgence to put yourself on the list of people for whom you care.
Question 3 A & B: These two questions screen for the presence of an Anxiety Disorder. You can read more about this condition at the NIMH Anxiety page.
Question 3 C & D: These two questions screen for the presence of Depression. You can read more about this condition at theNIMH Depression page.
Questions 4 & 5: These two questions screen for the presence of Post-Traumatic Stress Disorder. You can read more about this condition at the NIMH PTSD page.
Question 6: Significant scores here raise the possibility of your having prolonged effects of childhood stress. This can cause other types of hidden stresses described above and can also lead to one or more of the following:
- Low self-esteem
- Addictions (tobacco, alcohol, drugs, work, sex, eating, gambling, exercise, shopping)
- Eating disorders
- Regularly finding yourself in relationships where you are treated disrespectfully
- Cutting, burning or otherwise deliberately injuring yourself