‘My symptoms are so real, how can you say that they are only functional?’

Many people struggle to believe that their very real symptoms have no physical diagnosis. When a symptom occurs, it is natural to expect that it may be due to a physical disorder in your body. This is especially the case when your symptom seems to arise out of the blue. So, it is important that your doctor has worked hard to exclude all the possible physical causes of your symptoms.

But once this has been done, or the pattern of the symptoms are very erratic and do not fit any possible physical diagnosis, both you and your doctor need to focus on what it means to have a functional condition.

I find many of my patients with particularly nasty symptoms struggle to accept that they can ‘just happen’. But in the second part of my book, I highlight many of the factors that create the likelihood of a symptom occurring, sometimes with a very insignificant precipitating event.

They may have lived with the predisposing factors for a while and think that they can get away with placing their body under huge demand. But eventually, their system reacts with the result that symptoms suddenly appear. It’s like a bridge that is overloaded and suddenly, seemingly out of the blue, collapses.

People with functional conditions often suffer more than people with physical diagnoses. For example, if you suffer a heart attack, this can be very painful, but emergency treatment can rapidly relieve the pain. Someone with chest pain due to functional causes are harder to diagnose and treat and it can take a long time to resolve.

Fatigue can be particularly difficult to resolve if it is functional. If I am treating someone with thyroid disease or iron deficiency for example, the fatigue may be severe but will settle once the treatment is introduced. Functional fatigue can take months or even years to resolve.

Part of the reason for this prolonged recovery is that it often takes a long time before the person is ready to accept a functional diagnosis. And even when the diagnosis is finally accepted, understanding what to do to recover is poorly understood by patient and doctor alike.

As a doctor who has treated many people with functional conditions, it is rewarding to witness their recovery, even from symptoms that have totally disrupted their lives and relationships.

Over the following weeks, I will discuss some of the stories and struggles my patients have experienced, and how they have triumphed in the end.

I wish you good health.