Mental health articles

OF mental health care and mentally ill

how to deal with physical complaints

How to deal with this problem

Questions to ask the person with multiple physical complaints

• When did this start? The longer duration of the symptoms, the more likely they are to be related

to mental illness.

• How have you been feeling emotionally? Have you been worried about anything? Have you been

feeling down? Have you lost interest in your daily life? Ask questions to identify depression and

anxiety.

• Do you drink alcohol? If so, follow further questions on problem drinking.

• What do you feel has caused your symptoms? The person’s views on the illness can be a valuable

way of determining whether it is an emotional problem.

Things to look for during the interview

• A worried or tense look on the face.

• Any signs of physical illness and weight loss.

What to do immediately

• Make sure that the person is not suffering from a physical illness before you assume that the

complaints are due to a mental illness.

• Reassure the person that there is no life-threatening or serious physical illness. This does not

mean that she is not suffering some other illness.

• Explain the link between emotions and physical experiences.

• Explain that there is no need, at present, for further tests or investigations.

• Try to avoid using labels such as ‘mental’ illness, since the person may resent this. After all, many people (including health workers) do not associate complaints such as headache with mental illness. Instead, you could say “Your symptoms are being made worse by your worries and tension. You have

been worried about your husband’s drinking problem. This could be giving you a headache and make your heart beat fast.”

• Teach the person relaxation (breathing) exercises and problemsolving.

• Encourage some physical activity or exercise such as walking, shopping and household activities if these have been stopped.

• Do not prescribe vitamins or painkillers unless there is clear evidence of malnutrition or a painful physical illness.

• Antidepressant medication can be used in the following instances:

• if there are clear symptoms of depression, particularly if there are also suicidal ideas or weight

loss or sleep disturbance;

• if there are panic attacks and severe symptoms of anxiety;

• if you have no time to provide counselling and prefer to rely on medication.

When to refer

• If you are not sure about the possibility of a physical illness, you should refer for further

opinion. Some physical illnesses can produce chronic, multiple physical symptoms along with emotional effects. Examples of such illnesses are arthritis and diabetes.

• If the person is severely depressed and suicidal, refer to a mental health specialist.

• Many people with depression have social and personal problems that may be difficult to resolve

in a clinic. Refer such people to other agencies.

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