Headaches, Stomach-Bowel-other Physical Problems caused by Brain Chemistry of MH disorders
What points are you trying to get across with this discussion?
That many Headaches, Bowel and Stomach upsets, Rashes and other physical problem may be primary manifestations of mental health problems such as that caused by an unstable moods brain chemistry which I will use as an example, for illustrative purposes.
Can physical problems like headaches, stomach and bowel upset, rashes, bet wetting, soiling and other somatic problems have their causation in problems with brain chemistry?
Yes and they may the first and only manifestation of a major mental health problem, though usually other symptoms are present of the underlying primary disorder if one looks for them closely and takes a careful history.
What do you mean the underlying primary disorder?
The primary disorder may be mood disorder like Unipolar or Bipolar Depression, on some Anxiety Disorder, and the physical symptom is the somatic or physical equivalent of the usual symptoms or the disorder or is so intense, frequent or dominant that the other symptoms of the primary disorder though present may not be so obvious or easy found, thus missed. For example a person having symptoms of headaches and irritable bowel symptoms has the brain chemistry of a mood or anxiety disorder, and it is this chemistry disturbance which is causing and driving the physical symptoms.
Why is this important to know this concept?
Because until the mental health problems brain chemistry is treated the physical problems may not get better, and may only be covered up or patched up by other treatments and to add insult to injury the mental health problem is not getting addressed and may just get worse.
Why is this happening?
Because the primary disorders brain chemistry, the true cause of the physical problem is not directly recognized, diagnosed and treated, the physical problems not only don’t get better, but also their presence continue to fuel and drive the underlying mental health disorder with its symptoms such as anxiety, panic, depression or mood instability.
Can you illustrate this with some examples?
A very good and comprehensive example is the various presentations of severe mood instability that may eventually show itself with an Atypical Unstable Mood Disorder or a classical disorder in the Bipolar Spectrum, whose underlying brain chemistry is that of a very excitable brain that responds preferentially to mood stabilizing medications.
Often in these cases the child, adolescent or adult though having many symptoms of an unstable mood, these symptoms are overshadowed by physical symptoms starting even in infancy with GI and Sleep disturbance, often presenting as severely “colicky” infant, who grow up to be an equally colicky child, adolescent and adult with GI symptoms such as upset stomach, GERD, and constipation, diarrhea, IBS, irritable bowel syndrome.
This same person may have severe and recurrent headaches of migraine proportion, and continues to have all kinds of insomnia type problems, much as they had as an infant, child and teenager, like too much sleep getting up to eat, hard to wake up, too little sleep, fragmented and unrestful sleep.
How are these people usually treated?
These physical symptoms are either dismissed as a phase, part of normal development, or insignificant. This is especially in the case of the younger child or teen who cannot speak up for them self, and really express to health care professionals how bad they feel, and are given a chance to tell their story, which is the medical history. Or at the best if they or their parents fuss and make enough noise some symptomatic treatments for the GI problems, the sleep and the headaches will be attempted, with the usual reassurances that these things represent nothing serious, and will pass, or are due to just the general stress of growing up.
How should they be treated?
First the primary diagnosis must be recognized, diagnosed and then treated. If the health care professional listened to the child and their family, and took more time to take a more thorough mental health history of the child and the family, they would find likely many symptoms of an unstable mood, going back or years and for generations . Symptoms that would be revealed would be excessive irritability, anger, and rage, periods or depression, distractibility, pressured thinking, impulsive behaviors, negativity of thinking, mood, and behavior , unstable relationships with sibs, peers and family members. The family history would likely have drug and alcohol problems, poor work and school performance, and perhaps people treated for various kinds of depressions and anxiety disorders.
This kind of information should really change treatment options shouldn’t it?
Often it doesn’t because health care professionals and people in general don’t know what I know that this history, symptom presentations, and the physical symptoms represent part of the unstable mood brain chemistry problem, so the appropriate medication management with mood stabilizing medications is not considered or done.
Have you had success with using mood stabilizers to help these physical problems?
Very much so, with many happy patients and their families who finally have gotten relief for these problems as their mood disorders are successfully treated. The bowels and stomach become regulated, the sleep gets improved , the headaches go away, and your have a happier, less irritable, angry and more productive person who also is easier to live with. It is a win -win situation for all concerned.