MUS are persistent symptoms of pain or discomfort in the body for which medical assessment and investigations do not find a physical problem or any other medical condition which would explain such symptoms.           

The symptoms of MUS are sometimes labelled as being ‘made up’ or being ‘all in your head’, although the physical symptoms that you are experiencing are entirely real. Even if there is no physical explanation for your physical symptoms, they can often result in anxiety or depression.

With around a quarter of people visiting their GP being diagnosed with MUS, the diagnosis is very common. If you have complaints of pain in any location on your body, including headaches, muscle or joint pain, or fatigue lasting for several months, then referral for a psychological assessment may be helpful. The mind and body are closely linked; physical symptoms are influenced by your mental state whether or not there is an underlying physical cause. People with anxiety and depression often have aches, pains and fatigue, and people with physical disorders often have depression and anxiety.

There are several reasons why you may be diagnosed with MUS, despite there being no clear link to a physical condition which matches your symptoms. It is important to recognise that stressful life events, worries, and mental health conditions such as anxiety and depression can manifest in the form of physical complaints, despite appearing to be based only in your mind.

The intrinsic connection between your mind and body means that when your mind is affected by stress, anxiety or depression, it is the physical symptoms of these conditions which are initially most apparent. For this reason, you may not be aware that you have anxiety or depression, instead remaining focused on the physical symptoms which you may believe are due to a physical cause.

Some of the physical symptoms that you may experience when you have anxiety, depression or high levels of stress include:

• Anxiety - rapid heartbeat and palpitations, breathlessness, tremors, dry mouth, chest tightness and neck stiffness are some of the associated symptoms of anxiety
• Depression - when you are feeling depressed, your tolerance to physical pain becomes lowered. Symptoms relating to the mental and emotional side of the condition include extreme sadness and feelings of hopelessness, although your body can react in the form of physical complaints such as loss of appetite, loss of weight, low energy and general aches and pains
• Stress – we have evolved to respond to stress in a way that means we are ready for physical action of some kind. Periods of increased stress, such as following a bereavement, working through money, relationship, or job problems, will cause a physical reaction in your body that means the heightened energy response can cause headaches, muscle tension, feelings of nausea and dizziness which can make you feel particularly uncomfortable

Excess worry can worsen physical symptoms

You may naturally worry more about your physical health than others, and this can cause you to overanalyse your symptoms to the extent that it causes physical complaints to worsen. This may happen for several reasons including:

• Friends or family becoming ill, which may lead you to worry that you may get the illness too
• If your parents regularly worried about your health as a child then the habit becomes difficult to break, which may lead to you seeking help for symptoms, even if there is nothing of urgency to worry about
• History of illness, particularly serious physical illnesses such as cancer, can make you worry that your symptoms will one day return, which can lead to you overthinking and interpreting even minor physical complaints as something much more serious

Possible diagnoses for MUS

While initial diagnoses may conclude that you have MUS, further physical examinations or psychological assessments can ultimately help to determine whether there are existing physical or mental health conditions that are the reason behind your physical complaints.

Physical diagnoses which may be given for MUS include:

• Irritable bowel syndrome (IBS) - chronic stomach complaints
• Fibromyalgia - body pain and muscle tenderness
• Non-epileptic attack disorder - where fits appearing as epilepsy occur without any problems with electrical activity in the brain normally seen in the condition

Mental health diagnoses which may be given for MUS include:

• Body dysmorphic disorder (BDD) - where excessive concern about physical aspects of your body cause severe distress and impacts on daily functioning
• Dissociative disorder - physical symptoms such as fits and loss of memory which seem to be caused by problems in your nervous system but are actually brought on by excessive stress
• Somatic symptom disorder (SSD) - a group of psychological disorders where physical symptoms are experienced as a result of stress, usually lasting a long time

It is believed that women are more affected than men by MUS, with reasons for this at least partially explained by women being more likely to seek help and support for MUS, while men are less likely to report physical symptoms until their symptoms worsen. MUS is also common amongst young people. Having a recent infection, physical illness, or experiencing a stressful life event can mean that you are more likely to be diagnosed.

If you have existing problems with anxiety, depression or stress, or are generally someone who has extreme reactions to distress, then you are more likely to receive a diagnosis of MUS. Associated symptoms of these mental health conditions and their associated pressures on your mental wellbeing can also manifest in the form of physical symptoms, with a link to mental health not always being made in the first instance.

If you believe that you may be experiencing symptoms of MUS, help and support is available at Priory. Using a bespoke treatment plan aimed at treating the psychological impact on MUS, our specialised consultants and therapists will help you work towards reducing the impact that MUS has on your life.