Why Chronic Illness Symptoms are Commonly Dismissed as Just Stress

Amina AlTai had always prided herself on her drive and resilience. When she began experiencing brain fog and fatigue, Ms. AlTai, 39, simply thought it was from working long hours in her marketing job. So she started writing down reminders to keep herself on track. But then her hair started falling out, she gained and lost a lot of weight and she started having gastrointestinal issues.

Ms. AlTai was certain that something was wrong. But the first six doctors she saw didn’t take her seriously, she said. Some told her she had so much hair that losing a little bit shouldn’t be a problem. Several said she seemed healthy, and dismissed her symptoms as simply stress. It was only when another physician ordered blood tests that Ms. AlTai was diagnosed with Hashimoto’s disease and celiac disease, two autoimmune conditions that can damage the thyroid and the small intestine.

“They called me and told me, ‘Don’t go into work. Go to the hospital instead, because you’re days away from multiple organ failure,’” Ms. AlTai remembered. The two chronic diseases had upended her ability to regulate hormones and absorb critical vitamins and nutrients.

Scientists now know that stress is intimately linked with many chronic diseases: It can drive immune changes and inflammation in the body that can worsen symptoms of conditions like asthma, heart disease, arthritis, lupus and inflammatory bowel disease. Meanwhile, many issues caused by stress — headaches, heartburn, blood pressure problems, mood changes — can also be symptoms of chronic illnesses.

For doctors and patients, this overlap can be confusing: Is stress the sole cause of someone’s symptoms, or is something more serious at play?

“It’s really hard to disentangle,” said Scott Russo, director of the Brain-Body Research Center at the Icahn School of Medicine at Mount Sinai.