"It's All in Your Head": The Silent Harm of Dismissal in Chronic Illness Care

Living with a chronic illness is a challenge many of us never anticipated. The physical symptoms can be debilitating, yet for many people, the hardest battles are not fought against their own bodies, but in the doctor’s office. Time and time again, patients with chronic illnesses like Ehlers-Danlos Syndrome (EDS), fibromyalgia, or long COVID are met with a devastating phrase that leaves scars deeper than their condition itself: "It's all in your head."

These four words can be crushing. They invalidate pain, erase years of suffering, and sever the fragile trust between patient and provider. While intended to steer patients toward mental health solutions, this dismissal often worsens the very struggles healthcare professionals are trying to address. It’s time we talk about the silent harm this narrative causes—and how it can be stopped.

The Impact of Invalidation on Mental Health

When someone seeks help for unexplained symptoms, they are already vulnerable—grappling with fear, confusion, and often physical pain. Hearing that their condition isn't real or is "psychosomatic" undermines their reality, leaving them to question their own experiences.

This erasure can have several severe mental health consequences:

1. Heightened Anxiety and Depression

Being told that your symptoms aren't real or important can deepen existing anxiety and depression. Many patients find themselves trapped in a spiral of self-doubt, wondering if perhaps they are imagining their condition. For some, the constant rejection from medical professionals can trigger feelings of hopelessness and even suicidal thoughts.

2. Medical Trauma and Avoidance

Repeated invalidation can lead to trauma, where future interactions with healthcare providers become sources of fear. Many patients start avoiding medical care altogether, fearing further dismissal or ridicule. This can prevent them from accessing vital treatment, worsening both their physical and mental health.

3. Loss of Identity and Isolation

Chronic illness already strips people of many life goals and opportunities. Being dismissed by healthcare professionals can erode a person's sense of self-worth, making them feel like a burden to others. Friends and family may also echo this doubt, leaving patients feeling isolated and unheard.

Understanding the Stigma: Why Does This Happen?

The dismissal of chronic illness is often rooted in systemic biases and knowledge gaps within the healthcare system. Many conditions that fall under the chronic illness umbrella, including EDS, have complex symptoms that defy easy diagnosis. Medical training often prioritizes clear, measurable evidence over subjective reports of pain or fatigue.

When faced with uncertainty, some medical professionals fall back on outdated stereotypes, seeing patients as anxious, overreacting, or psychologically fragile. This bias can be particularly damaging for women, who are disproportionately affected by chronic illnesses and often labeled "hysterical" when reporting symptoms.

However, acknowledging uncertainty can be a powerful and compassionate alternative. Saying, "I'm sorry, we don't know enough about this condition yet, but I'm here to help," validates the patient's experience without compromising the provider’s professionalism. It fosters trust and opens the door to collaboration rather than conflict.

Stories of Struggle Within the Community

In the EDS community and beyond, stories of mental health crises—including suicide attempts—are tragically common. People who face daily pain, fatigue, and invalidation may reach a breaking point. These are not isolated incidents—they reflect a systemic failure to address the whole person in healthcare.

One person described the moment they were told their condition was psychosomatic:"It felt like my whole world crumbled. I had fought so hard just to be heard, and in an instant, it was all dismissed. I thought, 'If even my doctor doesn’t believe me, what’s the point of going on?'"

How Healthcare Professionals Can Do Better

The solution isn't complicated, though it does require a shift in mindset and training. By embracing a trauma-informed approach, medical professionals can reduce the harm caused by invalidation. This involves a few key practices:

1. Validate the Patient's Experience

Even when a condition isn’t fully understood, acknowledging a patient’s pain and distress is essential. Simple phrases like, "I believe you" or "I'm here to help figure this out" can provide much-needed reassurance.

2. Admit Knowledge Gaps

It's okay for healthcare professionals to say, "We don't know enough about this yet." Honesty builds trust and shows that both patient and provider are on the same team.

3. Focus on Collaborative Care

Rather than dismissing symptoms as psychological, providers should explore all possibilities and offer support for both physical and mental health. Chronic illness often involves a complex interaction between the body and mind, and patients benefit most from an integrated approach.

4. Educate About Chronic Illnesses

Medical schools and ongoing training programs need to provide better education on conditions like EDS, fibromyalgia, and long COVID. This will reduce reliance on stereotypes and promote early, accurate diagnoses.

Empowering Patients and Advocates

While systemic change is essential, peer support and advocacy can offer immediate relief to those affected. Online communities provide safe spaces where patients can share their stories, learn from others, and access resources for mental health care. Advocacy campaigns can also raise awareness among healthcare professionals and the public about the hidden mental health crisis in the chronic illness community.

For advocates like myself, the message is clear: We need empathy, not dismissal. Hope, not harm.

A Call to Action

It’s time for healthcare professionals to listen. Chronic illness is not "all in your head." It’s real, it’s life-altering, and it demands to be taken seriously. By validating patients, admitting what we don't know, and striving for better care, we can prevent further trauma and create a system that supports both physical and mental well-being.

For those who have faced dismissal and are struggling, know this: You are not alone. Your pain is valid. There is hope, and there are people who believe you.

Together, we can change the narrative—one conversation at a time.