MARY SHOMON: The conventional wisdom is that people with autoimmune diseases -- like Hashimoto's and Graves' disease -- may end up, on average, spending as long as 5 years, and see as many as 5 doctors, before getting correctly diagnosed. That's a long time to suffer from chronic health symptoms that are not being taken seriously. What would you advise to those who genuinely have physical symptoms, but are still in the midst of this search for a diagnosis?
JAN NICHOLSON, EdD: I urge you to have confidence that you are the foremost expert about the functioning of your own body, to be attuned to what your body is saying and to your emotional experience, and to be persistent until you have some answers. It is much easier in today's world of the internet to be informed about what various symptoms might mean, so take advantage of that. It's important to attend to your intuition as well. When the search for answers is taking so long, it means searching also for doctors who have excellent diagnostic abilities and who are respectful of a patient's insights and input. It is common for someone in that situation to develop symptoms of stress, perhaps symptoms of depression or anxiety. And so it is crucial to do things in the meanwhile that help you cope and keep your spirits up, whatever that may be. This will be very individual, what helps one person to manage stress and to have a positive outlook may be quite different from what helps another.
Some tried and true methods, however, include meditation, exercise, yoga, massage, time in nature, having fun, laughing, having good social support from loved ones and friends, perhaps from a support group. Being mindful about eating in a healthy way and getting enough sleep. Of course, as a psychotherapist myself, I recommend [psychotherapy] also as an avenue for emotional support and good insights, particularly if you feel like friends and family have heard enough of your complaints for now, or if they don't seem to be offering sufficient understanding.
MARY SHOMON: Q: Many women with legitimate thyroid symptoms are told, without even getting the blood tests that can diagnose a thyroid condition, that their symptoms are due to stress or depression. Do you have any suggestions on how a woman can communicate with her practitioner so as to have her symptoms taken seriously, and not be automatically dismissed as having a mental health problem?
JAN NICHOLSON, EdD: It would be great if a depression diagnosis always included a check of the thyroid, given legitimate thyroid symptoms. Let's hope the education of practitioners leads to that some day. And for greater awareness of the public, so that people have more knowledge of what constitutes legitimate thyroid symptoms. Perhaps your books on thyroid should be required reading! If a woman does know she is having symptoms indicative of thyroid dysfunction, then she needs to politely but firmly and persistently educate her practitioner to take her symptoms seriously. The more calm and assured she can be, the more likely she will be heard without resistance or defensiveness.
If the practitioner persists in saying it is a mental health problem and that is as far as we're going to look, then find another practitioner who will do the kind of thorough testing that is required to truly diagnose a thyroid difficulty. This often means seeking care from a holistic physician.
Integrative clinical psychologist Jan Nicholson, EdD is a 1983 graduate of Harvard University's Counseling and Consulting Psychology program, completing her predoctoral internship at Children's Hospital in Boston. Additionally, she completed a two-year training program in Gestalt Psychology at the Washington Center for Consciousness Studies, and a semester in International Trauma Studies at NYU. Her passion has been to explore mind-body medicine throughout her career and to integrate such approaches into her therapeutic work, including meditative awareness, guided imagery, clinical hypnosis, coreSomatics, SomatoEmotional Release, Reconnective HealingTM, Reiki, and EMDR. She has a private practice with offices in both Alexandria and Falls Church, Virginia. You can read more about her work at her web site .
