This past New Year’s Eve, a 47-year-old woman went to the emergency room twice complaining of difficulty breathing and chest tightness. She was diagnosed with stress and sent home. She died that same night from pulmonary edema.
Around that time, I learned that a friend was in an induced coma due to severe meningitis. She had been feeling unwell for several days and thought she was depressed.
A couple of years ago, a family doctor (unaware that I was a psychologist) tried to prescribe me an antidepressant for what was understandable fatigue due to a physical ailment. And all without conducting an in-depth interview or even a simple Beck Depression Inventory.
These cases are not as isolated as they seem.
Lately, I’ve noticed an increasing reliance on the term “psychological” to dismiss ailments without proper medical testing. But believing that almost everything is psychological and accepting it as a preliminary diagnosis can be deadly (and that’s not an exaggeration).
The danger of thinking that everything is in the mind
For decades, medicine practically ignored the mind. Psychology was relegated to a secondary, almost ornamental role, and many “mental” problems were viewed with disdain or as anecdotal. However, it seems we have taken an extreme turn in the opposite direction.
The mind is becoming the universal culprit for any ailment. Headaches, fatigue, dizziness… the quickest (and also the most convenient) response is: “It’s psychological.”
What was once ignored now seems to justify almost everything. It’s assumed that if nothing relevant appears in the initial tests, it must be anxiety, stress, or depression. That’s where a slippery slope begins, because real symptoms are ignored, treatments are delayed, and the person suffers unnecessarily.
A study conducted at the University of Cambridge with over 3,000 people suffering from an autoimmune disease confirmed that receiving a misdiagnosis of a psychological condition caused harm to 72% of them, even decades later. In addition to physical deterioration, attributing their symptoms to a mental health problem also led to:
- Damage to self-esteem and a tendency to blame oneself
- Decreased trust in health services
- Tendency to minimize symptoms and not seek help when needed
In fact, there is also a phenomenon known as “diagnostic overshadowing” which consists of mistakenly attributing physical symptoms to a pre-existing mental illness or a previous diagnosis, instead of investigating whether there is a new physical problem.
In other words, the doctor simply assumes that all the symptoms stem from the same known psychological cause, and therefore doesn’t consider other medical explanations. This, obviously, prevents a correct diagnosis, delays treatment, and often leads to a worsening of the illness.
The golden rule: psychological disorders are the last resort
Of course, psychosomatic symptoms and mental disorders exist. But attributing fatigue, dizziness, shortness of breath, nervous tics, or tachycardia to psychological problems without a thorough evaluation is playing with fire.
Mental disorders are not a catch-all diagnosis. You can’t slap the label “stress” on something that could be pancreatic cancer or heart failure. The consequence isn’t just an anecdotal error; it could be a preventable death.
When I was in college, the golden rule was: Psychology should be the last stop, not the first. First, we rule out the physical, the biological, the potentially fatal, and only then can we think: “Well, there might be a psychological component that we should investigate.”
Clinical practice has made it clear that the mind and body are deeply connected, but also that they can follow separate paths. Not all pain or mental discomfort is caused by “stress.” Not all dizziness is “anxiety.” And not all “fatigue” is depression, even if those conditions are present.
Thinking that almost everything is psychological is a luxury we cannot afford when human life is at stake.
So the next time someone tells you to worry less, that it’s all psychological, remember that psychology comes after everything else has been ruled out, not before.
Ignoring that rule is not only negligent, but also dangerous. And yes, it can literally kill you. So don’t downplay your symptoms by thinking it’s “just” anxiety or a bit of depression. Seek medical help and only accept a psychological diagnosis once other underlying conditions have been ruled out.
References:
Sloan, M. et. Al. (2025) ‘I still can’t forget those words’: mixed methods study of the persisting impact on patients reporting psychosomatic and psychiatric misdiagnoses. Rheumatology; 64(6): 3842–3853.
Hallyburton, A. (2022) Diagnostic overshadowing: An evolutionary concept analysis on the misattribution of physical symptoms to pre-existing psychological illnesses. Int J Ment Health Nurs; 31(6): 1360-1372.
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