Negative life events that persist for more than a short time sometimes can cause physical symptoms.  We can divide the wide range of issues that can do this into five major categories, which simplifies the diagnostic process considerably.  In evaluating medically unexplained symptoms, I inquire into each category in a process called taking the Stress History.  I do this after having acquired a clear chronology of the patient’s illness.  I know when and where symptoms began and their pattern over time.  This often enables me to find links between symptoms and stresses.  For example, I often ask if anything stressful occurred just prior to the onset of the illness.  When I find these connections in timing, it increases the likelihood that the stress is responsible for the symptom.

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