Physical symptoms

• cardiovascular symptoms such as tachycardia or palpitations

• respiratory symptoms such as dyspnoea or chest pain

• gastrointestinal symptoms such as dry mouth, nausea, anorexia, dys-phagia or diarrhoea

• muscle tension, including tension headache

• frequency of micturition

• flushing of the face and chest.

These physical symptoms can be explained by overactivity of the sympathetic nervous system, muscle tension, and/or over-breathing. In many medical settings, both patient and doctor place more emphasis on the physical aspects than the mental ones, resulting in diagnostic confusion and unhelpful or even harmful treatment (see Chapter 9).

Patients are oversensitive to minor environmental changes, and difficulties in personal relationships are often associated.

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