When I was in severe pain, I was told over and over again by doctors: 'It's just your anxiety'
This First Person column is written by Macenzie Rebelo, who lives in Toronto. For more information about First Person stories, see the FAQ.
Growing up, I was a cautious child and quickly labelled as a "worrywart" by a school counsellor.
But it wasn't just worrying. I had frequent panic attacks and was diagnosed with an anxiety disorder when I was seven.
Anxiety was a tangible feeling I knew through and through. It was just a part of who I was from my childhood.
So, several years later, when I sat in the emergency room as an adult with severe chest pain, I was surprised when my symptoms were described as symptoms of anxiety. I knew from multiple experiences what a panic attack was. This intense chest pain was foreign and unknown – 100 per cent not anxiety.
I left the hospital that day feeling confused and disheartened.
At 19, I wasn't sure how to advocate for myself or if I was even allowed.
However, I know I am not alone in feeling this way. Several studies have shown women can feel dismissed by the health-care system and are regularly ignored in medical settings. Gender bias training is provided in some medical schools to rectify bias, whether conscious or not. But regardless of these recognitions, it's still common for women's symptoms to be attributed to stress and anxiety with no further medical exploration.
For me, there's an additional layer. I actually have a diagnosis for anxiety.
While anxiety is a very serious condition in its own right, it shouldn't be used as a blanket explanation to dismiss other potential causes. A 2017 study by the Canadian College of Health Leaders found, "poorer physical care for persons with mental illnesses is another consequence of stigmatization. Persons with lived experience of a mental illness commonly report barriers to having their physical care needs met, including not having their symptoms taken seriously when seeking care for non-mental health concerns."
In my experience, I found it's easy to be dismissed — written off as paranoid or hyperaware or overly anxious. My anxiety diagnosis became a scapegoat — the only thing some people see about me, or at least that's what it felt like. Even with good intentions, some doctors aren't trained to see past certain assumptions, and that can lead to harmful oversights.
Because I grew up in a family with several health issues, I always believed what a doctor told you was the truth, even if it seemed wrong.
That's why the day after I went to the ER, I went to a walk-in clinic hoping to receive more clarity. But, to my frustration, I was met with the same variation of response by another doctor.
"You're on Cipralex? For how long?"
My anxiety medication, something I had been on since I was 16, seemed to explain away all of the symptoms: chest pain, rashes, body aches and fatigue.
Even still, I continued to check myself into a hospital four times over the next one and a half weeks. Stripping down into a gown, answering the same questions about my health, diet and medical history left me feeling vulnerable, embarrassed and belittled.
I would wait for hours, just to be sent back home with no answers. The electrocardiogram and blood tests revealed nothing, and I was made to feel as if I was overreaching and wasting the medical system's time. It left me feeling that my illness was my fault, and if I could somehow control my anxiety, it would all stop.
Within a week and a half, my health declined rapidly. The constant cycle of stress and hospital visits worsened my symptoms. My mother was also constantly researching my symptoms and took her findings to the doctors. She, too, received the same response: that it had to be my anxiety.
Sick of all of the runaround, she took me back to the emergency room the same day, and this time didn't take no for an answer. Mom demanded I receive an X-ray, clearly stating why I needed one and listing every single symptom. The emergency doctor, who recognized me from the previous evening, scheduled me for an X-ray that very night. It revealed a penny-sized obstruction in my right lung.
"It could be a tumour, blood clot or liquid. We aren't sure," the doctor said.
My initial feeling was relief.
I was, ironically enough, reassured to know there actually was something "wrong" with me and that it wasn't just my anxiety.
But the feeling quickly subsided to shock and then anger. This all could have been avoided and resolved weeks earlier if only someone had believed me sooner and seen past my anxiety medications.
Within a few hours, I was given an MRI and diagnosed with pleurisy — inflammation of the thin tissue lining surrounding the lungs and chest cavity. I was prescribed a steroid shot, which immediately made me feel better.
Anger boiled up inside me again. Was it this simple? One single shot could've erased weeks of pain I experienced? What bothered me so much was that I couldn't understand why the doctors kept saying it was my anxiety.
Eventually, I was diagnosed with lupus.
Now that seven years have passed, I wonder how things could have played out differently if I did not have an anxiety diagnosis. Would doctors take my symptoms seriously from the start?
I can only speculate, but I believe my mental health played a role in the minimization of my pain and experience.
Despite my soft rebuttals with doctors, which required a lot of courage for me to do, I left my appointments feeling like I had lost a debate. It was my mother who stood up for me in medical spaces.
Without her persistence, research and instincts, there is a good chance my lupus symptoms would have become worse. I used to be too intimidated by the medical system to advocate for myself, but she taught me how to speak up.
As a young woman, I remember carrying this sense of guilt, as if I were being too difficult with doctors. Looking back, the only thing I would change is not being loud enough.
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