Whether from relationships or other sources, stress can cause physical and mental complications that become medically significant. Photo courtesy Kristin Brenemen

"My man is killing me!"

This is what my patient told me. She was a 35-year-old schoolteacher who came in for a follow-up appointment after complaining of chest pain two weeks ago. On the day of her last appointment, she got a same-day referral to a cardiology clinic. While there, she had a full cardiac workup with no findings of heart disease, other than a slightly elevated blood pressure for which she was started on a low-dose fluid pill. She also complained of extreme fatigue and muscle aches.

After discussing the normal results of all her lab tests, in addition to the normal cardiac report, we discussed the dynamics of her relationship, which she identified as the root of her stress. With tears in her eyes, she told me that she has caught her boyfriend on more than four occasions involved with other ladies.

She said he promised to marry her if she forgave him, but his actions were clear that marriage was not a reality for their future. She admitted that she wanted to end the relationship but feared that she would be alone. She also said that she wanted to have children but feared that her clock was running out.

I explained to her that stress has physical and mental complications that are medically significant. Research has repeatedly demonstrated that the adverse effects of prolonged stress. The release of stress hormones, including cortisol, which results in elevated blood pressure, uncontrolled diabetes, cardiovascular disease, fatigue and many other physical consequences. Research has also repeatedly demonstrated psychological problems, including the exacerbation or the acquirement of clinical psychological disorders such as anxiety and depression.

In worst-case scenarios, which can occur, a person under extreme prolonged stress can lose their life due to the medical or psychological complications, whether from heart disease or suicide. I told my patient that she had to consider the fact that stress is something to be taken seriously.

After a long session with my patient, we both agreed that it was best that she reevaluate her relationship. We discussed various options such as seeing a therapist and possibly a psychiatrist for an evaluation. We also discussed her love for this man, and identified that she must first have love for herself. She then told me that she no longer loved this man but loved the idea of him. She admitted that her greatest current concerns were what her family and friends would think. With tears in her eyes as she left the office, she thanked me and said that she was going to make a tough decision.

She stopped, wiped the tears away, and told me, "I am going to choose myself!" She then smiled and said, "I am already feeling better." I found myself with a big smile and a high five for my patient as she left the office.