“I Can’t Forget Those Words:” The Lasting Consequences of Medical Gaslighting

People who suffer from systemic autoimmune rheumatic diseases such as lupus, vasculitis or rheumatoid arthritis may experience long delays in diagnosis. Not infrequently, healthcare professionals dismiss their symptoms as psychiatric or psychosomatic–to patients, all in your head. How does such medical gaslighting affect patients?

Medical Gaslighting Has Lasting Consequences for Mental Health:

Such conditions may trigger a wide range of symptoms from a variety of different organs. It may be tempting for a doctor to suggest that they are psychosomatic rather than to admit that he or she does not know how to reach a diagnosis. A recent study published in the journal Rheumatology found that such a misdiagnosis can have devastating lasting mental health consequences (Rheumatology, March 3, 2025). These may include feelings of self-doubt, shame and suicidal thoughts.

How Was the Study Conducted?

The researchers surveyed two groups of patients with systemic autoimmune rheumatic diseases, a total of 3,396 individuals. Not all of these people had experienced delayed diagnoses or been misdiagnosed as suffering psychiatric problems. Those who had undergone such medical gaslighting were often harmed, however.

According to the researchers,

“Patients reporting psychosomatic and/or psychiatric misdiagnoses had significantly lower mental wellbeing, and higher depression and anxiety levels (all p<0.001), and lower levels of satisfaction with every aspect of medical care, compared to patients reporting no psychosomatic or psychiatric misdiagnoses.”

More than 80% of those initially misdiagnosed said it had damaged their self-worth. Nearly three-quarters of them said they still worried about it. They were also less likely to trust their healthcare providers after that experience.

One young woman with multiple autoimmune conditions told the investigators:

“One doctor told me I was making myself feel pain and I still can’t forget those words. Telling me I’m doing it to myself has made me very anxious and depressed.”

Another patient reported:

“When a rheumatologist dismissed me I was already suicidal, this just threw me over the edge. Thankfully I am terrible at killing myself, it’s so much more challenging than you think. But the dreadful dismissiveness of doctors when you have a bizarre collection of symptoms is traumatizing and you start to believe them, that it’s all in your head.”

Doctors Could Reverse Consequences of Medical Gaslighting:

Most of the physicians were not trying to cause their patients distress. Some may even have thought that chalking the varied symptoms up to a psychological condition would be reassuring. A few were open to hearing how their misdiagnosis had affected a patient.

One volunteer spoke with a doctor who had offered such a dismissive diagnosis.

“She was shocked and had no idea … She was great. Took it on the chin. Listened and heard. Apologised profusely…For me, the scar of the original encounter was transformed into something much more positive.”

When specialists dismiss symptoms as psychological, patients may distrust doctors and become depressed. We suspect that many patients suffer harms when told their problems are psychosomatic, not only those with lupus or vasculitis. Doctors who worry about patient mistrust might discuss previous misdiagnoses with them.  Perhaps they could empathize regarding the negative mental health consequences.

Certain conditions may result in a range of medically unexplained symptoms, sometimes including mental health problems. The authors recommend that doctors consider systemic autoimmunity when patients describe a long-list of seemingly disconnected symptoms.