'It is all in your head' is no more helpful an answer to the patient's puzzling and troubling question than were 'the spirits are angry' or 'the gods are punishing you' or 'your four humors are unbalanced.'
The American Psychiatric Association has proven itself incompetent to produce a safe and scientifically sound diagnostic system. Psychiatric diagnosis has become too important in people's lives to be left in the hands of one small and insulated professional organization.
The golden rule: an underlying medical illness or medication side effect has to be ruled out before ever deciding that someone's symptoms are caused by mental disorder. And the underlying medical illness may take time to declare itself.
His physical exam was always completely normal, save for some scars on his back and thighs, surely from his construction job. Basic lab tests showed nothing abnormal. I just couldn't put it together. What was I missing?
We, as adults, know that stomachaches, chest pains, and even colds and headaches can follow a string of stressful social interactions. For the love of God, I have been waiting for this UCLA study for decades.