Understanding Mind-Body Symptoms in Children: When Medical Tests Come Back Normal

Your child has been to the family doctor. Maybe they’ve seen a pediatrician, a neurologist, a gastroenterologist, or even visited the emergency department more than once.

They’ve had blood work. Imaging. Tests.

Everything comes back normal.

But your child is still living with daily stomach aches, headaches, nausea, dizziness, chronic pain, overwhelming fatigue, or even fainting or difficulty walking. They may be missing school, giving up sports they once loved, or spending more time worrying about what their body might do next.

If this sounds familiar, you are not alone.

For many families, this is one of the most confusing and overwhelming experiences they will face. Parents often find themselves caught between two difficult realities: the symptoms are clearly real, but no one can find a medical explanation.

Some individuals receive a diagnosis of Functional Neurological Disorder (FND) or Functional Neurological Symptom Disorder (FNSD), terms that have largely replaced the older diagnosis of conversion disorder. Although this article explores mind-body symptoms more broadly, many of the concepts discussed are relevant to these conditions as well.

Recently, we sat down with occupational therapist Kirsten Frank Colwell, who works with youth living with chronic pain and other mind-body conditions, to talk about why this happens and, more importantly, how children can recover.

The first thing she wants families to know is simple:

“The symptoms are real. We can see them, we can test them, and we know children are experiencing them. The question isn’t whether they’re real. It’s understanding what’s causing them.”

It’s Not “All in Their Head”—But the Brain Is Involved

One of the biggest misconceptions about mind-body conditions is that people assume someone is suggesting the symptoms are imaginary.

That isn’t true.

As Kirsten explains:

“Our brain is in charge of everything happening in our body. It’s controlling everything we think and everything we feel by sending messages through our nervous system. It can actually cause those symptoms to happen.”

Our brain constantly scans for danger. Most of the time it does this without us even realizing it. It adjusts our heart rate, digestion, breathing, muscle tension, hormone levels, and immune system every second of the day.

When the brain begins to believe that something isn’t safe—whether because of stress, pain, illness, overwhelming emotions, or other life experiences—it can start sending protective signals throughout the body.

Sometimes those protective signals don’t turn off.

The result can be very real physical symptoms, even when medical tests are normal.

It’s also important to note- we all experience the mind-body connection on a daily basis. When we are excited about something like a roller coaster or big game, we might feel our heart beating fast; when we are nervous before a presentation, we might get sweaty palms or feel nauseous. This is normal! For many people, these symptoms don’t cause difficulties with daily life, and rely on the mind-body connection. 

What Can Mind-Body Symptoms Look Like?

Every child is different.

Some children develop ongoing pain that seems to have no clear medical explanation. Others struggle with constant nausea, stomach pain, dizziness, headaches, or exhaustion.

Some experience more significant neurological symptoms.

Kirsten explains that these conditions often fall under a broader group of disorders involving the mind-body connection. They can include:

• Chronic pain
• Persistent headaches
• Chronic nausea or vomiting
• Ongoing stomach pain
• Disorders of gut-brain interaction
• Functional neurological disorder (FND)
• Dizziness or fainting episodes
• Difficulty walking
• Changes in speech
• Loss of sensation
• Seizure-like episodes that are not caused by epilepsy

While these symptoms may look very different from one child to another, they share something important in common.

The nervous system has become dysregulated, and the brain is continuing to send signals that something is wrong—even when the body itself is safe.

Why Does This Happen?

“It’s a good question,” Kirsten laughs. “I think it’s multi-layered.”

There isn’t one single cause.

For some children, symptoms develop after an illness or injury.

For others, they may appear during periods of ongoing stress or significant life changes.

Some children have experienced trauma. Others have not.

Kirsten often sees children who are naturally anxious, highly sensitive, or incredibly driven.

“A lot of the perfectionistic traits—that’s really common. A lot of those internalizing tendencies come out in very physical ways for these kids.”

Interestingly, many of these children don’t meet the criteria for an anxiety disorder or depression.

Instead, their bodies become the place where stress shows up.

Just as some adults develop migraines during stressful periods or notice stomach upset before an important presentation, some children experience much bigger physical responses when their nervous system becomes overwhelmed.

The Long Road to Finding Answers

One of the hardest parts for families is that these conditions are often diagnosed only after many other possibilities have been ruled out.

Children may see specialist after specialist.

They may undergo countless investigations.

Parents often spend months—or even years—looking for an explanation.

Kirsten explains that this is completely understandable.

“These are really hard conditions to diagnose. Everyone is concerned, rightfully so when symptoms start showing up in a youth.”

Doctors first need to make sure there isn’t another medical condition causing the symptoms.

Only after serious illnesses have been ruled out do conversations begin about the possibility that the nervous system itself has become stuck in a protective pattern.

For many families, hearing this can bring mixed emotions.

Some feel relieved to finally have an answer.

Others worry they’re being told the symptoms aren’t real.

Why “It’s Just Stress” Can Feel So Hurtful

When parents hear that symptoms may be connected to stress, anxiety, or the nervous system, it can sometimes sound like someone is saying:

“It’s all in your head.”

That isn’t what healthcare providers mean.

In fact, Kirsten says one of the biggest parts of her work is helping families understand the difference.

“Those symptoms are real. We can see them. We can sometimes even test them. They’re very real, and for families and youth to hear this can be really validating, because many people have been dismissed.”

The difference is simply where the symptoms are coming from.

Rather than being caused by damage to the heart, stomach, muscles, or nerves, the symptoms are coming from a brain and nervous system that have become overprotective.

Even though the source of these symptoms is our nervous system, that doesn’t make the pain any less real.

It simply changes how we help the body recover.

When the Brain Learns Danger

Imagine a smoke alarm.

Its job is to protect your family.

If there’s a real fire, you want it to go off.

But imagine that same smoke alarm starts sounding every time someone makes toast.

The alarm isn’t broken because it doesn’t work.

It’s broken because it’s become too sensitive.

Our nervous systems can do something similar. They learn to expect danger. Over time, they begin responding to situations that are no longer actually unsafe in an effort to be helpful.

The body isn’t trying to cause problems.

It’s trying to protect us.

The challenge is helping the brain recognize that it no longer needs to stay on high alert.

Understanding the Diagnosis Is Part of the Treatment

One of the most important moments in recovery often comes when children and families truly understand what is happening.

Kirsten explains:

“If you don’t have buy-in to this mind-body connection, those kids often don’t experience recovery from their symptoms.”

Why?

Because fear keeps the nervous system activated.

If every symptom is interpreted as evidence that something dangerous is happening, the brain continues sounding the alarm.

But when children begin to understand that the symptoms are coming from an overprotective nervous system—not from ongoing injury—they can slowly begin teaching their brain that they are safe.

As Kirsten puts it:

“Once these kids and families understand why these symptoms are occurring and that it’s not actually dangerous to start living their life normally, we start to see success- that’s actually the treatment. We know this can be scary for a lot of people and make them worried things actually might get worse, but we also know that positive experiences and success help kids to regain trust in their body and feel more in control”

This is something we explore in our Supportive Parenting for Anxious Childhood Emotions (SPACE) group, Empowered Parents. Parents often struggle to know when their child’s brain is asking for protection and when their nervous system needs the opportunity to learn that they are safe. We help families find that balance, gently reducing accommodations where appropriate while supporting children to build confidence through everyday experiences.

Recovery Means Gently Returning to Life

This surprises many families.

When children are in pain or feeling sick every day, the natural instinct is to stop activities until they feel completely better.

Sometimes that is necessary.

But with many mind-body conditions, waiting for symptoms to disappear before returning to life can unintentionally keep the nervous system stuck.

Instead, recovery often involves gradually returning to normal daily activities while building confidence that the body is safe.

That might mean:

• Going back to school.
• Seeing friends.
• Participating in sports.
• Walking a little farther each day.
• Returning to hobbies they once enjoyed.

The goal isn’t to ignore children or dismiss their symptoms.

The goal is to teach the nervous system a new message:

I can do hard things. My body is safe. I can cope.

Parents, Schools, and Therapists All Play an Important Role

Recovery is rarely something a child does alone.

Parents often need support in learning how to respond calmly to symptoms without accidentally reinforcing fear.

Schools also become important partners.

Kirsten frequently works with educators whose first instinct is to send children home every time symptoms appear.

Instead, she helps schools understand that many of these children are safe to remain at school while receiving appropriate support.

Keeping routines as consistent as possible often helps the nervous system learn that everyday activities are not dangerous.

It isn’t about dismissing a child’s experience.

It’s about responding with calm confidence instead of fear.

Treatment Is About Retraining the Nervous System

Unlike many medical conditions that rely primarily on medication or surgery, treatment for mind-body conditions often focuses on helping the nervous system regain a sense of safety.

Kirsten explains that the current gold standard often involves a team approach that includes:

• Physiotherapy
• Occupational therapy
• Psychotherapy

Each professional supports recovery in a different way.

Occupational therapists help children gradually return to meaningful daily activities while building confidence in what their bodies can do.

Psychotherapists help children understand emotions, cope with stress, and develop nervous system regulation skills.

Physiotherapists help children rebuild movement and physical confidence.

Together, these approaches teach the brain and body that life is safe again.

There Is Hope

One of the most reassuring things Kirsten shared is that many of these children are incredibly resilient.

Some don’t have a formal mental health diagnosis.

Some aren’t “anxious kids.”

They simply have nervous systems that became overwhelmed.

With the right education, the right support, and a treatment team that understands the mind-body connection, children can recover.

They can return to school.

They can play sports again.

They can spend time with friends.

They can trust their bodies again.

If your child has been living with chronic pain, unexplained physical symptoms, or functional neurological symptoms, know that you are not imagining what you’re seeing—and neither are they.

The symptoms are real.

But so is recovery.

At Acorn Counselling, we work collaboratively with families and healthcare providers to help children understand the connection between their brain, body, and nervous system. Whether your child is living with chronic pain, anxiety-related physical symptoms, or functional neurological symptoms, our team is here to help them reconnect with the activities, relationships, and life they love. If you’d like to learn more or book with Kirsten or one of our psychotherapists.