Maybe youve had a horrible week, but by the time your therapy session rolls around, you feel fine. Or maybe youve been feeling sick at home, but once you walk into your doctors office, all those symptoms disappear.

Going to see a health care provider while youre not actually experiencing otherwise bothersome symptoms can be challenging. What if your doctor doesnt believe you? What if they cant adequately treat you?

These concerns can be even bigger for people with long-term health conditions.

Unfortunately, many individuals with chronic illnesses may feel the need to amplify their symptoms to ensure they are taken seriously by health care providers, a phenomenon often driven by the fear of being dismissed or gaslit, said Matt Glowiak , a clinical faculty member at Southern New Hampshire Universitys mental health counseling program.

Hes heard numerous stories in which patients are misdiagnosed or dismissed because their provider cant discover the root cause of their problem.

This vicious cycle continually negatively impacts the mind-body-spirit pathway, worsening all aspects of health, he added.

These situations can leave us with a host of feelings, from confusion to irritation to worry. Why does this happen? Should you just cancel the appointment? Heres what could be going on:

Symptoms naturally fluctuate.

The fact you happen to feel better at the doctors office could be a coincidence. In some moments, symptoms may present as quite severe, while in others, they are seemingly dormant or non-existent, Glowiak said. This is completely normal.

Thankfully, health care providers do (or should) understand this. Symptoms may come and go, and we cant expect them to commence on command just because we are in the doctors office, said Dr. Katie Deming , a radiation oncologist and TEDx speaker.

As a doctor, I am not surprised if my patient cant reproduce their symptoms in my office, Deming added. It is my job to take a full history to understand the problem and help the patient find a solution, regardless of whether the symptoms are present during the visit.

Your mental health can affect your symptoms.

Sometimes (not always!) physical symptoms are the result of feeling stressed, for example. That doesnt make those symptoms any less of a problem or less real it might just explain why they come and go.

Even somatoform symptoms those with seemingly no medical cause do negatively impact people, Glowiak said. Mental health complications impact physical health negatively, similar to how a positive mindset is healing.

In other words, when your stress goes away, symptoms like nausea, rapid heartbeat or other discomfort might go away, too. For some people, this can happen at a doctors office, when theyre surrounded by others who can help.

You have a lot on your mind.

You may have to squeeze your appointment into a busy day thats distracting you from your symptoms.

You may be rushing to get to the office or Zoom call right after you finish work or get the kids to where they are going, said Katherine Danley , a licensed clinical social worker with Thriveworks in Tampa, Florida . Your mind might be somewhere else.

Youre worried your symptoms arent a big deal after all.

Trying to reassure yourself that youre fine compared to those with worse problems can make you minimize your symptoms ahead of your appointment.

Most people feel that their experiences are not as bad as others and sometimes not worthy of being brought up, Danley said.

You may worry your therapist will judge you , she added, or you may feel uncomfortable with the vulnerability involved in a health care appointment.

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