The patient should be encouraged to work and to socialize despite the symptoms. The major disability from MCS is often the isolation and withdrawal experienced as the patient seeks to avoid chemical exposures. Yet there is no evidence that such avoidance is effective or that continued exposure leads to any adverse biologic effects. Therefore, the physician should not encourage the patient to avoid low-dose exposure to a variety of chemicals. Indeed, according to Sparks and associates,23 “[a] recommendation for long-term avoidance of chemical exposures is contraindicated. It is also impossible to accomplish.”
The patient should be encouraged to increase activity gradually, while keeping anxiety or other symptoms at tolerable levels. This can be accomplished by following a systematic plan of behavioral treatment, desensitizing the patient to the distress experienced in symptom-producing situations. Relaxation or breath-control exercises may be helpful, as well as teaching the patient that autonomic symptoms of arousal, such as palpitations and tremor, are not dangerous and that activity can persist despite their occurrence.27,28