What is somatic symptom disorder?
People with somatic symptom disorder obsess over physical senses and symptoms, such as pain, shortness of breath, or weakness. This condition has been previously called somatoform disorder or somatization disorder. It’s marked by the belief that you have a medical condition even if you haven’t been diagnosed with anything, and despite reassurances from your doctor that you have no health issue responsible for your symptoms.
This can lead to major emotional stress when your doctor and those around you don’t believe that your symptoms are real.
The main symptom of somatic symptom disorder is the belief that you have a medical condition, which you may not actually have. These conditions range from mild to severe and general to very specific.
Additional characteristics include:
- symptoms that aren’t related to any known medical condition
- symptoms that are related to a known medical condition, but are much more extreme than they should be
- constant or intense anxiety about a possible illness
- thinking that normal physical sensations are signs of illness
- worrying about the severity of mild symptoms, such as a runny nose
- believing your doctor hasn’t given you a proper examination or treatment
- worrying that physical activity will harm your body
- repeatedly examining your body for any physical signs of illness
- not responding to medical treatment or being very sensitive to medication side effects
- experiencing a disability more severe than what’s generally associated with a condition
People with somatic symptom disorder genuinely believe they have a medical condition, so it can be hard to distinguish somatic symptom disorder from a real medical condition that needs treatment. However, somatic symptom disorder tends to cause an obsessive concern over symptoms that often get in the way of daily life.
Researchers aren’t sure about the exact cause of somatic symptom disorder. However, it seems to be associated with:
- genetic traits, such as pain sensitivity
- having negative affectivity, a personality trait that involves negative emotions and poor self-image
- difficulty dealing with stress
- decreased emotional awareness, which can make you focus more on physical issues than emotional ones
- learned behaviors, such as getting attention from having an illness or increasing immobility from pain behaviors
Any of these traits, or a combination of them, can contribute to somatic symptom disorder.
Over the years, researchers have identified some possible risk factors that might increase your risk of having somatic symptom disorder. These include:
- having anxiety or depression
- being diagnosed with or recovering from a medical condition
- having a high risk of developing a serious medical condition, due to family history, for example
- previous traumatic experiences
Before diagnosing you with somatic symptom disorder, your doctor will start by giving you a thorough physical examination to check for any signs of a physical illness.
If they don’t find any evidence of a medical condition, they’ll likely refer you to a mental health professional, who will start by asking questions about your:
- symptoms, including how long you’ve had them
- family history
- sources of stress
- history of substance abuse, if applicable
They might also ask you to fill out a questionnaire about your symptoms and lifestyle. A mental health professional will focus more on how you think about your symptoms, rather than the actual symptoms themselves.
You’ll likely be diagnosed with somatic symptom disorder if you:
- experience one or more physical symptoms that cause distress or interfere with your everyday activities
- have excessive or endless thoughts about how serious your symptoms are, causing you to give too much time and energy to evaluating your health
- continue to experience symptoms for six months or more, even if these symptoms change over time
Treating somatic symptom disorder usually involves therapy, medication, or a combination of both, to improve your quality of life and relieve anxiety over your physical health.
Psychotherapy, also called talk therapy, is a good first step in treating somatic symptom disorder. Cognitive behavioral therapy (CBT) is a particularly helpful form of psychotherapy for somatic symptom disorder. It involves working with a therapist to identify negative or irrational thoughts and patterns.
Once you’ve identified these thoughts, your therapist will work with you to come up with ways to work through them and more effectively respond to stressful situations. You’ll also learn different ways to manage anxiety about your health, as well as any other mental health conditions, such as depression.
Antidepressant medications can also help with somatic symptom disorder and reduce anxiety. They tend to work best when combined with some form of psychotherapy. If your doctor does suggest medication, you may only need to take it temporarily. As you learn new coping tools in therapy, you may be able to gradually reduce your dosage.
It’s important to know that many antidepressants cause side effects when you first start taking them. If you have somatic symptom disorder, make sure your doctor goes over all of the possible side effects with you so they don’t cause more anxiety. Keep in mind that you may have to try a few medications before you find one that works for you.
Left untreated, somatic symptom disorder can lead to some complications for both your overall health and lifestyle. Constant worrying about your health can make daily activities very difficult.
People with this disorder often have a hard time maintaining close relationships. For example, close friends and family members may assume you’re lying for malicious reasons.
Frequent doctor’s visits about your symptoms can also lead to high medical costs and problems maintaining a regular work schedule. All of these complications can cause added stress and anxiety on top of your other symptoms.
Having somatic symptom disorder can feel extremely overwhelming, but with the right therapist, and in some cases the right dose of medication, you can improve your quality of life. If you’re not sure where to start, check out this list of mental health resources.
Your symptoms might never go away completely, but you can learn how to effectively manage them so they don’t consume your daily life.