Somatic Symptom Disorders
 

Overview

Somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or dizziness, that results in major distress and/or problems with daily activities. The individual has excessive worries, feelings and behaviors relating to the physical (somatic) symptoms. 

Sometimes people experience the symptoms even though they do not have a diagnosed medical condition. Other times people experience more concern about symptoms than would be expected with their diagnosed medical condition. Even though they do not have a diagnosed medical condition or experience the symptoms out of proportion to their diagnosed condition, they truly experience the symptoms (that is, not faking the illness). 

A person is not diagnosed with somatic symptom disorder solely because a medical cause can’t be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion. 

Symptoms & Signs

Pain is the most common symptom, but whatever the symptoms, there is excessive thoughts, feelings or behaviors related to those symptoms that cause significant problems and make it difficult to function. These thoughts, feelings and behaviors can include:

• Constant worry about potential illness
• Viewing normal physical sensations as a sign of severe physical illness
• Fearing that symptoms are serious, even when there is no evidence
• Frequent health care visits that don't relieve your concerns or that make them worse
• Being unresponsive to medical treatment or unusually sensitive to medication side effects

• Fearing that physical activity may cause damage to your body
• Repeatedly checking your body for abnormalities
• Thinking that physical sensations are threatening or harmful
• Feeling that medical evaluation and treatment have not been adequate
• Having a more severe impairment than is usually expected from a medical condition

For somatic symptom disorder, more important than the specific physical symptoms you experience is the way you interpret and react to the symptoms and how they impact your daily life. 

Related Disorders

• Illness Anxiety Disorder

  involves a person preoccupied with having an illness or getting an illness – constantly worrying about their health. They may frequently check themselves for signs of illness and take extreme precautions to avoid health risks. This condition was previously referred to as “hypochondriasis.” Unlike somatic symptom disorder, a person with illness anxiety disorder generally doesn’t experience symptoms.

• Conversion Disorder

  is a condition in which symptoms affect a person’s perception, sensation or movement with no evidence of a physical cause. A person may have numbness, blindness or trouble walking. The symptoms tend to come on suddenly and may last for a while or may go away quickly. People with conversion disorder also frequently experience depression or anxiety disorders.

• Factitious Disorder

  involves people producing or faking physical or mental illness when they are not really sick, or intentionally making a minor illness worse. A person with factitious disorder may also create an illness or injury in another person, for example faking the symptoms of a child in their care. The person may or may not seem to benefit (such as getting out of school or work) from the situation they create.

Treatment

The goal of treatment is to improve your symptoms and your ability to function in daily life. Psychotherapy can be helpful for somatic symptom disorder. Sometimes medications may be added, especially if you're struggling with feeling depressed.

• Psychotherapy: Because physical symptoms can be related to psychological distress and a high level of health anxiety, psychotherapy — specifically, cognitive behavioral therapy (CBT) — can help improve physical symptoms. 
  
  CBT can help you:
  • Examine and adapt your beliefs and expectations about health and physical symptoms
  • Learn how to reduce stress
  • Learn how to cope with physical symptoms
  • Reduce preoccupation with symptoms
  • Reduce avoidance of situations and activities due to uncomfortable physical sensations
  • Improve daily functioning at home, at work, in relationships and in social situations
  • Address depression and other mental health disorders
  • Family therapy may also be helpful by examining family relationships and improving family support and functioning.
• Medications: Antidepressant medication can help reduce symptoms associated with depression and pain that often occur with somatic symptom disorder. If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.