What is Somatic Symptom Disorder?
Somatic symptom disorder was previously called “somatization disorder” or “somatoform disorder”. It is a mental illness that causes bodily symptoms. These symptoms can be pain, weakness or shortness of breath. The individual has excessive thoughts, feelings or behaviors related to the physical symptoms. This results in major distress. They can have problems functioning in daily life.
People with somatic symptom disorder are not faking their illness. The distress they experience is real. This is so even if a physical explanation can be found. This distress significantly affects their daily functioning. They can have emotional stress when their doctor and those around them don’t believe that their symptoms are real.
Many tests need to be performed to rule out other possible causes before one diagnoses somatic symptom disorder. A diagnosis of somatic symptom disorder requires that the subject has recurring somatic complaints for at least six months.
Many people who have somatic symptoms disorder will also have depression or anxiety disorder.
Symptoms of Somatic Symptom Disorder
Symptoms may be mild to severe. There may be one or more symptoms. Symptoms tend to last many years. Usually, the symptoms appear during adolescence. But, usually, patients are diagnosed before the age of 30 years.
The person may be distressed. Or, they can have trouble functioning.
Often, no medical cause can be found for the symptoms. However, if any medical illness is found, the symptoms are out of proportion.
Symptoms can appear in almost any part of the body. Physical symptoms that can occur with somatic symptom disorder include:
- Fatigue or weakness
- Shortness of breath
Symptoms may be specific or nonspecific. Sometimes the symptoms do not signify serious disease. Somatic symptoms without an evident medical explanation are not sufficient to make this diagnosis.
The other symptoms can include:
- Repeated bodily checking for abnormalities
- Repeated seeking of medical help and reassurance
- Avoidance of physical activity
- Extreme anxiety about symptoms
- Excess concern that mild symptoms are a sign of serious disease
- Spend a lot of time and energy dealing with health concerns
The patient may seek care from multiple doctors for the same symptoms. They do not feel reassured by the medical evaluation or treatment.
A person with somatic symptom disorder also may have symptoms of anxiety and depression. Hence, they may begin to feel hopeless and attempt suicide. They may have trouble adapting to the stresses of life. The individual may abuse alcohol or drugs. Sometimes they can abuse prescription medicines.
The cause of the symptoms reported by people with somatic symptom disorder is not known. It could be that people with this disorder perceive bodily sensations in an unusual way. Or they may describe feelings in physical, rather than mental or emotional, terms.
Risk factors for this disorder are:
- Genetic traits, such as being more sensitive to pain and other sensations
- Having a negative outlook and poor self-image
- Difficulty in dealing with stress
- Family upbringing
- History of physical or sexual abuse
DSM-5 lists the following diagnostic criteria for somatic symptom disorder:
- One or more bodily symptoms. These are distressing. And, they result in significant impairment in functioning in daily life.
- Excessive thoughts, feelings, or behaviors related to the bodily symptoms as manifested by at least one of the following:
- Out-of-proportion and persistent thoughts about the seriousness of one’s symptoms
- Consistently high level of anxiety about symptoms
- More time and energy devoted to these symptoms
- Symptomatic for more than 6 months
Treatment of Somatic Symptom Disorder
Cognitive-behavioral therapy (CBT) may help reduce symptoms. CBT involves working with a therapist to identify negative thought patterns. Then one learns to deal more effectively with stressful situations. CBT also addresses any anxiety or depression that is present.
Sometimes, antidepressant medication gives relief from physical symptoms.
Treatment aims at managing conflict at home. It also aims at coping with problems with work and social functioning.
It is useful to manage stress (for example, relaxation techniques).