What is Somatic Symptom Disorder?

Somatic symptom disorder is when someone focuses too much on physical symptoms, like pain or fatigue, which leads to significant emotional distress and problems with daily activities. You might have a diagnosed medical condition linked to these symptoms or not, but your reaction to the symptoms is unusual.

You often assume the worst about your symptoms and frequently go to the doctor, searching for answers even after severe conditions have been ruled out. Your health concerns may take over your life to the point where it's difficult to function, and this can sometimes lead to disability.

Severe emotional and physical pain may accompany somatic symptom disorder. Treatment can help alleviate symptoms, lead you to recovery, and improve your quality of life.

What are the signs and symptoms of Somatic Symptoms disorder?

Symptoms of somatic symptom disorder can be:

You may experience specific sensations like pain or shortness of breath or general symptoms such as fatigue or weakness. These symptoms may not be linked to any medical cause that can be identified, or they may relate to conditions like cancer or heart disease, but they can be more intense than what is usually expected. Symptoms can occur as a single issue or multiple issues, or they may vary over time. They can range from mild to moderate and moderate to severe.

The most common symptom is pain, but no matter what your symptoms are, you have more behaviors, thoughts, or feelings related to those symptoms than anyone else, which interferes with your life, limits your activities, and sometimes even incapacitates you.

These thoughts, feelings, and behaviors can include:

• Worrying constantly about becoming ill
• Assuming that normal physical sensations mean you have a severe illness
• Believing your symptoms are serious even though there is no evidence that they are
• Assuming the sensations pose a threat or harm
• Lack of sufficient medical check-up and treatment
• Perceiving damage caused by physical activities to the body.
• Going through your body constantly and assessing abnormalities
• Frequent visits for treatment with a feeling that there is no relief or worsening of concerns
• Insensitive reaction towards medical treatment or sensitivity to the effects of medicines
• Having more severe incapacitation than normally expected in most medical conditions

For individuals with somatic symptom disorder, it is more crucial than the physical symptoms they experience, how they interpret and react to those symptoms, and how they impact their daily lives.

What are the causes of somatic symptom disorder?

The cause of somatic symptom disorder is not known, but any of the following may contribute:

• Genetic and biological factors, such as increased sensitivity to pain
• Family influence, which may be genetic, environmental, or both
• Personality trait of negativity, which can influence how you define and experience illness and somatic symptoms
• Reduced consciousness of or difficulties with emotional processing, making the physical symptoms the central focus rather than the emotional problems
• Acquired behavior refers to actions you develop over time, such as seeking attention or rewards from having an illness. It may also include "pain behaviors," like avoiding activities because of symptoms, which can make your disability worse.

To diagnose somatic symptom disorder, you will likely have a physical exam and any necessary tests your doctor recommends. This helps determine if you have any health conditions that need treatment.

Your healthcare provider may also refer you to a mental health professional. This professional can conduct a psychological exam to discuss your symptoms, fears, stressful situations, relationship issues, things you might avoid, and your family history.

• Ask you to complete a psychological self-report or questionnaire
• Ask about alcohol, drug, or other substance use

Diagnostic criteria

According to the DSM-5, American Psychiatric Association highlights the following considerations in diagnosing somatic symptom disorder:

You have one or more physical symptoms, like pain or fatigue that are upsetting or make daily life difficult. You think a lot about how serious your symptoms are. You feel very anxious about your health or symptoms or spend too much time and energy worrying about them. You have symptoms that concern you for over six months, although the specific symptoms may change.

What are the treatments for somatic symptom disorder?

Treatment aims to reduce the symptoms and impairments in your daily life. Psychotherapy, also known as talk therapy, can be beneficial for somatic symptom disorder. At times, medications can be prescribed mainly if you feel depressed.

Psychotherapy

Because physical symptoms could be connected to psychological distress and high levels of health anxiety, psychotherapy — most specifically, cognitive behavioral therapy — can potentially improve the situation with the physical symptoms.

CBT might help you:

• Look through and possibly change your beliefs and expectations about your health and physical symptoms
• Learn ways to reduce stress
• Learn how to manage uncomfortable physical symptoms
• Decrease preoccupation with symptoms
• Decrease avoidance of activities and situations because of inadequate physical feelings
• Improve daily life at home, work, relationships, and social situations.
• Treat depression and other mental health issues.
• Family therapy can help by examining family relationships and boosting family support.
• Medications: Antidepressant medicine can help reduce symptoms of depression and pain that often come with somatic symptom disorder.

If a medication isn't working, your doctor may prescribe another or a combination of medications to increase its effectiveness. It may take a few weeks after initial treatment with a drug to notice symptom improvement.

Discuss medication choices with your doctor and potential side effects and risks.

What are the risk factors for Somatic Symptom Disorder?

Some of the risk factors that are associated with a higher chance of developing somatic symptom disorder include the following.

• Depression or anxiety
• Illness or recovery from one
• Family history of illnesses
• Trauma, violence, or stressful life events
• History of trauma, for example, sexual assault while young.
• Low education and socio-economic status

How to prevent from somatic symptom disorder?

There is not much known about how to prevent somatic symptom disorder. However, these steps may help:

• In case you develop anxiety or depression, see a professional for as early an appointment as possible.
• Learn to recognize how stressed you are and how the physiological changes impact your body — and habitually practice stress management and relaxation.
• If you suspect you have somatic symptom disorder, seek professional early treatment to prevent symptoms from progressing and interfering with your quality of life.
• Stay on your treatment regimen and avoid relapse or worsening.

How can I care for myself at home?

Although somatic symptom disorder is best treated by a specialist, you can also take the following lifestyle and self-care measures:

• Cooperate with your medical professionals: Make time for regular check-ups with your doctor and mental health specialist to discuss your concerns and establish trust. Talk about appropriate restrictions on exams, testing, and specialist referrals. Avoid frequent visits to the ER or consulting multiple doctors at once, as this can complicate your care and require more testing.
• Practice stress management and relaxation techniques: Techniques like progressive muscle relaxation can help improve your symptoms.
• Get active physically: A graduated activity program can likely calm your mood, improve your physical symptoms, and improve physical function.
• Participate in activities: Stay engaged in your work and social and family activities. Do not wait until your symptoms are gone to participate.
• Avoid alcohol and recreational drugs: Substance use will make your care more difficult. Discuss any need to quit with your healthcare provider.

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