What Is Somatic Symptom Disorder?

January 31, 2023

Somatic symptom disorder (SSD) is a mental illness in which the patient exhibits physical symptoms, a process referred to as somatization, such as pain, fatigue, among other bodily sensations, as well as excessive thoughts, feelings, and actions worrying about the symptoms. The individual may not necessarily have a mental disorder, but if there is one, they respond to it excessively. Patients with SSD have deep thoughts and feelings in response to their symptoms.

Risk Factors and Causes Of Somatic Symptom Disorder

Unfortunately, the exact cause of somatic symptom disorder is not entirely clear. A number of factors, however, play a role in this condition, including genetic factors such as a family history of SSD, heightened sensitivity to pain or other sensations, a negative personality, and learned behavior regarding the benefits gained from being ill (e.g., not having to do much activity or someone bringing food). Risk factors for SSD include suffering from a mental illness such as depression or anxiety, recovering from a medical condition or being at risk of developing one (e.g., a family history of cancer), high periods of stress, or experiencing significant trauma (in childhood or the present).

Symptoms of SSD

Symptoms of SSD range based on the individual, but often include shortness of breath, pain, fatigue, weakness, or intensified symptoms of a pre-existing disease (e.g., heart disease). However, the symptoms may also have no discernable link to another medical condition. Patients with SSD also exhibit obsessive thoughts, feelings, and even actions regarding the symptoms. These can cause other significant issues and make it difficult to function. The obsessive thoughts, feelings, and actions when related to SSD include excessive worry about potential illnesses, mistaking normal physical sensations for symptoms of devastating illnesses, health care visits not relieving medical concerns, and constantly visiting a health care facility for checkups. The patient may also experience unusual sensitivity to medical treatment and repeatedly check their body for physical abnormalities.

Complications Of SSD

Somatic symptom disorder in patients is also associated with numerous potential complications, which can significantly worsen the condition when left unchecked. These complications include having problems with a significant other, family, or friends; issues affecting the workplace and professional relationships; financial problems, often the result of an increased number of health care visits; poor physical or mental health; and an increased risk of committing suicide. These potential complications make it important to receive swift and proper treatment for SSD as soon as it is diagnosed by a healthcare professional.

Diagnosing SSD

The doctor will run a series of physical exams and other tests to accurately diagnose SSD. These tests may also reveal health conditions requiring treatment. As part of the tests, the primary doctor will often refer the patient to a mental health professional, who will conduct a full psychological evaluation to discuss the symptoms the patient is experiencing, as well as assessing other influencing factors, such as relationship issues, fears, and family medical history of the condition. Mental health professionals will often require the patient fills out a questionnaire as part of this assessment, and ask about potential substance abuse.

An SSD diagnosis requires the three elements as detailed for SSD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The patient must present one or more somatic symptoms that are either significantly distressing or cause issues in daily life; must exhibit persistent and obsessive thoughts or feelings about the symptoms and their severity, including heightened anxiety about health; and the symptoms must continue for six months or more, even if they vary.

Medical Treatment For SSD

The treatment is intended to improve oneself symptoms and the ability to function normally. Psychotherapy, also termed cognitive behavioral therapy, can help the individual with somatic symptom disorder learn how to reduce stress and cope with physical symptoms, reduce avoidance of situations due to fear of acquiring a particular disease, and improve their relationships with family and friends. Additional strategies used to help ease symptoms of SSD include examining beliefs about health, addressing potential mental illnesses, such as depression and anxiety, and learning exercises to reduce the patient’s preoccupation with the symptoms they are experiencing.

The doctor may also recommend the patient try an antidepressant medication to help alleviate symptoms of SSD. Patients should note it may take up to a couple of weeks to notice an improvement. If there is no improvement with a specific medication, doctors will often either switch the specific medication, adjust dosage, or recommend a combination of medications to help with symptoms.

Lifestyle Adjustments For SSD

Treatment for SSD does not stop when a patient is out of the doctor’s office. Lifestyle adjustments can make a significant difference for many individuals with SSD. The first major element of these lifestyle adjustments, of course, is for the patient to work closely with their care provider to help determine what adjustments are appropriate and to measure their effectiveness over time.

Although these adjustments will vary, common areas include incorporating regular physical activity into their routine; practicing stress management techniques such as meditation or yoga; remaining involved or starting to get involved in social activities with friends, family, and colleagues despite symptoms; and avoiding substances such as alcohol, cigarettes, and recreational drugs.

Related Disorders to SSD

One of the most common terms out there concerning an individual being excessively worried about or believing they have a serious medical condition is hypochondria. However, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer recognizes hypochondria as a potential diagnosis. Instead, patients are likely to have SSD or a similar condition, known as illness anxiety disorder (IAD). IAD, like SSD, includes excessive worry about the presence of a serious illness or the risk of developing one, though the main difference between the two is those with IAD are more likely to have no physical symptoms or pain, just the excessive worry.

Two other disorders related to SSD, though less so than IAD, are conversion disorder and factitious disorder. The latter is a mental illness in which the patient attempts to deceive others, including doctors, into believing they are seriously ill; purposely tries to fall ill or injure themselves; or exaggerates symptoms of an existing illness. Conversion disorder is a medical condition in which the patient experiences paralysis or other loss of physical function without a discernible medical cause, often suddenly and during a time of significant stress.

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