Somatic Symptom and Related Disorders

Somatic symptoms and related disorders refer to a group of mental health conditions characterized by an intense focus on physical symptoms (somatic) that can be extremely distressing and lead to significant disruption of daily functioning.

Psychological symptoms are typically the first indicator of a mental health condition. This means that people’s thoughts, emotions, and behaviors are out of the ordinary or disturbing. However, in somatic symptom-related disorders, the individual’s primary focus is on physical symptoms or other emotional sensations rather than on the underlying mental causes responsible for them (a process known as somatization).

These medically unexplainable symptoms are generally much worse than those usually associated with any existing medical condition or may occur without an obvious medical problem. Somatic symptom and related disorders are common in children and adolescents and can begin as early as preschool. People with somatic symptoms may see a variety of medical specialists and undergo numerous medical tests in search of an answer, often with little to no positive results. However, it’s important to note that somatic symptoms are real and can cause significant distress and impairment to the sufferer.

Types of Somatic Symptom and Related Disorders

The emotional response to physical symptoms is universal. However, those who suffer from a somatic symptom or a related disorder often experience extreme levels of distress due to their condition. These reactions determine the specific type of somatic symptom and related disorders.

Somatic Symptom Disorder (SSD)

Somatic Symptom Disorder (SSD) – is characterized by an extreme focus on physical symptoms, such as pain or fatigue, resulting in major emotional distress and problems functioning. People with somatic symptom disorder may have excessive thoughts, feelings, and behaviors relating to the physical symptoms. The symptoms may or may not be associated with a medical condition, but the reaction to the symptoms is not normal. Approximately 7% of adults in the U.S. have SSD.

Illness Anxiety Disorder

Illness Anxiety Disorder – previously known as hypochondria or hypochondriasis, is characterized by excessive worry about having or developing a serious medical condition. They may conduct regular health checks and go to great lengths to protect themselves from potential dangers. In contrast to those with somatic symptom disorder, those with illness anxiety disorder rarely display physical manifestations of their condition.

Factitious Disorder

Factitious Disorder – involves people who deliberately falsify physical or psychological symptoms to deceive others. These individuals may also induce illness or harm in another individual (factitious disorder imposed on another) under their care. People with factitious disorders are aware that they are responsible for their symptoms or illnesses, yet they cannot identify the source of their problems or change their behavior. The identification and treatment of a fictitious disorder are challenging. However, medical and mental health care is essential for averting life-threatening injuries and possibly death from the self-harm characteristic of this condition.

Signs and Symptoms

Somatic symptom disorders are defined by a common characteristic: physical symptoms that cause significant distress or impairment. The physical symptoms of somatic symptom disorder include:

  • Pain on a specific part of the body
  • Pain associated with sexual activity or menstruation
  • Fatigue
  • Dizziness
  • Fainting
  • Weakness
  • Headaches
  • Constipation
  • Diarrhea
  • Digestive issues
  • Breathing difficulties

The behavioral symptoms of somatic symptom disorder include:

  • Focusing excessively on one’s physical symptoms
  • Constantly checking in with physicians
  • Sensitive to medication reactions
  • Concerns for one’s physical well-being take precedence above all else
  • Exaggerating the severity of a condition
  • Excessive preoccupation with nonexistent health problems
  • Dissatisfied with the medical treatment they receive

Signs of an illness anxiety disorder include:

  • Avoiding people or places because they are afraid of getting sick
  • Researching diseases and symptoms all the time
  • Exaggerating the severity of symptoms
  • High levels of anxiety about personal health
  • Obsession with ordinary functions of the body, like the heart rate
  • Excessive disclosure of symptoms and health status to others
  • Checking for indicators of disease, such as testing their blood pressure or temperature, regularly
  • Seeking reassurance about their symptoms or health from loved ones
  • Unease with normal bodily functions such as flatulence or perspiration

Signs of a factitious disorder include:

  • Extensive knowledge of medical terminology and diseases
  • Symptoms that are vague or inconsistent
  • Conditions that deteriorate for no discernible reason
  • Conditions that do not react to traditional therapy
  • Seeking treatment from a multitude of physicians or facilities
  • Reluctance to allow medical professionals to speak with family, friends, or other healthcare providers
  • Frequent hospitalizations
  • A propensity for frequent testing or risky operations
  • Numerous surgical scars or indications of multiple surgeries
  • Having few visitors while in the hospital
  • Disputes with staff and physicians

Risk Factors

Risk factors for a somatic symptom disorder may include:

  • History of anxiety and depression
  • Having a medical condition, being in the process of recovering from one, or having a strong family history of a medical problem
  • Trauma, violence, child abuse, sexual abuse, and other stressful life events
  • Poor socioeconomic status and illiteracy

Risk factors for illness anxiety disorder may include:

  • A period of intense stress
  • History of abuse
  • A severe childhood illness or a parent with a severe illness
  • Personality traits, such as an excessive penchant for worry
  • Overuse of the internet for medical research

Risk factors for a factitious disorder may include:

  • Psychological, physical, and sexual abuse in childhood
  • Having a major illness as a kid
  • The death, illness, or abandonment of a loved one
  • A lack of self-esteem or a sense of identity
  • Personality disorders
  • Depression
  • Individuals who work in the healthcare field

Diagnosis and Treatment

Diagnosing somatic symptoms and related disorders requires a thorough assessment of medical history as well as a psychological evaluation. Despite the lack of definitive treatment, somatic symptoms and related disorders can be managed. The goal of treatment is to restore normalcy to the individual’s life as much as possible despite the condition. Medication and psychotherapy (cognitive-behavioral therapy and family therapy) are the usual modes of treatment.

Somatic symptoms and related disorders are already stressful enough without the added burden of having an “invisible” sickness or being told your symptoms are “only in your imagination.” Professionals at Turning Point centers are aware of this fact and, as a result, assemble a multidisciplinary team of professionals to treat both mental and physical symptoms simultaneously. Many families find it comforting to learn that their loved one’s symptoms are real and that others are experiencing or have experienced something similar.

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