Physical Symptoms of Mental Health: Somatic Symptom Disorder

Somatic symptom disorder arises when a person is experiencing symptoms such as pain, weakness, and shortness of breath that interferes with daily life and is unrelated to medical illness. Thoughts, behaviors, and feelings about the symptoms co-occur with the physical manifestation. While not medically caused, those afflicted do not think they are making their experience up; this can be particularly frustrating and upsetting for those experiencing it because while they know something doesn’t feel right, there seem to be no answers. As one can imagine, this can cause a great deal of anxiety and hinder day-to-day life. If you or someone you care about is experiencing symptoms like this, keep reading!

Diagnosis and Criteria

To meet the DSM criteria for somatic symptom disorder, a person must be experiencing somatic symptoms that disrupt daily life. While the symptom reported might change, the client reports some sort of symptom persistently for at least six months and is accompanied by:

  • Perseverating, ruminating, and sometimes extreme thoughts regarding the seriousness of symptoms
  • Persistent high levels of anxiety about overall health and symptoms
  • An excessive amount of time spent exploring health concerns (examples: spending hours on the research of symptoms, seeking opinions from several different doctors despite the answer being the same)

What causes somatic symptom disorder?

While researchers are still uncertain of the exact cause of somatic symptom disorder, some reported commonalities include genetic traits such as pain sensitivity. Patients frequently present with negative affect, poor self-image, and lack of emotional awareness. This disorder is common in those with difficulty managing stress, often paired with learned behaviors such as getting attention due to an illness or needing care. This struggle with understanding and labeling emotions and sitting with them causes them to place a significant focus on physical issues instead.

Additional Risk factors that contribute to his disorder include:

  • anxiety and depression
  • previous medical condition
  • previous traumatic experience
  • familial history of severe medical conditions.

Treatment

STEP 1: When treating somatic symptom disorder, it is essential first to rule out any potential medical issues. It is an important first step to understanding if any present issues might otherwise explain the cause of symptoms. This step includes finding health care providers with whom the person trusts and feels safe. Establishing this rapport with a care team also helps relieve this anxiety and allows the person to feel heard, reassured, and supported.

STEP 2: Psychotherapy or talk therapy is an essential step in working with a person to identify the behaviors and thoughts behind somatic symptom disorder. It is also an opportunity to explore whether the person feels heard, understood, and validated in their daily life. Therapists and clinicians can work with clients to separate feelings from the physical presence of symptoms and support them in building coping skills to articulate their wants and needs better. Stress management, mindfulness, and DBT skills are essential components of support for this disorder.  

STEP 3: Medication is also an option for those struggling with depressive or anxiety symptoms that cause a barrier to implementing behavioral changes. Medications paired with therapy in these situations can be a powerful and effective combination in reducing the intensity of symptoms so that they can be more present in treatment.

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