“All emotions, even those that are suppressed and unexpressed, have physical effects. Unexpected emotions tend to stay in the body like small ticking bombs – they are illnesses in incubation” –Marilyn Van M. Derbur.“

Somatic Symptom Disorder (SSD)formerly known as “Somatization Disorder” or “Somatoform Disorder” is a form of mental illness that causes one or more bodily symptoms, including pain. The symptoms may or may not be traceable to a physical cause including general medical conditions, other mental illnesses, or substance abuse, but regardless, they cause excessive and disproportionate levels of distress. The symptoms can involve one or more different organs and body, systems, such as:· 

  • Pain.
  • Neurological problems.
  • Gastrointestinal complaints.
  • Sexual symptoms.

It is imperative to understand that individuals with Somatization Disorder are not faking, the pain that they are feeling is real even though there may be no physical evidence for it. Telling them to stop faking or snapping out of it can further increase the stress and can tend to be counterproductive.


An individual who is suffering from Somatization Disorder are under distress from their symptoms, since the pain has no physical or medical cause they are not able to understand where the pain is stemming from. Even after undergoing a myriad of medical tests, there is no conclusive diagnosis and this confusion leads to an increase in the stress and frustration one feels if they haven’t been diagnosed with Somatization Disorder. 

Patients may experience notable impairment in their daily, social, occupational and other areas of functioning. Initially patients may not be able to understand or even accept that their condition is a manifestation of their psychological stress or an extension of a psychiatric disorder, it is hence important to educate them on how stress affects our body and the kind of impact it creates.

SYMPTOMS:

According to the Mayo Clinic, the symptoms of Somatic Symptom Disorder are as follows:·  

  • Specific sensations, such as pain or shortness of breath, or more general symptoms, such as fatigue or weakness.
  • Unrelated to any medical cause that can be identified, or related to a medical condition such as cancer or heart disease, but more significant than what’s usually expected.
  • A single symptom, multiple symptoms or varying symptoms.
  • Mild, moderate or severe.

Pain is the most common symptom, but whatever your symptoms, you have excessive thoughts, feelings, or behaviors related to those symptoms, which cause significant problems, make it difficult to function and sometimes can be disabling. These thoughts, feelings and behaviors can include:·       

  • Constant worry about potential illness.
  • Viewing normal physical sentences as a sign of severe physical illness.
  • Fearing that symptoms are serious, even when there is no evidence.
  • Thinking that physical sensations are threatening or harmful.
  • Feeling that medical evaluation and treatment have not been adequate.
  • Fearing that physical activity may cause damage to your body.
  • Repeatedly checking your body for abnormalities.
  • Frequent healthcare visits that don’t relieve your concerns or that make them worse.
  • Being unresponsive to medical treatment or unusually sensitive to medication side effects.
  • Having a more severe impairment than is usually expected from a medical condition.

CAUSES OF SOMATIZATION DISORDER:

  1. GENETICS: Individuals who have relatives with a mental health condition or individuals who are sensitive towards pain are more likely to have Somatic Symptom Disorder.
  2. MENTAL HEALTH CONDITIONS: Having a mental health condition like Depression and Anxiety can also make one vulnerable for Somatization Disorder.
  3. STRESS OR TRAUMA: Increased levels of stress or experiencing stress, trauma or violence either in the present or in the past can also contribute towards the development of Somatization Disorder.
  4. MEDICAL CONDITIONS: Having a medical condition can also contribute towards the development of Somatic Symptom Disorder.
  5. DECREASED AWARENESS OF PROBLEMS: A decreased awareness of problems leads to the physical symptoms becoming more prominent and the emotional issues tend to be ignored and hence are not addressed.

COMPLICATIONS:·
  • Anxiety.
  • Depression.
  • Stress.
  • Poor health.
  • Problems or complications at work or unemployment.
  • Relationship issues.
  • Financial problems or other stressors.
  • Personality disorder or other mental health disorders.

CO-MORBID CONDITIONS:

1. CONVERSION DISORDER: Conversion Disorder is also called Functional Neurological Symptom Disorder is a neurological condition wherein the symptoms cannot be traced back to a physical or medical condition. When it comes to Conversion Disorder, the emotional or psychological stress is manifested into a physical condition, as a means to deal with the emotional conflict. Individuals may have symptoms like:·

  • Uncontrollable or abnormal movements.
  • Paralysis.
  • Blindness or tunnel vision.
  • Loss of sensation or numbness.
  • Loss of hearing.
  • Loss of smell or loss of speech.

It is important to understand that Conversion Disorder develops suddenly, the symptoms that one experiences are real and they have no control over it.

2. HYPOCHONDRIASIS OR ILLNESS ANXIETY DISORDER: Illness Anxiety Disorder, most commonly known as Hypochondriasis is a condition wherein an individual has excessive worry and is preoccupied about having a serious illness or disease. They are convinced that a minor problem they are facing is the sign and symptom of a major disorder. For example, if they have a minor ache in the chest area, they may come to the conclusion that they are having a heart attack and a normal headache may be interpreted as having a brain tumor.

3. OTHER SPECIFIC SOMATIC SYMPTOM DISORDER: This category involves conditions wherein somatic symptoms transpire for a period of less than six months or may include a specific condition known as Pseudocyesis. Pseudocyesis is the medical term for a false pregnancy; a false belief that a woman has that she is pregnant. Pseudocyesis can cause many of the signs and symptoms of pregnancy, outward signs of pregnancy and often resembles the condition in every way except for the presence of a fetus.

TREATMENT OF SOMATIC SYMPTOM DISORDER:

MEDICATION: Somatic Symptom Disorder is caused due to an underlying mental health condition or some stress or trauma. The first line of treatment is to tackle the underlying Depression, Anxiety or any other mental health condition. Usually with Somatization Disorder, individuals visit many physicians and specialists before seeking help from a psychiatrist, due to which the symptoms tend to become chronic. In these situations, it is important to take some treatment and medication if required.

PSYCHOTHERAPY: Resolving the stress, depression, anxiety or any other issue is important and along with medication, psychotherapy would also help. Cognitive Behavioral Therapy (CBT) is based on the premise that a negative perception towards a stressful situation in one’s life leads to negative thoughts, which further leads to negative emotions which ultimately leads to unhealthy behavior. With the help of CBT one can learn to deal with these negative thoughts, unrealistic beliefs, learn to deal with current and future stress, adapt a healthy and realistic belief symptom and a way to deal with your thoughts and physical symptoms.

POINTS TO REMEMBER:

  1. Adhere to your treatment: When it comes to Somatization Disorder, it is important to adhere to and follow your treatment ad per your Psychiatrist’s orders.
  2. Seek and follow up with therapy: Somatization Disorder has an underlying psychological condition or some stress which hasn’t been addressed, it would help to seek therapy and try to reduce the stress or deal with the underlying depression or anxiety which would also help to ease the physical symptoms.
  3. Exercise is a must: Exercise is one of the most vital ingredients towards the treatment process. Exercise helps with one’s mood and also help with the physical symptoms.
  4. Relaxation for the mind and body: Learning and practicing relaxation techniques like Deep Breathing, Progressive Muscle Relaxation (PMR), Imagery, etc., helps in keeping oneself calm and lowering the stress levels.
  5. Isolation is a no-no, socialization is the way to go: Isolating yourself or keeping yourself in the confines of your home is not going to help, rather it just tends to make you focus on the physical symptoms. Socializing and building some amount of social support helps one take their mind off the symptoms. It is however important to remember to not to focus on the problems and talk about it all the time, engaging in other conversation topics would help.
  6. Deal with problems: Avoiding problems or not dealing with them as they come will not help. Trying to deal with the problems helps, with the help of therapy one can even learn problem solving.
  7. Stay away from alcohol, drugs and other substances: Abstaining from alcohol, drugs and other substances tends to help.
  8. Do what makes you feel happy: Engaging in activities or hobbies that your enjoy or previously enjoyed may also help, considering that they should be healthy. Initially you may not feel like engaging in these activities but understand they will help divert your mind and attempt to lift your mood so give it a go.


“If your body is screaming in pain,whether the pain is muscular contractions, anxiety, depression, asthma or arthritis, a first step in releasing the pain may be making the connection between your body pain and the cause. Beliefs are physical. A thought held long enough and repeated enough becomes a belief. The belief then becomes biology” –Marilyn Van M. Derbur.

“This was a characterological prelude, but it wasn’t chemical or somatic. It was the anatomy of melancholy, not the anatomy of his brain” – Jeffery Eugenider.