Somatic Symptom Disorder Symptoms & Treatments

The incidence of somatic symptom disorder (SSD) is rising across the world due to a rise in associated factors such as mental stress, depression, alcohol abuse, physical or sexual abuse, and unhealthy lifestyles.

It is important to get an early diagnosis of somatic symptom disorder (SSD) in order to live a healthy and active life.

Continue reading to learn more about somatic symptom disorder, its physical symptoms, causes, risk factors, and available treatment options.

What is somatic symptom disorder?

Somatic symptom disorder is a psychological condition that causes the patient to feel extremely distressed about his or her physical symptoms and health concerns. People with somatic symptom disorder feel extreme anxiety about one or more symptoms they are experiencing. The disorder often disrupts the patient’s daily life and ability to function, creating an adverse impact on their quality of life.

Patients with SSD often report a wide range of medically unexplained symptoms, although they have no medical illness. These symptoms sometimes include normal body sensations and discomfort. Even if a medical condition is causing one or more symptoms, the health anxiety and psychological distress felt by the patient are out of proportion to its severity.

People with SSD are often not aware of their underlying mental health condition. They believe they have serious physical ailments which cause them extreme anxiety. The psychological symptoms associated with somatic symptom disorder can lead them to get a medical evaluation from multiple healthcare providers and undergo many tests and procedures to uncover the serious disease or medical condition causing their symptoms, most of which will reveal no physical cause.

What are the somatic symptoms of SSD?

SSD usually presents with mild symptoms, although the patient may perceive them as severe. Nearly 30% to 60% of patients with somatic symptom disorder have depression, anxiety, or some other mental health disorders. There are often multiple somatic symptoms with or without a clear cause or a diagnosed medical condition.

Some common physical symptoms of SSD include:

Chronic pain
Fatigue or extreme weakness that mimics the symptoms of chronic fatigue syndrome
Dyspnea (shortness of breath)

Evaluating the patient’s feelings, thoughts, and behaviors related to these symptoms is essential for diagnosing SSD.

For example, patients with SSD typically present the following behaviors:

Feeling extremely anxious about their bodily symptoms.
Concern that their medically unexplained symptoms could be the signs of a serious medical condition.
Believing that their primary care physician is not taking their symptoms seriously enough.
Consulting more than one primary care physician or going from one healthcare practitioner to another.
They see their doctor for multiple tests and examinations but do not believe the results when they are normal.
Unusually sensitive to medications.
Spending excessive time, effort, and energy dealing with their health concerns.
They have difficulty performing routine activities in their daily life because of anxiety about their physical symptoms.
Becoming dependent on others, often demanding emotional support and help.

What are the common causes of SSD?

A combination of biological, psychological, and environmental factors is believed to contribute to the development of somatic symptom disorder.

The common causes that can trigger the development of somatic symptom disorder include:

A history of physical or sexual abuse in childhood
A lack of emotional awareness
Inadequate emotional development or supportive relationship during childhood, usually as a result of parental neglect

What are the risk factors for SSD?

Some factors that can increase the risk of developing somatic symptom disorder include:

Neglect during childhood
History of physical and sexual abuse
Substance use disorder
Heightened attention or response to physical sensations or bodily symptoms
Alcohol use disorder
A stressful lifestyle
History of trauma
Chronic medical illness during childhood
Pre-existing mental health conditions, such as anxiety and depression
Preexisting personality disorders, including paranoid personality disorder, avoidant personality disorder, or obsessive-compulsive personality disorder.

How common is somatic symptom disorder?

Somatic symptom disorder is becoming increasingly common in adolescents and young adults. These mental health disorders are estimated to affect nearly 5% to 7% of the adult population and usually develop by the age of 30 years. However, in rare cases, somatic symptom disorder can occur in children. Somatic symptom disorder typically occurs more in women than men.

Diagnosis of somatic symptom disorder

Your physician will perform a complete physical and medical evaluation and order some laboratory tests to rule out possible conditions or related disorders that could be responsible for your bodily symptoms. Your healthcare provider will also ask you about your personal and family medical history.

If test results are normal, suggesting that you do not have a medical disorder or that your medical condition does not match the severity of your physical symptoms, the healthcare provider might consider psychological factors and may choose to refer you to mental health care professionals for further assessment.

A mental health provider will be able to help confirm the diagnosis of somatoform disorders, such as somatic symptom disorder, through cognitive behavior therapy, where they will evaluate the presence of disproportionate and persistent thoughts and preoccupation with physical symptoms.

The diagnosis of SSD is suspected when the patient has one or more symptoms that cause immense distress or disrupt their daily life for at least six months. The patient must also have excessive feelings, behaviors, and thoughts about the physical symptoms that meet at least one of the criteria mentioned below:

Continuously high level of anxiety about physical symptoms or associated health concerns
Long-lasting and overly excessive thoughts about the intensity and seriousness of physical symptoms
Excessive time and energy spent on managing physical symptoms and other health concerns
Difficulty accepting that their concerns are exaggerated or not the result of a serious disease

Treatment of somatic symptom disorder

The goal of the treatment of somatic symptom disorder is to relieve the physical symptoms and behaviors related to somatoform disorders and address the emotional and psychological symptoms through talk therapy (psychotherapy) and cognitive behavior therapy. Some patients with somatic symptom disorder are prescribed psychosomatic medicine, such as antidepressants, to treat underlying depression and anxiety.

Cognitive behavioral therapy (CBT) is an effective form of psychotherapy commonly recommended for patients with SSD or related disorders. This therapy helps people modify their thinking and reactions in order to alter the way they feel or perceive their physical symptoms and physical sensations.

Under the guidance of a mental health provider such as a psychiatrist or psychologist, CBT can help patients cope with health anxiety and stress caused by a somatization disorder more efficiently.

If you are diagnosed with a somatoform disorder like SSD, CBT will help you:

Recognize the factors that seem to make your symptoms worse.
Evaluate your feelings, thoughts, and perceptions about your physical symptoms and general health.
Find safe and effective ways to reduce anxiety and stress through relaxation techniques.
Reduce excessive thoughts and concerns about your physical symptoms.
Go through your daily life with more ease and confidence in your general health.
Find ways to stay socially active, even if you have multiple symptoms.

Your mental health provider might prescribe medications, such as anxiolytic or antidepressant drugs, to help you avoid anxiety and depression. In addition to improving mood, these drugs have also been reported to help ease other symptoms associated with somatic symptom disorder, including pain, weakness, fatigue, and sleep problems.

What is the prognosis for somatic symptom disorder?

Somatic symptom disorder (SSD) is a chronic condition marked by recurrent episodes that come and go for several months to even years.

If left untreated, this condition can disrupt the daily life of the patient, resulting in adverse consequences such as:

Poor work performance
Unemployment or the loss of a job
Limited daily function
Psychological disability
Alcohol and substance use disorders
Reduced quality of life

However, timely diagnosis and proper treatment can relieve the symptoms of SSD, resulting in the improvement or remission of the symptoms. This can allow the patient to lead a healthy and active life.

Somatic Symptom Disorder: Frequently Asked Questions

Is illness anxiety disorder the same as somatic symptom disorder?

No, illness anxiety disorder is a psychological condition in which the patient is preoccupied or excessively anxious about developing an illness. Unlike somatic symptom disorder and other somatoform disorders, patients with illness anxiety disorder usually do not experience severe physical symptoms or physical disorders.

Is conversion disorder the same as somatic symptom disorder?

No, conversion disorder is a functional neurological symptom disorder that affects the functions of the nervous system. This condition causes symptoms similar to mental health disorders that interfere with the physical sensations, perceptions, and mobility of the patient.

People with conversion disorder often experience anxiety and depression. However, experiencing distress about their physical symptoms is not a crucial element for the diagnosis of conversion disorder.

How can I take care of myself if I am diagnosed with SSD?

If you are diagnosed with this somatic symptom disorder, you can take the following steps to support your recovery:

Develop a supportive relationship with your family as well as your primary care provider and mental health provider.
Consult only one primary care provider to avoid unnecessary tests and procedures.
Visit your primary care provider regularly to reevaluate your physical symptoms and assess how you are coping.
See your mental health professional to identify possible risk factors and monitor and manage your psychological symptoms, such as excessive anxiety and worry, as well as associated mental disorders, such as depression.

When should I see my psychiatrist about somatic symptom disorder?

You should see mental health professionals if you feel so worried or anxious about your physical symptoms that you cannot perform simple daily tasks. You should also see a healthcare provider if you develop signs of depression or any medically unexplained symptoms.

What is the best treatment for severe somatic symptom disorder?

Psychotherapy, such as CBT, is one of the best treatments for patients with somatic symptom disorders.

How long do somatic symptoms last?

Somatic symptom disorder, if not treated properly, can persist for several months to years. However, proper treatment by a mental health professional can help a patient recover and avoid the recurrence of symptoms.

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