Somatic Symptom Disorder: An in-depth guide to this illness
Ever felt that that migraine was a tumor forming in your brain? Well, if you have somatic symptom disorder, that’s exactly how it is! In this article, we will cover: what is somatic symptom disorder? What is it’s symptoms, causes, and treatments? What are the diagnosis and misdiagnosis? What are some ways to prevent SSD?
What is somatic symptom disorder?
Somatic symptom disorder (SSD) involves having a serious focus on physical symptoms, like fatigue or pain, to the point that it causes other problems or emotional distress. Essentially, they have intense thoughts, behaviors, and feelings that interfere with everyday life. It’s similar to an anxiety disorder.
Formerly called somatoform disorder, and also known as hypochondriasis (now an outdated term), somatoform disorders, briquet’s syndrome and illness anxiety disorder, it can also be defined as any mental disorder that appears in the form of physical symptoms that suggest an injury or an illness, but that don’t need to be explained by a general medical condition or substance, nor is it connected to another medical disorder.
For example, someone who had an operation without any complications may be concerned about the physical sensations after the surgery leaving them impaired or disabled. It is generally a chronic condition.
The pathophysiology, the psychological process of injury or disease, of somatic symptom disorder is actually unknown. The primary symptoms can be considered a heightened awareness of normal bodily sensations. This heightened awareness can be paired with a cognitive influence that interprets any physical symptom as proof of a medical illness. Some brain imaging studies have shown that there is an association between one or more of the somatic symptom disorders, with a reduced volume in the amygdala and a connection between the amygdala and the regions of the brain that control the executive and motor functions.
Somatic symptom disorder in the United States, according to a community sample study, affects only about 0.1% of the U.S. population. Medical studies have suggested that women with somatic symptom disorder in the United States make up about 2% of the U.S. female population. However, other studies have said that there is a broader and looser version of somatic symptom disorder that makes up 11.6% of the United States population. Clinical trials have looked at the amount of Americans affected by hypochondriasis (4-6%), body dysmorphic disorder (2%), conversion disorder (5-15%).
On an international level, according to a Belgian study, somatic symptom disorder is the third most commonly occurring psychiatric disorder in the word with 8.9% of the population affected. Depression and anxiety disorders ranked the top two psychiatric disorders. Another European study estimated the cost of the population having somatic symptom disorders throughout Europe to be around 22 billion Euros a year. That price equals how much it costs annually with multiple sclerosis, traumatic brain injuries, or Parkinson’s disease.
Somatic symptom disorder doesn’t seem to increase the risk of death on its own. However, there is evidence that suggests that it is associated with increased suicide attempts. This is due to the fact that some people who have been diagnosed with somatic symptom disorder have been misdiagnosed and experience iatrogenic complications due to surgical operations or invasive procedures due to the diagnosis.
In terms of sex and age statistics, the female: male ratio is 10:1. Females have a higher prevalence than males. In terms of age, symptoms can begin whenever- childhood, adolescence, or adulthood. However, the majority of people begin to show symptoms before the age of 30.
Symptoms of somatic symptom disorder
People who suffer from somatic symptom disorder spend a great amount of their time and energy thinking and worrying about their symptoms. Common symptoms can vary from mild to severe and can include:
- Pain (in a specific area)
- Shortness of breath
How people can feel and react to the symptoms of somatic symptom disorder can vary. However, they can only be diagnosed with it if the symptoms persist for six months or more. Furthermore, they may:
- Be concerned that mild symptoms are a disease. For example, thinking your migraine means you have a brain tumor.
- Feel serious and extreme anxiety about any symptoms.
- Go to the doctor more than once and not believe the results.
- Spend a lot of time and energy dealing with health concerns.
- They may have trouble with their thoughts, concerns, feelings, and behaviors about their symptoms.
Causes of somatic symptom disorder
There are multiple factors that can cause somatic symptom disorder.
- Major stress in life
- People who have a negative outlook on life
- Negative personality
- A family history of somatic symptom disorder
- People who are highly sensitive to pain
- History of alcohol or substance abuse
- History of physical or sexual abuse.
Diagnosis of somatic symptom disorder
Somatic symptom disorder is characterized by the way that you feel and behave in relation to your physical sensations, not in the sensations themselves. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classified somatic symptom disorder as a disorder in 2013. The DSM-5 got rid of the diagnosis of somatization disorder, undifferentiated somatoform disorder, hypochondriasis, and pain disorder. The majority of the patients that were diagnosed with these disorders are now officially diagnosed, according to DSM-5, with somatic symptom disorder.
In order to diagnose somatic symptom disorder, there are criteria according to the DSM-5:
- Having one or more symptoms that are distressing or that cause disruption in everyday life
- At least one symptom is constantly present, usually more than six months.
- Having excessive thoughts, behaviors, or feelings that are related to the somatic symptoms in at least one of the following:
- Disproportionate and ongoing thoughts about how serious the symptoms are
- Continued high level of anxiety about the symptoms or health in general
- Spending an excessive amount of time and energy on the symptoms and health
Misdiagnosis of somatic symptom disorder
A large issue that comes up when diagnosing someone with somatic symptom disorder is that it is so vague that it will be misdiagnosed in 1 in 6 people with heart disease or cancer, 1 in 4 with irritable bowel syndrome and fibromyalgia, and 1 in 14 people who are not actually medically ill.
Somatic symptom disorder vs Illness Anxiety Disorder
What is the difference between a coffee mug and a coffee cup? They’re not the same, but they are closely related. The same idea goes for SSD and Illness Anxiety Disorder (IAD). They are two closely related medical conditions that are easily mixed up. Illness Anxiety Disorder is simply the anxiety that comes with worrying about one’s health and symptoms. Essentially, they are overly worried about having or getting a disease. For example, they may think that normal bodily processes like sweating or awareness of their own heartbeat as a sign of illness. SSD involves being overly worried about already existing symptoms. However, both SSD and IAD are disruptive to everyday life.
Somatic symptom disorder vs conversion disorder
Like the coffee mug vs coffee cup, SSD and conversion disorder stem are closely related. However, conversion disorder stems from SSD. While SSD involves an extreme anxiety to symptoms, conversion disorder is much less common and involves such an anxiety that the “symptoms” actually convert themselves into reality. Essentially, it’s the genuine loss of a bodily function due to excessive anxiety. Some examples involve blindness, paralysis, and numbness. These reactions represent fixed ideas about the neurological malfunction that “come to life,” so to speak. This “coming to life” results in psychogenic and neurologic deficits.
Treatment of conversion disorder is lengthy and rather complex. One treatment of conversion disorder is narco analysis. Essentially, a truth serum.
Treatments for somatic symptom disorder
Being multifaceted, everybody is treated on an individual basis for somatic symptom disorder. Treatments include medication and psychology, among other things.
Medical treatments could include:
- Antidepressants to address underlying anxiety and depression
Psychological treatments could include:
- Establishing a strong relationship with the caregiver
- Cognitive Behavioral Therapy
- Mindfulness-based therapy
Other treatments include:
- Scheduling regular doctors visits, both medical and psychological, to be sure that other medical diseases are ruled out.
- It is advised to only have one doctor.
If not treated, somatic symptom disorder can lead to:
- Trouble functioning in everyday life
- Problems with friends, family, and at work
- Poor and worsened health
- Money problems due to constant doctor visits and tests
- An increased risk for depression and suicide
What to do if you have a loved one with somatic symptom disorder
It’s important to remember that someone who has somatic symptom disorder isn’t faking their symptoms; they truly feel the pain and other medical problems. Be sure to treat the symptoms legitimately. Encourage your loved one to consider going to a mental health expert to learn ways to cope with the reaction to these symptoms and any disability the symptoms cause. The disability caused may also lead to your loved one being dependent, needing extra physical care, and emotional support.
Tips to prevent somatic symptom disorder
- If you know you are prone to somatic symptom disorder, counseling is a good option to help prevent.
- If you have any issues with anxiety or depression, contact a medical professional
- Understand how stress affects you and your body. Practicing relaxation and stress management techniques like meditation can help.
- Stick with your treatment plan to prevent a relapse.
Let us know what you think in the comments!
Anna is a freelance writer who is passionate about translation, psychology, and how the world works.