Somatic symptom disorder is when you worry about and focus on your physical health to a degree that it impacts your daily life. You may also think minor health problems or normal body functions are symptoms of a serious medical problem. For example, you may be sure that your headaches are caused by a brain tumor or your stomach pain is cancer. This condition used to be called hypochondria.
What Are the Features of Somatic Symptom Disorder?
People with somatic symptom disorder are worried about having a physical illness. The symptoms can range from general complaints, such as pain or tiredness, to concerns about normal body functions, such as breathing or stomach noises. If you have this, you are not faking or lying about your symptoms; you truly believe you are sick. Or, if you do have an actual physical illness, your level of worry and distress is out of proportion to what would normally be expected for the condition.
Somatic symptoms disorder can happen at any time in your life, but it usually begins in early adulthood, showing up by age 30. It happens in about 5%-7% of adults, and females are 10 times more likely to have somatic symptom disorder than males.
Symptoms of somatic symptom disorder
Warning signs that you might have this condition include:
- A history of going to many doctors or "shopping around" to get a diagnosis
- Being overly concerned about a specific organ or body system, such as the heart or the digestive system
- The symptoms or area of concern might shift or change.
- A doctor's reassurance does not calm your fears; you believe the doctor is wrong or made a mistake.
- Concern about the illness that is so extreme, it interferes with work, family, and social life
- Having anxiety, nervousness, and/or depression
- Physical symptoms like pain, weakness, or fatigue
- Symptoms or impairment that are more intense than expected for a health condition you have
- Constantly checking your body for anything abnormal
- Worry that physical activity will harm you
- Not responding to medical treatment
What Causes Somatic Symptom Disorder?
The exact cause of somatic symptom disorder is not known, but several things might be involved in the development of the condition.
History of abuse
If you've had trauma or abuse as a child, those acts can sometimes cause you to feel physical sensations differently or more intensely than expected as an adult.
History of serious childhood illness
Having a serious illness in childhood may make you more aware, and fearful, of symptoms you have in adulthood.
Emotional challenges
If you have problems processing emotions, it may make you more likely than others to focus on physical issues instead of emotional problems. If you tend to focus on negativity, that may impact the way you think of pain and illness.
Family history
If you have a parent or close relative with the disorder, you might have learned to be overly concerned about your health or overreact even to minor illnesses as a child. If a relative has the condition, you may be more likely to get it because of your genes. You may also have inherited a higher sensitivity to pain.
Learned behavior
If you have often received attention or benefits from having an illness, that could encourage you to focus on the condition. Pain behaviors, like avoiding activity out of fear that it will make symptoms worse, may actually make the condition worse.
Risk factors for having somatic symptom disorder include:
- A recent loss, trauma, or stressful event
- Having depression or anxiety
- Recently recovering from an illness
- Being at risk for an illness, like cancer, because of a family history of the condition
- Having a low socioeconomic status or education level
How Is Somatic Symptom Disorder Diagnosed?
Diagnosing somatic symptom disorder can be very difficult, because it really feels like your symptoms and feelings of distress are caused by a medical illness. Your doctor will give you a physical exam and psychological testing to diagnose the condition.
Physical exam
When your symptoms appear, the doctor will begin their evaluation with a complete history and physical exam. They will do tests necessary to find out if you have a condition related to your symptoms. If the exam and testing are negative, and the symptoms are still there, your doctor may screen you for somatic symptom disorder.
Psychological exam
If a physical illness is ruled out as the cause of your symptoms, your doctor will do a screening test. They will test to see if you are in pain, if the symptoms have lasted longer than 6 months, and if your condition is mild, moderate, or severe. The doctor will use a questionnaire that asks if you have symptoms like:
- Fainting or dizziness
- Pain in areas like the back, chest, or joints
- Stomach pain or bowel issues
- Trouble sleeping
- Headaches
- Low energy or abnormal tiredness
If your doctor thinks you need to see a specialist, they may suggest you get care from a psychiatrist or psychologist, health care professionals trained to diagnose and treat mental illnesses. These doctors can confirm the diagnosis and help you get the care you need to relieve your symptoms.
How Is Somatic Symptom Disorder Treated?
A main goal of somatic symptom disorder treatment is to help patients live and function as normally as possible, even if they continue to have symptoms. Treatment also aims to alter the thinking and behavior that lead to the symptoms.
The disorder can be very difficult to treat. This is partly because people who have it refuse to believe their symptoms and distress are the result of mental or emotional rather than physical causes.
Treatment for somatic symptom disorder most often includes a combination of options.
Supportive care
In most cases, the best course of action is for you to stay in regular contact with a trusted doctor. Within this doctor-patient relationship, they can monitor your symptoms and stay alert to any changes that might signal a real medical illness. The doctor's main approach is likely to focus on reassuring and supporting you and preventing unnecessary tests and treatments. But it might be necessary to treat some of the symptoms, such as severe pain. It's best to work with one doctor you trust instead of going to different doctors and emergency rooms. This will help you have more consistent care and avoid repeated testing.
Lifestyle changes
Somatic symptom disorder often comes along with depression, anxiety, and stress. For this reason, it may be helpful to try stress-reducing activities like yoga, meditation, or other stress management activities that work for you.
Exercise has also been shown to help improve mood and reduce stress. Talk to your doctor about starting an exercise program that will work for you. You can probably exercise even if you have some symptoms.
It's also important to keep your social connections during treatment. Unless you are dealing with severe pain or disability, make sure to be involved in work, family, and social activities that you enjoy.
Finally, it's best to avoid using alcohol and recreational drugs while you are getting treatment. If you think you may have an issue with these substances, talk to your doctor about ways to quit.
Antidepressant or anti-anxiety drugs are sometimes used if a person with somatic symptom disorder also has a mood disorder or anxiety disorder. You may have to try more than one medication, or combine some to find what works best for you. It can take weeks to see the full effect of a new antidepressant, so stay on your treatment unless your doctor tells you to quit.
Psychotherapy (a type of counseling), particularly cognitive behavioral therapy, can help change the thinking and behaviors that contribute to the symptoms. Talk therapy also can help you learn better ways to deal with stress and improve social and work functioning. Even if you feel that your symptoms aren't caused by emotional issues, therapy may be a good option to help you:
- Cope with your symptoms
- Analyze your expectations about your health
- Spend less time worrying about your symptoms
- Take part in social activities
What Complications Are Linked to Somatic Symptom Disorder?
If you have somatic symptom disorder, it probably affects many areas of your life. You will likely have repeated episodes of symptoms over time. Other complications that you may have include:
Repeated testing. You may have reactions or health problems related to multiple tests, procedures, and treatments. In addition to the pain and frustration this disorder often causes you and your family, repeated episodes also can lead to high medical bills because of all of the tests and doctor appointments.
Social challenges. Your symptoms may cause you trouble functioning in daily life. The condition may also make it difficult to maintain relationships or cause problems at work.
Other medical problems. Medical problems not related to your somatic symptom disorder can be missed if you have a long history of having tests with negative results. Your doctor may be more likely to assume your other complaints are caused by this condition instead of another illness.
Mental health disorders. If you have somatic symptom disorder, you are more likely to have other mental health conditions, like depression and anxiety. You are also at a higher risk of suicide related to your depression.
What Is the Outlook for People With Somatic Symptom Disorder?
This disorder tends to be a chronic (long-term) condition that can last for years. Symptoms often come and go over time. Between 50% and 75% of people with the condition have an improvement of symptoms when treated. You are more likely to have better outcomes if you are in better health when you are diagnosed. Also, keep in touch with your doctor, go to all of your doctor appointments, and avoid unnecessary tests and treatments.
Can Somatic Symptom Disorder Be Prevented?
There is no known way to prevent somatic symptom disorder. But there are a few things that can help maintain your quality of life and reduce any disability you have from the condition.
If you have depression or anxiety, talk to your doctor about treatment options. If you are diagnosed with somatic symptom disorder, get treated early and stick with the treatment your doctor recommends.
It can also help to be aware of times when you are under stress and how it affects your body. If you are feeling stressed, use stress management techniques that work for you. This may help you manage symptoms.
Somatic Symptom Disorder Takeaways
Though you don't have a physical illness, the symptoms of somatic symptom disorder can seem very real. There is no way to prevent it from happening, but if you know the risks, you may be able to seek help early and improve your outcomes. Somatic symptom disorder can cause challenges with loved ones, work, and friends. Seeking mental health treatment is the best way to manage, and sometimes completely get rid of, symptoms.
Somatic Symptom Disorder FAQs
How do you live with someone with somatic symptom disorder? Though your loved on doesn't have a serious physical illness, their symptoms feel very real to them. Be supportive, and it's a good idea to encourage them to seek mental health treatment. If you are struggling with the extra care this person needs, it may be a good idea to talk to a therapist to help you feel better, too.
What is the difference between somatic symptom disorder and illness anxiety disorder? They are similar conditions and have also been called hypochondria and hypochondriasis. With illness anxiety disorder, you don't have symptoms but are constantly worried about getting sick. You might check yourself regularly for any illness and even take extreme measures not to get ill. Another similar condition is known as conversion disorder. The main differences are that you may not always be worried about your symptoms with conversion disorder. And symptoms are often related to the brain, like seizures, paralysis, and dulled senses (like sight or hearing).