ENGAGED SUPPORT SERVICES EDUCATION/INFORMATION
Information taken from the Mayo Clinic, Australian Psychological Society and other reliable sources, for education of staff and family members - 2024
Somatic Disorder
What is somatic symptom disorder?
Somatic symptom disorder (SSD) is a mental health condition in which a person feels significantly distressed about physical symptoms and has abnormal thoughts, feelings and behaviors in response to them. The disorder disrupts their daily functioning and quality of life. Although a person with somatic symptom disorder reports symptoms, the symptoms may have no medical explanation or be normal body sensations or discomfort. Even when there’s a medical cause, the person’s worry is out of proportion to the symptom. People with somatic symptom disorder are often unaware of their underlying mental health condition and believe that they have serious physical ailments. The distress often causes them to visit multiple healthcare providers and to have many medical tests and unnecessary procedures.
First Person Perspective:
You often think the worst about your symptoms and frequently seek medical care, continuing to search for an explanation even when other serious conditions have been excluded. Health concerns may become such a central focus of your life that it's hard to function, sometimes leading to disability. If you have somatic symptom disorder, you may experience significant emotional and physical distress. Treatment can help ease symptoms, help you cope and improve your quality of life. Somatic Disorder is part of a group of disorders known as Somatoform Disorders:
Who does somatic symptom disorder affect?
Somatic symptom disorder can occur in children, adolescents and adults, and it usually begins by age 30.
People assigned female at birth (AFAB) are 10 times more likely to have somatic symptom disorder than people assigned male at birth (AMAB).
How common is somatic symptom disorder?
Somatic symptom disorder is somewhat common and occurs in about 5% to 7% of the adult population.
Symptoms
Symptoms of somatic symptom disorder may be:
• 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 sensations 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 health care 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
• For somatic symptom disorder, more important than the specific physical symptoms you experience is the way you interpret and react to the symptoms and how they impact your daily life.
When to see a doctor
Because physical symptoms can be related to medical problems, it's important to be evaluated by your primary care provider if you aren't sure what's causing your symptoms. If your primary care provider believes that you may have somatic symptom disorder, he or she can refer you to a mental health professional.
Caring for a loved one
When physical symptoms considered to be somatic symptom disorder occur, it can be difficult to accept that a life-threatening illness has been eliminated as the cause. Symptoms cause very real distress for the person and reassurance isn't always helpful. Encourage your loved one to consider the possibility of a mental health referral to learn ways to cope with the reaction to symptoms and any disability it causes.
Physical disability may cause the person to be dependent and need extra physical care and emotional support that can exhaust caregivers and cause stress on families and relationships. If you feel overwhelmed by your role as caregiver, you may want to talk to a mental health professional to address your own needs.
Causes
The exact cause of somatic symptom disorder isn't clear, but any of these factors may play a role:
Genetic and biological factors, such as an increased sensitivity to pain
Family influence, which may be genetic or environmental, or both
Personality trait of negativity, which can impact how you identify and perceive illness and bodily symptoms
Decreased awareness of or problems processing emotions, causing physical symptoms to become the focus rather than the emotional issues
Learned behavior — for example, the attention or other benefits gained from having an illness; or "pain behaviors" in response to symptoms, such as excessive avoidance of activity, which can increase your level of disability
Childhood physical and sexual abuse.
Poor awareness of emotions or emotional development during childhood. This can be the result of parental neglect or a lack of emotional closeness.
Excessive anxiety and attention to bodily processes and possible signs of illness.
Risk factors
Risk factors for somatic symptom disorder include:
Having anxiety or depression
Having a medical condition or recovering from one
Being at risk of developing a medical condition, such as having a strong family history of a disease
Experiencing stressful life events, trauma or violence
Having experienced past trauma, such as childhood sexual abuse
Having a lower level of education and socio-economic status Complications Somatic symptom disorder can be associated with:
Poor health
Problems functioning in daily life, including physical disability
Problems with relationships
Problems at work or unemployment
Other mental health disorders, such as anxiety, depression and personality disorders
Increased suicide risk related to depression
Financial problems due to excessive health care visits
Management and Treatment
How is somatic symptom disorder treated?
The goal of treating somatic symptom disorder is to manage physical symptoms, as well as psychological symptoms using psychotherapy (talk therapy) and sometimes medications that treat underlying anxiety and depression.
Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps people learn ways to change their patterns of thinking or behaviour in order to change the way they feel. Under the guidance of a mental health professional (typically a Psychiatrist or Psychologist), CBT helps people better cope with anxiety and stress and respond to situations more effectively.
If you have somatic symptom disorder, CBT can help you:
Evaluate your feelings and beliefs about your physical symptoms and health in general.
Find ways to reduce stress and anxiety about your symptoms.
Stop focusing as much on your physical symptoms.
Recognize what seems to make your physical symptoms worse.
Find ways to stay active and social, even if you still have pain or other symptoms.
Function better in your daily life.
Your healthcare provider may prescribe medication, such as an antidepressant. In addition to helping mood, antidepressants have been reported to help ease such symptoms as pain, fatigue, pain in joints and sleep problems.
Prevention
Little is known about how to prevent somatic symptom disorder. However, these recommendations may help.
If you have problems with anxiety or depression, seek professional help as soon as possible.
Learn to recognize when you're stressed and how this affects your body — and regularly practice stress management and relaxation techniques.
If you think you have somatic symptom disorder, get treatment early to help stop symptoms from getting worse and impairing your quality of life.
Stick with your treatment plan to help prevent relapses or worsening of symptoms.
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