Somatic Symptom And Related Disorders

As mental health disorders characterized by an intense focus on physical (somatic) symptoms, somatic symptom and related disorders (including somatic symptom disorder) can manifest through physical symptoms, often associated with high levels of distress and functional impairment, even though they don't have a clear biological or medical explanation. The somatic symptoms often lead to significant emotional distress and can significantly impact daily functioning. 

Physical symptoms

Physical symptoms associated with some SSRDs include the following: 

• Chronic pain that persists for months or years, often in multiple areas of the body
• Fatigue and weakness
• Shortness of breath and chest pain
• Gastrointestinal symptoms, including nausea, bloating, and abdominal pain
• Dizziness or fainting
• Neurological symptoms, such as headache, back pain, and numbness or tingling in the limbs

Behavioral symptoms

Below are several behavioral symptoms that may impact people with SSRDs: 

• Seeking frequent medical consultations and multiple healthcare providers
• Relying heavily on medical tests and procedures, even when they are not necessary
• Avoiding physical activity due to fear of damaging the body
• Worrying excessively about possible medical conditions and their implications

Emotional symptoms

Emotional symptoms of SSRDs may include the following: 

• Excessive preoccupation and anxiety about physical symptoms
• Thoughts of helplessness
• Becoming overwhelmed by symptoms
• Becoming easily upset, irritable, or depressed
• Believing one is misunderstood or dismissed by healthcare providers

The presence of physical symptoms without a clear medical cause doesn't mean the symptoms are not real. The physical sensations experienced in somatic symptom and related disorders can cause genuine distress for those affected and may occur when there are problems with the body's communication system. Acknowledging that pain, discomfort, or other physical symptoms can have a psychological origin without being imagined or intentionally faked is often crucial. 

Illness anxiety disorder 

In cases of illness anxiety disorder, which falls under the umbrella of SSRD, individuals might not have physical symptoms but instead have a persistent fear of serious illness despite medical reassurance. They may frequently check their body for signs of illness, obsessively research medical information, or avoid medical appointments due to fear of receiving a serious diagnosis.

Conversion disorder 

Conversion disorder, additionally known as functional neurological symptom disorder, is another condition within the SSRD category. In this condition, individuals often experience real neurological symptoms like paralysis, blindness, or seizures, which a neurological disease cannot explain.

Factitious disorder and factitious disorder imposed on another 

Factitious disorder, another related condition, involves intentionally producing or feigning physical or psychological symptoms, typically to assume the role of a patient and receive attention or care. A recently defined diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, In factitious disorder imposed on another (previously known as Munchausen’s), individuals (often caregivers or parents) intentionally create or make up symptoms in another individual to receive attention, money, support, or other benefits. 

Diagnosing somatic symptom and related disorders

Healthcare providers can approach individuals with SSRDs with empathy and understanding. It can be crucial for the diagnostic process to be thorough and involve ruling out potential medical causes for the symptoms. Treatment often consists of a combination of physical and psychological approaches, addressing the physical symptoms and emotional distress accompanying them.

Somatic symptom and related disorders are complex, and the exact causes are not entirely understood. However, a combination of factors is often involved, including biological, psychological, and environmental influences. While these disorders can affect anyone, certain risk factors may increase an individual's likelihood of developing SSRD.

Biological factors

Below are some of the potential biological factors that could contribute to the development of SSRDs: 

• Genetic predisposition: SSRDs may run in families, indicating a possible genetic component.
• Neurological differences: Changes in brain structure and function could contribute to the development of SSRDs. Some studies have found abnormalities in the brain regions involved in processing pain, emotion, and stress. Reduced gray matter volume in particular brain regions may be linked to SSRD.

Psychological factors

The psychological factors sometimes leading to SSRDs could include: 

• Personality traits: Certain personality traits, such as neuroticism or a tendency to worry excessively, may predispose an individual to SSRDs.
• Coping strategies: Ineffective or maladaptive coping strategies, such as excessive focus on physical sensations, can increase the risk of developing an SSRD.
• Trauma or stress: Past traumatic experiences or ongoing chronic stress can contribute to developing SSRDs. In some cases, physical symptoms may serve to externalize emotional pain.

Environmental factors

Environmental factors that could lead to one of these conditions include the following: 

• Cultural influences: Cultural factors may play a role in the expression of SSRDs. In some cultures, it may be more socially acceptable to express distress through physical symptoms rather than emotional ones.
• Social learning: Observing family members or peers who focus heavily on physical symptoms to cope with stress may increase the risk of developing SSRDs.

Having or experiencing one or more risk factors does not guarantee that an individual will develop SSRDs. In addition, the absence of risk factors does not necessarily prevent the development of these disorders. The interplay between multiple factors is nuanced, and further research is needed to fully understand the underlying mechanisms of SSRD.

The treatment of somatic symptom and related disorders aims to reduce the intensity of physical symptoms, improve daily functioning, and address associated psychological distress. Treatment is often tailored to the individual, considering symptoms' severity, co-occurring mental health conditions, and personal preferences.

Medication

Although SSRD is primarily a psychological disorder, medications may be prescribed to manage specific symptoms or co-occurring conditions. Some medications that may be used include:

• Antidepressants: Antidepressants may be used to treat symptoms related to depression or anxiety, such as low mood or difficulty sleeping. 
• Anxiolytics: These medications may reduce symptoms of anxiety.
• Antipsychotics: For psychotic symptoms such as delusions or hallucinations, antipsychotics may be prescribed. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.

Other treatment options

Some clients with SSRD may benefit from complementary therapies and interventions, such as:

• Physical therapy: Physical therapy may be used for managing pain and improving mobility. 
• Occupational therapy: Occupational therapy may adapt daily activities to reduce symptoms. 
• Biofeedback: Biofeedback can be used when learning to control physiological responses to stress.

Self-care

In addition to professional treatment, self-care strategies can be essential in managing SSRD. Below are strategies that may be helpful to try at home: 

• Stress management: Learning to cope with stress through relaxation techniques, deep breathing, or mindfulness meditation can be helpful. 
• Physical activity: Regular, moderate exercise may reduce symptoms and improve mood. 
• Sleep hygiene: Prioritizing sleep and establishing a healthy sleep routine can reduce symptoms of exhaustion and improve mental well-being. 
• Healthy diet: Consuming a balanced and nutritious diet may help individuals manage symptoms and support overall health. 
• Support networks: Connecting with friends, family, or support groups for emotional support can be a way to cope with daily life. 

Individuals with SSRD can work closely with their healthcare providers to develop a comprehensive and personalized treatment plan. By addressing physical and psychological factors, individuals with SSRD may experience fewer excessive thoughts, feelings, and symptoms that cause anxiety. 

For those experiencing somatic symptom and related disorders, therapy can be crucial to improving daily functioning and addressing associated psychological distress. Online therapy platforms, like BetterHelp, offer convenient, and support for individuals managing SSRD. With licensed therapists experienced in treating SSRD, online platforms allow you to connect with a mental health professional from the comfort of your home at a time that suits you. You may find personalized treatment plans, resources for managing SSRD symptoms, and tailored strategies to help you improve your mental health. 

Beyond online therapy, there are various resources available for individuals living with SSRD, including but not limited to the following: 

• Medline Plus, a service of the US National Library of Medicine, provides comprehensive information about SSRDs, including diagnosis and treatment.
• The National Institute of Mental Health (NIMH) provides reliable information on SSRDs, including symptoms, causes, and treatment options.
• The American Psychiatric Association and Mental Health America offer comprehensive information on SSRDs, support resources, and tools for finding a healthcare professional.

Some people may find connecting with others who share similar experiences with somatic symptom disorder helpful. Support groups, both in-person and online, offer a space to share your story, learn from others, and gain encouragement and emotional support. Local organizations in your area may offer support groups for individuals with SSRDs. Additionally, online forums and social media groups are often available to individuals who cannot attend in-person meetings, which may be especially useful in times when a person feels extreme or exaggerated anxiety about physical symptoms, or when the physical pain and symptoms a person feels from psychological factors (such as weakness or paralysis) are particularly disruptive. 

By utilizing these resources and seeking professional support, individuals with SSRDs may gain valuable knowledge and tools to improve their quality of life and reduce the severity of symptoms. 

Please see our Get Help Now page for more immediate resources.

Recent research into somatic symptom and related disorders (SSRD) provides fresh insights into how physical symptoms intersect with mental health and the role that various treatments can play in managing these complex conditions. 

One study in primary care environments found that among individuals diagnosed with major depression, over 70% primarily presented with somatic complaints rather than the more commonly recognized emotional symptoms of depression. This study suggested that investigating recent life changes or losses and conducting assessments for deep-seated mood symptoms, such as a lack of interest or thoughts of worthlessness, could provide valuable information regarding the genesis of SSRDs. 

In terms of treatment, cognitive-behavioral therapy is increasingly being recognized as a viable approach for SSRDs. A recent study reinforced the value of CBT in treating SSRDs, demonstrating that this form of therapy can effectively alleviate symptoms regardless of the treatment setting. This research indicated that clients who underwent CBT experienced marked reductions in discomfort, anxiety, and depression and improved their ability to cope with pain. Furthermore, increased school attendance rates were observed among younger patients post-treatment with CBT. The benefits of CBT extended beyond the immediate treatment period, with clients experiencing lasting improvements in quality of life and social interactions.

These studies emphasize the benefit of a comprehensive approach to SSRD treatment that encompasses both physical and mental health considerations and underscore the potential of CBT as a long-term, effective treatment option.

Below are several statistics on somatic symptom and related disorders:

• An estimated 5% to 7% of the general population is affected by somatic symptom disorder (SSD), one of the several SSRDs listed in the DSM-V. 
• The female-to-male ratio in somatic symptom disorder is approximately 10:1, indicating that women are more likely to be affected by the disorder. 
• Studies tracking the progression of SSRDs over time have found that approximately 90% of these disorders persist for more than five years.
• After undergoing cognitive-behavioral therapy, 23% of individuals with somatic symptom disorder experienced a reduction of at least 50% in somatic symptoms immediately after treatment, and this figure increased to 27% at a later follow-up. Additionally, around 70% of patients achieved a clinically significant improvement in their symptoms.

These statistics highlight the prevalence of SSRDs and the potential benefits of seeking treatment for these conditions. To address the needs of this population, mental health professionals can be aware of the latest research and have a comprehensive understanding of SSRD diagnosis and treatment.