Definition Of Somatization And How It Impacts Your Mental Health
Updated August 28, 2020
Medically Reviewed By: Wendy Boring-Bray, DBH, LPC
Are you dealing with physical symptoms that won’t seem to go away, no matter what you or your doctor tries? If so, there might be something else going on with you. Your problem might be explained by a term called somatization. Here’s a definition of somatization and what it has to do with your mental health.
The Meriam-Webster Dictionary gives the medical definition of somatization as “ conversion of a mental state (such as depression or anxiety) into physical symptoms.”
Its second definition is “the existence of physical bodily complaints in the absence of a known medical condition.” However, this definition is changing. With the advent of the fifth edition of the Diagnostic and Statistical Manual used by psychiatrists and psychologists, a new understanding is beginning to emerge.
Somatic Symptom Disorder
Before the DSM-V came out, the assumption was that somatization should only refer to having symptoms that appeared to be physical but couldn’t be explained that way. This somatization definition came with the implicit view that the mind and body are separate. It also seemed to indicate that somatization conversion was a transformation of mental problems into bodily symptoms. It encouraged a belief that if medical problems couldn’t explain a symptom, then it was purely a mental disorder.
However, the DSM-V gave somatization conversion a new name: somatic symptom disorder. Along with the new name came a new concept and a new way of addressing somatization. The new medical definition of somatization, or somatic symptom disorder, says that people have bodily symptoms that cause them distress and life disruption. Also, it says that people who have somatic symptom disorder have thoughts, feelings, and behaviors that are excessive or disproportionate to the severity of their medical condition.
So, what does this mean to you? If you have bodily symptoms that no one can figure out, it may not be that you don’t have any medical problems at all. Instead, it might be that you do have some medical issues, but you think about them, feel upset about them, and change what you do more than you need to, given the mildness of your medical condition.
How Doctors Diagnose Somatic Symptom Disorder
Usually, it’s a primary care doctor rather than a psychiatrist who first discovers that someone has somatic symptom disorder (SSD). The first thing you need to know is that a doctor won’t give you this diagnosis just because they can’t find the source of your bodily symptoms. Instead, they will consider whether you meet the diagnostic criteria from the DSM-V, which are described by the American Psychiatric Association.
- You have one or more bodily symptoms that are distressing to you or cause disruption in your daily life.
- You have excessive thoughts, feelings, or behaviors about physical symptoms or health concerns, including one or more of the following:
- continuing thoughts that are excessive considering the seriousness of the symptoms you’re experiencing
- a high level of ongoing anxiety about bodily symptoms or overall health
- spending an excessive amount of time and energy on physical symptoms and concerns about health
- One of these symptoms never goes away, you may have one or more of these symptoms, and some signs may come and go.
Again, the definition of somatization doesn’t stop with the idea that you have bodily symptoms. It doesn’t even end with the fact that your doctor doesn’t know why you’re having physical symptoms. Instead, what’s important is that you’re experiencing and responding to them excessively.
People usually first show signs of somatic symptom disorder before the age of 30. However, that isn’t always the case. So, your doctor might consider your age, but they won’t ignore your condition just because your age is different or automatically assume you have it just because you’re thirty or younger.
Another part of the definition is that someone with SSD is not making up or intentionally exaggerating physical symptoms. There’s no attempt to fraudulently get the doctor to give them a diagnosis or prescribe a medication they want. Somatization isn’t your fault. But getting psychological help is something you can do to overcome it.
How Somatization Impacts Your Mental Health
When you’re experiencing somatization, you might have the mental health issue known now as somatic symptom disorder. At the same time, the disorder can cause additional effects on your mental health. Here are some of the ways it can change your life.
Excessive Doctor Visits
If you believe you have a severe medical condition that your doctor doesn’t recognize, you might go from one doctor to another doctor to find someone who has an answer. And, it’s natural to want to know why you’re feeling unwell. But if you can’t find a purely medical reason for your symptoms, it might be better to talk to a psychologist about it before you go on an endless quest for a medical diagnosis. Seeing so many doctors takes a lot of time and energy, it puts your focus entirely on your health, and it keeps you from enjoying your life.
Increasing Worry and Anxiety
Extreme anxiety may be a part of the reason behind your somatization. Beyond that, as you focus on your physical health, you may become even more anxious and worried about your medical condition. You may worry that your symptoms will last forever, getting worse and worse day after day. If you had anxiety before, or even if you never noticed it before the medical symptoms, your anxiety level may increase over time.
Depression is another mental disorder that can sometimes be present before somatization symptoms begin. And the depression can not only last but also increase after SSD begins. Because you’re concentrating so heavily on negative thoughts about your health, you may start seeing depression symptoms increase, or you might start seeing them for the first time.
Social and Relationship Issues
When you’re always concerned about your physical health, you might have trouble connecting with others. It’s hard to have fun or nurture a close relationship when all your thoughts center around your bodily symptoms. At times, your loved ones might be as concerned as you are. But at other times, they may become angry or resentful because the entire relationship seems to center around you. Even social gatherings may be difficult for you when you’re more concerned about your health than what’s happening at the event.
Problems at Work
Dealing with somatization can also affect how you perform and interact in your job. Because your worries and health-focused behaviors take so much time and energy, you have less of both to give to your work. You might find yourself leaving early or even taking whole days off when you don’t need to if your concerns about your mental health are too exaggerated. And problems at work can also cause problems with your mental health. Clashes with your boss or coworkers over your poor performance and attendance can cause increased emotional distress. And, as you have fewer successes at work, your self-esteem may plummet.
Treatment for Somatic Symptom Disorder
So, what can you do if you think you might be experiencing somatization? Somatic symptom disorder can be addressed with a combination of medical, psychiatric, and psychological treatments. It’s essential to have your primary care doctor, your therapist, and your psychiatrist (if you see one) all working together and on the same page when it comes to your physical and mental health.
The medical part of the equation starts with having a primary care doctor who you trust and who is willing to work with you to resolve this issue. They should be caring, supportive, and ready to consider that your problems might be a combination of medical and mental issues. When you see them, they should do whatever is necessary to take care of your physical wellbeing. They can reassure you and help you avoid tests that aren’t necessary. And, if they do tests, they can share them with you and explain how they do or don’t show medical problems.
You might or might not see a psychiatrist for help with somatization. A psychiatrist can prescribe medications if you need them for mental disorders like depression or anxiety. Antidepressants may help you deal with the symptoms of depression and feel less negative about your health. Anti-anxiety medications can ease your worry and fearfulness so that you can be more relaxed about your physical health. Both kinds of medications can help you shift your attention from your bodily complaints to more helpful, productive, and satisfying thoughts.
A therapist can help you with a variety of psychological treatments and techniques. The goal is to help you change the way you think and behave so you can deal with all your symptoms, whether medical or psychological. Another goal is to help you function better in your daily life.
One 2018 study – the first study exploring treatments for somatic symptom disorder using the DSM-V definition of somatization, found three types of therapy beneficial for people with SSD. One was bibliotherapy, which is the use of books for treatment. The other two types of treatment were both exposure-based cognitive behavioral therapy, one guided by a therapist, and one unguided. All three types of treatment showed significant results in treating people with SSD effectively.
Cognitive-behavioral therapy is a technique in which you learn to identify negative thoughts, evaluate how helpful they are, and change your thoughts and behaviors if it will be more helpful to do so. Exposure-based CBT uses this technique during a process in which you’re exposed systematically to the things you fear.
Learning the definition of somatization is an excellent first step to becoming mentally healthier. If you think you might need help with this mental health issue, the next step is getting a diagnosis and treatment. Many people like to start with their primary care doctor and get a referral to a psychiatrist or psychologist who can make the diagnosis and begin treatment.
You can also get psychotherapy for somatization by speaking with a counselor at BetterHelp. At BetterHelp, you can get therapy with a licensed counselor at a time that’s convenient for you and from whatever location you choose. By dealing with your mental health problems, you can develop a better attitude toward your physical health and learn to enjoy life more.