Definition Of Somatization And How It Impacts Your Mental Health

Medically reviewed by April Justice, LICSW
Updated May 3, 2024by BetterHelp Editorial Team

Are you dealing with physical symptoms that neither you nor your doctor can find the root cause of?  If so, it’s possible that you are dealing with a physical expression of stress, known as somatization. The term somatization usually refers to a physical expression of stress or other negative emotions that are due to the connection between your mind and your body. 

Define somatization

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Is your physical health impacting your mental health?

Soma is a Greek word that means body. According to Merriam-Webster, the medical definition of somatization is “conversion of a mental state (such as depression or anxiety) into physical symptoms.” This is followed by the second definition of somatization: “the existence of physical bodily complaints in the absence of a known medical condition.” However, 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 release of the DSM-V, it was believed that somatization referred only to physical symptoms that couldn’t be explained in a physical manner. The previous definition of somatization implied that the mind and body are separate and seemed to indicate that somatization conversion was a transformation of mental problems into bodily symptoms. Additionally, it encouraged the 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. The new definition of somatization, or somatic symptom disorder, states that people have bodily symptoms that cause them distress and disrupt their lives. These symptoms can include things like chronic pain, nausea, fatigue, stomach aches, and more. Those with somatic symptom disorder may also have thoughts, feelings, and behaviors that are excessive or disproportionate to the severity of their medical condition.

Another condition where somatization occurs is conversion disorder (functional neurological symptom disorder). In this condition, there are more neurological symptoms that affect motor or sensory function, like dizziness, paralysis, abnormal movements, memory loss, speech difficulties, and other sensory function symptoms. Factitious disorder is another condition related to somatization. However, factitious disorder often includes self-injury, and patients often know they’re falsifying symptoms without a definitive cause. This is different from malingering, which is falsifying conditions for an incentive, like avoiding military service or military service obligations. Factitious disorder is also different from illness anxiety disorder, which is commonly known as hypochondria. Someone with illness anxiety disorder may experience intense fear about being sick or unwell, but not display physical symptoms like a person experiencing somatization.

While these conditions can include somatization, they are different from somatic symptom disorder. All of these conditions, including SSD, conversion disorder, and factitious disorder, are classified as somatoform disorders.

If you have bodily symptoms that do not seem to be linked to any physical condition, like heart disease, it doesn’t necessarily mean there isn’t a medical condition present. Instead, it might indicate that you are experiencing stress or worry related to the medical condition, leading to a magnification of your physical illness.

How doctors diagnose somatic symptom disorder

Diagnosing somatic symptom disorder is often a process since it can take time for a doctor to rule out other conditions or medical disorders. Generally, there’s a strong doctor-patient relationship. A primary care doctor will typically be the one to discover that someone has somatic symptom disorder (SSD), rather than a psychiatrist. When it comes to diagnosing SSD, a doctor will not give this diagnosis simply because they can’t find the source of your physical symptoms. Instead, they will consider whether you meet the diagnostic criteria from the DSM-V, which are described by the American Psychiatric Association as follows:

  • You have one or more physical symptoms that are causing distress or disruption to 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 or physical complaints you’re experiencing
    • a high level of ongoing anxiety about  physical  symptoms or overall health
    • spending an excessive amount of time and energy on physical symptoms and concerns about health

At least one of your symptoms is consistent, even if some of the other symptoms come and go. The key factor in diagnosing Somatic symptom disorder is that you’re experiencing physical symptoms and excessively responding to them. Age is a factor in diagnosing Somatic symptom disorder since most people with this disorder show signs during early adulthood before the age of 30. However, this isn’t always the case, so if you think you may have Somatic symptom disorder, it’s important to see your doctor no matter what your age is.

When someone has SSD, the person’s symptoms are real, and they aren’t intentionally exaggerating their physical symptoms. Somatization disorders aren’t your fault, but getting psychological help is something you can do to overcome it.

How somatization impacts your mental health

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There is a strong connection between physical and mental health, which means any physical symptoms can impact your mental wellness. This may be especially true with Somatic symptom disorder as you work to find solutions and treatment for a physical symptom or symptoms. There are many ways that Somatic symptom disorder can impact your mental health.

Excessive doctor visits

If you believe you have a severe medical condition that your doctor doesn’t recognize, you might seek medical care from different doctors and go from one doctor to another doctor to find a healthcare professional who has an answer. It’s natural to search for answers and to try and find out what is causing your physical symptoms. If you can’t find a purely medical reason for your symptoms, it may be beneficial to talk to a psychologist about it before you continue searching for a medical diagnosis. Excessive doctor’s visits can result in unnecessary tests and drain your time and energy. They can also shift your focus to be entirely on your health and medical conditions, preventing you from enjoying your life. 

Increasing worry and anxiety

High levels of anxiety about your condition is one of the symptoms of Somatic symptom disorder. As you focus on your physical health, you may become even more anxious and worried about your medical condition. You may start to feel like your symptoms will last forever, which may lead to increased anxiety. Without treatment for your anxious feelings and SSD, your symptoms may continue to increase over time and possibly result in an anxiety disorder.

Increasing depression

Depression is a complex mental illness with many possible causes, including stressful changes or life events. You may have had depressive symptoms prior to SSD, or the physical symptoms and stress caused by SSD may lead to depressive symptoms, as dealing with health complaints can be a stressful event. However, there is treatment for depression, so it’s important to tell your symptoms with your doctor.

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 related to your medical conditions. At times, your loved ones might be as concerned about your somatic symptoms as you are, but it can also put stress on your relationship if it feels like the relationship is centered around what you are dealing with. Even social gatherings may be difficult for you when it’s hard to focus on anything but how you are feeling, especially if you’re in a great deal of pain. 

Problems at work

Dealing with somatization can also affect how you perform and interact at your job. Since your worries and health-focused behaviors take so much time and energy, you might have less of both to give to your work. You might find yourself leaving early or even taking whole days off frequently when you are hyper-focused on your concerns about your physical and mental health or dealing with somatic symptoms. It can also go both ways since you may already have problems at work that are adding to the stress of searching for answers surrounding your health. Work-related stress is one of the major causes of poor health and decreased productivity at work.

Treatment for somatic symptom disorder

Somatic symptom disorder can be addressed with a combination of medical, psychiatric, and psychological treatments. You may need the assistance of your primary care doctor as well as a therapist or psychiatrist to ensure you receive proper treatment.  

Medical treatment

Medical treatment for SSD starts with having a primary care doctor you can 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 psychological factors affecting your condition. When you see them, their priority should be your physical well-being, and they should be able to reassure you and help you avoid tests that aren’t necessary. 

Psychiatric treatments

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Is your physical health impacting your mental health?

Psychiatric care can help address some of the psychological factors impacting your condition. A psychiatrist can prescribe medications if you need them for mental disorders such as depression or anxiety or other related disorders. Antidepressants may help you deal with the symptoms of depression and have a more positive perspective on life. Anti-anxiety medications may ease some of your worry and fear from your illness anxiety disorder so that you can focus on improving your physical health. Both kinds of medications can help you shift your attention from your physical symptoms to more helpful, productive, and satisfying thoughts.

Psychological treatments

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. 

In 2018, the first study exploring treatments for somatic symptom disorder using the DSM-V definition of somatization found three types of therapy to be 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.

Online therapy provides an avenue for those who need psychological treatment to speak with a licensed therapist from anywhere. Online therapy is a convenient and safe option for those in need of support.

In this study on treatment for somatic symptom disorder, cognitive-behavioral therapy took place online. However, the results showed it was just as effective as in-person therapy. Therapy may also help if you’re experiencing depressive symptoms or any other related conditions. At BetterHelp, you can get somatic therapy with a licensed counselor at a time that’s convenient for you and from whatever location you choose. Online therapy can help improve symptoms from conditions including SSD, depression, anxiety, eating disorders, and other mental illnesses.

Takeaway

Understanding the symptoms and causes of somatic symptom disorder is a positive first step to improving your physical and mental health. 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.

By prioritizing your mental health, you can get the treatment you need and live a healthier and more fulfilling life.

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