Psychosomatic Symptom Disorder

When someone is not feeling well, they may not want to be told their symptoms are psychosomatic. For many people, the term psychosomatic symptoms has connotations akin to "imaginary." If you feel you are told your symptoms aren't authentic or valid, you might feel brushed off and disrespected. However, a new definition of psychosomatic symptoms is emerging as scientists explore the mind-body connection.

Medical doctors and mental health professionals may also change how they view psychosomatic symptoms. Both psychological stress and biological factors can influence your health, and psychosomatic symptoms can be as crucial to address as physical symptoms. Additionally, many mental health conditions and concerns can cause real physical health problems.

What is somatic symptom disorder?

Signs of somatic symptom disorder

Significant emotional and physical distress may be present with somatic symptom disorder. While each individual's experience may be different, there are some common psychosomatic symptoms of this condition, including the following:

• Specific sensations, such as shortness of breath or pain

• Weakness or fatigue

• Constant worry about potential illness

• A tendency to think that anything with a physical cause is life-threatening or harmful

• Doubts about the adequacy of a recent medical evaluation or treatment

• A tendency to repeatedly check the body for abnormalities

• Frequent medical visits that don't relieve concerns or worsen them 

• A severe impairment that would be associated with a medical condition, although there is no supporting diagnosis

Suppose you believe you may be experiencing signs of a psychosomatic disorder. In that case, you might seek medical care or the support of a healthcare provider or mental health professional who can provide a diagnosis and help you explore psychosomatic treatment options.

Diagnostic criteria

The DSM-5 outlines several diagnostic criteria for psychosomatic disorder. Each of the criteria must be met for diagnosis. The criteria include the following: 

• Four pain symptoms in any main area of the body 

• Two or more gastrointestinal concerns 

• One sexual or reproductive symptom, such as irregular menstrual cycles 

• One pseudo-neurological symptom, such as dizziness, headaches, weakness, or numbness 

Additionally, the psychosomatic symptoms must not be explained by a diagnosable medical condition; if a diagnosable medical condition exists, they must be more excessive or intense than expected based on testing or laboratory findings. 

If the psychosomatic symptoms are feigned or produced on purpose by an individual, they may meet the criteria for factitious disorder instead. 

Causes

The exact cause of psychosomatic disorders may vary. However, some of the following factors might have a role in the development of psychosomatic illness:

• Genetic and biological factors contributing to increased sensitivity to pain 

• Difficulty processing emotional issues 

• Learned behaviors resulting in symptoms of psychosomatic symptom disorder

• Attachment difficulties 

Risk factors

The risk factors for psychosomatic disorder include but are not limited to:

• A stressful event, such as trauma 

• A low level of education

• Lower socioeconomic status

• A history of anxiety or depression

• A family history of chronic or terminal illness 

• A mental health condition, like a personality disorder 

Medical conditions that may have a psychological component

While not all medical conditions are caused by mental health concerns, stress may worsen some. If you're experiencing any of the following medical conditions or psychosomatic symptoms and begin to feel emotional or mental strain, you might make an appointment with a healthcare provider for an evaluation. The conditions and symptoms include:

• Pain

• Fatigue

• High blood pressure (hypertension)

• Skin disorders, such as psoriasis or eczema

• Gastrointestinal disorders, such as stomach ulcers or irritable bowel syndrome (IBS) 

• Heart disease

• Heart palpitations

Many physical diseases or conditions, such as the ones listed above, may be made worse by mental factors. Additionally, studies show a connection between stress, trauma, and physical illness.

Are somatic symptoms harmful?

Psychosomatic symptoms can feel real to the person experiencing them. Additionally, the psychosomatic symptoms may be real. For example, headaches, menstrual pain, and high blood pressure can have physical complications. The long-term effects of psychosomatic symptoms can also be severe. For example, psychosomatic disorder may be associated with the following: 

• Failed relationships

• Loss of employment

• Financial difficulty related to loss of employment or excessive medical attention

• Development of other mental health conditions, such as anxiety and depression 

• Increased suicide risk related to depression

If you are experiencing excessive thoughts or urges of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support. 

Prevention and treatment

It may be challenging to prevent psychosomatic symptoms. However, recognizing when you are feeling stressed and how your body responds may help prevent them. It can be helpful to learn relaxation techniques, such as meditation or yoga, to address these symptoms. In addition, take care of your body by eating nutritious food, exercising regularly, avoiding substance abuse, and getting enough sleep. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

If you're experiencing anxiety or depression or feel unable to process emotions associated with the psychosomatic symptoms you are feeling, you might discuss your concerns with your primary care provider. They may review your medical history and make recommendations for care regarding your medical symptoms, in addition to providing a referral regarding the psychosomatic symptoms you're experiencing.

How to know a symptom is somatic 

Visiting a doctor may still be beneficial if you're experiencing distressing symptoms, such as chest pain, shortness of breath, upset stomach, fever, or extreme pain. Emergencies can occur to anyone, so ensuring you are healthy may benefit you if you're concerned. However, if you frequent doctors' offices or hospitals or use medical care as a compulsion, consider partaking in a few coping mechanisms at home before deciding whether to make an appointment or go to your local hospital. 

Additionally, note that panic attack symptoms can feel like a medical emergency. Those experiencing panic disorder may have frequent panic attacks, which can show as distressing physical symptoms such as shortness of breath, rapid pulse, sweating, headaches, gastrointestinal issues, and pain. Often, panic attacks are temporary. If you find that your symptoms subside after you are distracted or have a self-care activity to work on, it may be that you were experiencing psychosomatic symptoms. 

Although mental health conditions may cause somatic symptoms or stress, you are valid and not alone. You are not "crazy.” Psychosomatic symptoms can be painful, distressing, and stressful. If you are experiencing them, consider reaching out to a licensed mental health professional for support. 

Therapy

Cognitive-behavioral therapy (CBT) is a standard treatment for psychosomatic symptoms. According to the American Psychiatric Association, CBT can involve helping patients learn new ways of coping with and solving problems while they gain a deeper understanding of their physical and mental health conditions. With CBT, patients may learn to set realistic goals and identify and change behaviors that have a negative impact on their physical and emotional well-being. It may also work to identify the psychological causes of mental health conditions such as childhood trauma or other experience. 

Individual counseling can be facilitated in a counselor or therapist's office, local mental health clinic, or online. If you are unsure about in-person sessions, you might opt for online counseling through a platform like BetterHelp. A licensed therapist may assist you through several treatment methods, such as CBT, which research shows as effective as in-person treatment when provided online.