Somatization disorder, formerly known as psychosomatic disorder and more recently referred to as somatic symptom disorder, is a mental disorder in which a person regularly experiences bodily pain, discomfort, or other physical sensations that cannot be attributed to physical or medical causes.
This disorder usually begins before age 30 and is more common in women than men. It is a chronic condition that greatly hinders one’s ability to lead a normal life. Generally, a person with somatization disorder will experience pain of undeterminable cause in more than one part of the body.
Abdominal pain, headaches, and back pain are common complaints. Sufferers also seem to have increased anxiety over their health and experience typical discomfort in a more threatening way.Their overwhelming belief that they have a serious illness often results in frequent doctor visits and unnecessary medical tests.
Somatization disorder should not be confused with Munchausen syndrome or factitious disorder. Those with Munchausen syndrome actively seek to create symptoms of illness by ingesting things that will make them sick or injecting themselves with foreign matter to make themselves ill. Nor should it be confused with those who fake an illness to avoid work or other obligations occasionally.
People suffering from somatization disorder genuinely fear that they have a serious health condition and have real physical symptoms. They are not being manipulative or faking illness. Although it may seem as if the pain is imagined, the pain itself is real; it just cannot be linked to any physical causes.
It should also be noted that somatic symptoms may be a sign of other psychological illnesses. Depression, anxiety, and certain personality disorders such as dissociative personality disorder all include somatic issues as a symptom. Thus, it can be difficult to determine whether a person has somatization disorder or if their symptoms are part of an underlying psychological disorder.
Somatization disorder can manifest with just about any physical sensation in any part of the body.
Besides pain or discomfort, sufferers may experience trouble swallowing, shortness of breath, dizziness, weakness, or a host of other physical sensations. They may even vomit or have diarrhea. They may have just one recurrent symptom or many varying symptoms, ranging in intensity from mild to severe.
The physical symptoms are not the primary issue with somatization disorder. Rather, it is the individual’s perception and reaction to whatever sensations they are experiencing, as well as their constant worry over their own health, that can be disabling.
Somatization disorder can negatively affect a person’s life in a number of ways. Relationships are difficult to sustain because the individual is often unable to contribute physically, financially, or emotionally as expected. The individual is likely to face employment issues due to missed work, and financial loss due to excessive medical bills.
These troubles increase stress levels, exacerbating symptoms and leading to a cycle that is difficult to overcome. Often, the individual experiences a great deal of self-doubt and may begin to feel worthless or hopeless, leading to depression or anxiety issues.
In fact, individuals with somatization disorder are at increased risk for suicide. In some cases, somatic symptoms may be a sign of depression or anxiety. In fact, it may be difficult to determine which came first without an extensive evaluation.
Prior to diagnosis, it is critical to have a very thorough medical examination to rule out possible causes that may have been missed during routine physical examinations. A full psychological evaluation should then be conducted to determine if a diagnosis of somatic symptom disorder (aka somatization disorder) is appropriate.
The clinician will likely review family history, current stressors, possible substance abuse, and other issues that may be contributing factors. A self-assessment questionnaire may also need to be completed. It is crucial for the individual to be completely honest when filling this out. Providing as many truthful details as possible makes it more likely that an effective treatment plan can be implemented.
A clinical diagnosis is not made until the individual has been exhibiting symptoms for at least six months. In many cases, the pain episodes will come and go, but the anxiety and obsession with one’s health will remain consistent throughout the period. In addition, this preoccupation must cause significant distress and interference in overall life functioning.
Although specific causes of somatization disorder have not been identified, there are many potential triggers. It is possible that genes play a role. Some individuals may be biologically programmed with a higher sensitivity to pain. And, people with pessimistic personality traits – which may be inherited – might be more likely to interpret symptoms in a negative fashion and imagine the worst. Family experiences and environment may be involved as well. A family member’s serious disease or related death may cause one to develop a heightened awareness resulting in a preoccupation with one’s own health and symptoms.
In some cases, somatization disorder could be the result of learned behaviors. For example, a child who receives significantly more attention during an illness may eventually learn to focus excessively on minor aches and pains out of habit. Or, if parents tend to overreact or panic whenever their child is sick or hurt, the child is more likely to become overly fearful themselves.
Finally, a person may simply learn, over time, that they can avoid certain tasks or situations when they are ill or hurt. Although in these types of cases it may seem as if the person is pretending to be sick or in pain, he or she likely has little insight or conscious control over their behavior.
Somatization disorder often co-exists with other mental health issues. Those suffering from depression, anxiety, or post-traumatic stress disorder are more likely to develop somatization disorders, as are those who suffered childhood trauma, especially physical or sexual abuse.
In addition, those recovering from a serious illness or who have a strong family history of serious illness are more prone to somatization issues. While this disorder affects people from all walks of life, there seems to be a slightly higher incident among those who have lower socio-economic status and education levels.
The purpose of treatment is to help the individual reduce symptoms and improve daily life functioning. Cognitive behavioral therapy is often a recommended treatment option for somatization disorder. This type of therapy helps individuals identify how specific thought patterns influence one’s feelings and behaviors.
By identifying and examining negative thought patterns, participants gain insight and learn techniques to modify their thoughts and behaviors. Helping individuals learn to cope with stress and minor discomfort, while developing realistic health expectations, are a few benefits. In addition, psychotherapy (‘talk therapy’) may help sufferers identify pent-up emotions that may be a contributing factor.
Another option, psychosocial rehabilitation, features programs that focus on peer relationships and meaningful activities. These programs may reduce symptoms by providing participants with emotional support and a sense of purpose. Finally, medications may be prescribed to alleviate depression and reduce symptoms.
Since the causes of somatization disorder are unclear, prevention measures are not clearly defined either. Learning how to manage stress is very important, as is recognizing how your body physically reacts to stressful situations. If one is aware of common physical sensations that accompany stress, he or she is less likely to overreact to these cues. Stress reduction and relaxation techniques like deep breathing or progressive muscle relaxation may be beneficial.
Lifestyle choices and self-care play a role as well. Getting enough sleep, eating a balanced diet, and exercise – even light walking or stretching – are protective factors. Staying active and engaged, for example developing a hobby or finding other ways to keep busy, are crucial for those who are coping with somatic symptoms. In addition, avoiding things like alcohol, drugs, and toxic people (those who are negative, angry, or abusive) is important too, as they tend to exacerbate issues.
If you have been diagnosed with depression, anxiety or other mental health issues, it is vital that you stick to your treatment plan.
The most important thing to remember is that, although the person’s behavior may seem deliberate or purposeful, it is not. There is generally no conscious manipulation on their part. The mind-body connection is still a mystery, even in the 21st century. We know that there are many cases of amputees who still feel sensation in their missing limb, even years later.
This well-documented phenomenon is evidence of how the mind can create physical sensations without medical cause. We also know that physical issues like headaches and stomach upset are often directly linked to emotional stress.
Ultimately, regardless of the origin of the pain, people suffering from somatization disorder just want to find relief. As frustrating as it can be for those who are dealing with somatization disorder in a loved one, imagine how frustrated the sufferer must feel.