Learn about symptoms, causes and treatment for this disorder, which is linked with major emotional distress and impairment.
Somatic symptom disorder is characterized by an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning. You may or may not have another diagnosed medical condition associated with these symptoms, but your reaction to the symptoms is not normal.
You often think the worst about your symptoms and frequently seek medical care, continuing to search for an explanation even when other serious conditions have been excluded. Health concerns may become such a central focus of your life that it's hard to function, sometimes leading to disability.
If you have somatic symptom disorder, you may experience significant emotional and physical distress. Treatment can help ease symptoms, help you cope and improve your quality of life.
Symptoms of somatic symptom disorder may be:
Pain is the most common symptom, but whatever your symptoms, you have excessive thoughts, feelings or behaviors related to those symptoms, which cause significant problems, make it difficult to function and sometimes can be disabling.
These thoughts, feelings and behaviors can include:
For somatic symptom disorder, more important than the specific physical symptoms you experience is the way you interpret and react to the symptoms and how they impact your daily life.
Because physical symptoms can be related to medical problems, it's important to be evaluated by your primary care provider if you aren't sure what's causing your symptoms. If your primary care provider believes that you may have somatic symptom disorder, he or she can refer you to a mental health professional.
When physical symptoms considered to be somatic symptom disorder occur, it can be difficult to accept that a life-threatening illness has been eliminated as the cause. Symptoms cause very real distress for the person and reassurance isn't always helpful. Encourage your loved one to consider the possibility of a mental health referral to learn ways to cope with the reaction to symptoms and any disability it causes.
Physical disability may cause the person to be dependent and need extra physical care and emotional support that can exhaust caregivers and cause stress on families and relationships. If you feel overwhelmed by your role as caregiver, you may want to talk to a mental health professional to address your own needs.
The exact cause of somatic symptom disorder isn't clear, but any of these factors may play a role:
Risk factors for somatic symptom disorder include:
Somatic symptom disorder can be associated with:
Little is known about how to prevent somatic symptom disorder. However, these recommendations may help.
To determine a diagnosis, you'll likely have a physical exam and any tests your doctor recommends. Your doctor or other health care provider can help determine if you have any health conditions that need treatment.
Your medical care provider may also refer you to a mental health professional, who may:
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, emphasizes these points in the diagnosis of somatic symptom disorder:
The goal of treatment is to improve your symptoms and your ability to function in daily life. Psychotherapy, also called talk therapy, can be helpful for somatic symptom disorder. Sometimes medications may be added, especially if you're struggling with feeling depressed.
Because physical symptoms can be related to psychological distress and a high level of health anxiety, psychotherapy — specifically, cognitive behavioral therapy (CBT) — can help improve physical symptoms.
CBT can help you:
Family therapy may also be helpful by examining family relationships and improving family support and functioning.
Antidepressant medication can help reduce symptoms associated with depression and pain that often occur with somatic symptom disorder.
If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.
Talk with your doctor about medication options and the possible side effects and risks.
While somatic symptom disorder benefits from professional treatment, you can take some lifestyle and self-care steps, including these:
In addition to a medical evaluation, your primary care provider may refer you to a psychiatrist or psychologist for evaluation and treatment.
Before your appointment, make a list of:
Ask a trusted family member or friend to go with you to your appointment, if possible, to lend support and help you remember information.
Questions to ask may include:
Don't hesitate to ask any other questions.
Your medical care provider or mental health professional may ask you questions, such as:
Your medical care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.