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Somatic Symptom Disorders

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Somatic Symptom Disorders

You are sitting in your doctor’s office on the exam table, holding your stomach. The pain in your stomach consumes all your thoughts and feelings. This pain has been present for over half a year now, and your concern for your health has taken over your life. Sometimes the pain is in your stomach, and other times you feel pain across your back. You have already seen your doctor several times, but you are not sure what else to do.

  • What is Somatic Symptom Disorder?
  • What are the different types of somatic symptom and related disorders?
  • What causes Somatic Symptom Disorder?
  • What is the difference between Somatic Symptom Disorder and Illness Anxiety Disorder?
  • What are some treatments for Somatic Symptom Disorder?

Definition of Somatic Symptom Disorder

Somatic Symptom Disorder (SSD) is a mental disorder involving physical complaints (usually pain) in one or more areas of the body that are very distressing and disruptive to life. Physical complaints like stomach pain or back pain may be linked to a specific medical condition, or the doctors may not be able to find a cause for the pain.

Somatic Symptom Disorder involves obsessive concern over one or more somatic complaints, mostly commonly somatic pain.

The main idea is that the physical symptoms cause the person so much distress or other problems in life. They may worry all the time about their symptoms, spend lots of time and energy trying to figure out what is wrong, or misjudge the seriousness of the problems.

Most people think that the physical symptoms have to be medically unexplained. This is actually a myth! Even if the person has a medical condition that could cause those symptoms, they can still be diagnosed with SSD if their symptoms are causing significant problems in their life.

A key part of SSD is what the person experiencing the symptoms thinks about their symptoms and potential causes. Are their thoughts flooded with worry or anxiety over their pain? Are they frequently gone from work because they were so worried or went to the doctor again? Do they think they might die at any moment, even though there is no clear indication of that?

Somatic Symptom Disorder a red glow on a the top of a woman's back illustrating pain in her shoulder StudySmarterSomatic pain, pixabay.com

Types of Somatic Symptom and Related Disorders

SSD is not the only disorder with somatic symptoms! The word somatic just means something to do with your body (rather than your mind). There are actually five disorders that include somatic problems as major symptoms:

  • Somatic Symptom Disorder

  • Illness Anxiety Disorder

  • Functional Neurological Symptom Disorder (Conversion Disorder)

  • Psychological Factors Affecting Other Medical Conditions

  • Factitious Disorder

Functional Neurological Symptom Disorder

We will cover Illness Anxiety Disorder later. Functional Neurological Symptom Disorder (FNSD), formerly known as Conversion Disorder, involves problems in motor or sensory functions that have no known medical cause. The idea is that psychological distress converts itself into a physical symptom. Motor problems could look like paralysis, tremors, seizures, or trouble walking. Sensory problems can involve a reduced or absent ability to feel, see, or hear; problems with speech; or problems swallowing. A person can even experience a motor problem and a sensory problem together.

Psychological Factors Affecting Other Medical Conditions

Say you have a heart condition. The lining in your heart is weak, making your heart muscles weak overall and putting you at higher risk of heart problems. You also get angry easily, lose your temper often, and have trouble coping with stress. These psychological concerns (anger, temper outbursts, and stress problems) cause your heart condition to get worse. This is an example of psychological factors affecting other medical conditions.

The idea is that you have a diagnosed medical problem, like a heart condition. You also have some kind of psychological concern that makes your medical condition worse. Maybe your psychological state is making your medical problems worse, keeping you from recovering, creating problems adhering to your treatment, increasing the risk of health problems, or causing worse health symptoms. The psychological concern could be about your emotional state, relationships, ability to cope with stress, personal choices, or denial of your health problem.

Factitious Disorder

You may have heard of Factitious Disorder by another name: Munchausen Syndrome. Have you seen a TV show with a character who is faking a medical condition? Maybe you have met someone who did this in real life. Factitious Disorder means faking an illness either by lying about symptoms or causing the symptoms yourself. Someone who fakes a medical condition in someone else (like a child) is diagnosed with Factitious Disorder Imposed on Another instead.

Causes of Somatic Symptom Disorder

There is no single, clear cause of SSD. Personality traits can play a role in developing this disorder. High emotional instability and anxiety or depression can increase the risk of SSD. Stress, health problems, and childhood abuse are a few other risk factors. SSD is more common in people with little education or money. Women are more likely than men to develop SSD. Interestingly, SSD seems to be just as prevalent across cultures.

Somatic Symptom Disorder and Illness Anxiety Disorder

It is really easy to confuse SSD with Illness Anxiety Disorder (IAD). They are completely different disorders, though. IAD is about really high levels of anxiety about your health. There could be some somatic symptoms like in SSD, but anxiety about having a serious health problem is the main focus. Generally, someone with IAD worries obsessively about any kind of physical symptom. Something small like shoulder pain, arm pain, or headaches can cause someone with IAD to go into a full-blown panic about their health.

Somatic Symptom Disorder letter tiles spelling out anxiety StudySmarterHealth anxiety, pexels.com

Things that most of us would dismiss as regular aches and pains are alarming to someone with IAD. They often go to the doctor or hospital, or they completely avoid medical care. Either way, they continue to think about and worry about having a major health problem. IAD used to be called hypochondriasis. Someone with IAD worries that they either have a serious condition or will come down with one. Remember, the main thing that bothers someone with IAD is not their physical symptoms; it is the constant worry that they are seriously ill.

So, those with SSD are worried that their physical symptoms could be connected to a serious illness. The main concern is the physical symptoms. In IAD, the individual is worried that they have or will have a serious illness. The main concern is having or coming down with a serious illness. IAD can include somatic symptoms, but it can also happen without them.

Somatic Symptom Disorder a young woman bending over her laptop looking worried StudySmarterChecking symptoms online, pexels.com

Treatments for Somatic Symptom Disorder

SSD is a pretty new diagnosis. Since it hasn’t been around for a long time, there is no commonly accepted best treatment for it. Generally, SSD is treated through therapy and medication. Cognitive-behavioral therapy, mindfulness-based therapies, and stress-reduction therapies may be helpful.

Medication is used to help improve the person’s ability to function in life rather than to take away the somatic symptoms. If someone has both SSD and another mental disorder, they can take medicine to help treat their other mental disorder. Antidepressants are a common medication choice since they can help treat anxiety and depression symptoms.

Somatic Symptom Disorders - Key Takeaways

  • Somatic Symptom Disorder (SSD) is a mental disorder involving physical complaints (usually pain) in one or more areas of the body that are very distressing and disruptive to life.
  • Most people think that the physical symptoms have to be medically unexplained, but this is actually a myth!
  • The word somatic just means something to do with your body (rather than your mind).
  • The main concern in SSD is the physical symptoms, but the main concern in IAD is having or coming down with a serious illness.
  • Treatments for SSD are about improving the person’s ability to function in life rather than taking away the somatic symptoms.

Frequently Asked Questions about Somatic Symptom Disorders

Somatic Symptom Disorder (SSD) is a mental disorder involving physical complaints (usually pain) in one or more areas of the body that are very distressing and disruptive to life.  

There is no single, clear cause of SSD, but personality traits, emotional instability, other mental disorders, stress, health problems, childhood abuse, little education or money, and female gender can all increase the risk of developing SSD.

There is no known cure for somatic symptom disorder, but treatment can greatly improve it.

Somatic Symptom Disorder is not extremely common, with a 4-6% prevalence rate in adults.

Yes, somatic symptom disorder is a mental illness.

Final Somatic Symptom Disorders Quiz

Question

What is somatic symptom disorder?

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A constant worry about potential illness and physical symptoms mirroring actual illnesses.

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What are pseudoneurlogic symptoms?

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Symptoms that mirror neurological disorders. These symptoms can be blindness, paralysis, seizures, and more.

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What is conversion disorder?

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SSD focused on pseudoneurologic disorders and symptoms.

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What is pain disorder?

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SSD focused on chronic pain.

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What is hypochondriasis?

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Answer

The fixation that you might have a life-threatening illness.

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What is body dysmorphic disorder?

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Believing part or all of your body is defective or flawed.

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What is undifferentiated somatoform disorder?

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SSD that doesn't fit in any of the subdiagnoses.

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What is an example of how SSD can be a learned behavior?

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 If a child gets more attention from having an illness, they might subconsciously exhibit those symptoms more.

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What are pain behaviors?

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Behaviors and changes in behaviors in response to symptoms.

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What is an example of pain behaviors?

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If your leg hurts, you will walk on it differently and avoid certain activities. 

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What is the main form of treatment for SSD?

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Psychotherapy

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Can SSD be cured?

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No

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Can childhood abuse or neglect increase your risk of developing SSD?

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Yes

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Does having a high pain threshold increase your risk of developing SSD?

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No

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Do anxiety and depression increase the risk of developing SSD?

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Yes

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Does a positive outlook on life and a sunny disposition increase risk of developing SSD?

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No

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Can antidepressant medications help in treating SSD?

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Yes

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Seizures and blindness are examples of what type of symptom?

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Answer

Pseudoneurologic symptoms

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What is Somatic Symptom Disorder (SSD)?

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Answer

SSD is a mental disorder manifesting as physical symptoms.

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What is Illness Anxiety Disorder?

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Illness Anxiety Disorder is an anxiety disorder focused around a person's own health and risk of developing illness.

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What are some of the factors that could cause SSD?

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Genetics, hypersensitivity to pain, learned behaviors from childhood, traumatic experiences.

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What is dissociative amnesia?

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Dissociative amnesia is a loss of memory from key parts of someone's life, usually around traumatic events.

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What are dissociative fugues?

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Dissociative fugues are bouts of dissociative amnesia where someone forgets their identity and abandons their daily activities.

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What is Dissociative Identity Disorder (DID)?

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DID is a dissociative disorder where the person has 2+ distinct personality states.

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What are alters?

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Alters are the distinct personality states someone with DID would have.

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What are some examples of alter types?

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Protector, persecutor, child/little, sexual, fragments.

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What are fragment alters?

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Alters that hold specific memories or emotions.

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What is depersonalization disorder?

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Depersonalization disorder is a disconnect between yourself and/or your environment.

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What causes dissociative disorders?

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Traumatic events cause dissociative disorders.

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True or False: long term physical, sexual, or emotional abuse in childhood is the biggest risk factor for developing dissociative disorders.

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True

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True or False: having a different medically diagnosed condition means you are less likely to develop SSD.

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False

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True or False: traumatic events can cause both SSD and dissociative disorders.

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True

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True or False: only children can develop dissociative disorders.

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False

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True or False: it is easy to tell when someone is in a dissociative fugue.

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False

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True or False: around half of people with SSD experienced childhood trauma from their primary caretaker.

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True

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True or False: people with Illness Anxiety Disorder often don't experience symptoms of illnesses or diseases.

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True

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True or False: A key part of SSD is what the person experiencing the symptoms thinks about their symptoms and potential causes. 

Show answer

Answer

True 

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True or False: The word somatic just means something to do with your body (rather than your mind).  

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Answer

True 

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How many disorders include somatic problems as major symptoms? 

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Answer

Five 

Show question

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Which of the following is NOT one of the five disorders that include somatic problems as major symptoms? 

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Answer

Post Traumatic Stress Disorder (PTSD) 

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True or False: A person can even experience a motor problem and a sensory problem together. 

Show answer

Answer

True 

Show question

Question

Which of the following disorders involves problems in motor or sensory functions that have no known medical cause? 

Show answer

Answer

Functional Neurological Symptom Disorder (Conversion Disorder)

Show question

Question

Which of the following disorders means faking an illness either by lying about symptoms or causing the symptoms yourself? 

Show answer

Answer

Factitious Disorder 

Show question

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Which of the following disorders is also known as "Munchausen Syndrome"? 

Show answer

Answer

Factitious Disorder 

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True or False: Personality traits can play a role in developing SSD? 

Show answer

Answer

True 

Show question

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True or False: SSD is more common in people with little education or money. 

Show answer

Answer

True 

Show question

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True or False: Men are more likely than women to develop SSD. 

Show answer

Answer

False

Show question

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True or False: Someone with IAD (Illness Anxiety Disorder) worries that they either have a serious condition or will come down with one.

Show answer

Answer

True 

Show question

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True or False: In regards to SSD, antidepressants are a common medication choice since they can help treat anxiety and depression symptoms. 

Show answer

Answer

True 

Show question

Question

Which of the following disorders is Somatic Symptom Disorder often confused with? 

Show answer

Answer

Illness Anxiety Disorder

Show question

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