What You Should Know About Somatic Symptom Disorder

In this day and age, it's incredibly easy to become hyper-focused on health symptoms and fear the worst. Between the wide array of digital resources at our fingertips and living through a global pandemic, it can be tempting to overanalyze every little ache and pain, even when you do actually have something wrong.

When a person significantly stresses about physical symptoms to the point that their daily life is disrupted, they may be diagnosed with somatic symptom disorder (via Cleveland Clinic). This mental health condition is characterized by an abnormal response to physical symptoms, whether or not the symptoms can be medically explained. Those with this condition experience thoughts, behaviors, and feelings that are out of proportion to the symptoms they're having, which affects their quality of life.

Somatic symptom disorder (SSD) usually develops by the age of 30, and females are 10 times more likely than men to be diagnosed. The disorder occurs in about 5-7% of all adults, making it fairly common.

Somatic symptom disorder used to be classified under the term hypochondria, according to the Mayo Clinic. With the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, hypochondria was redefined to include both SSD and illness anxiety disorder. Illness anxiety disorder occurs when someone has an unrealistic fear of becoming ill or developing a medical condition, but no physical symptoms are actually present, making it different from SSD (via Cleveland Clinic). By distinguishing between the two, people who have reasonable health concerns won't be unnecessarily diagnosed with a mental health condition. Be careful when using the term "hypochondriac," as it may not accurately describe someone's condition.

Both of these diagnoses differ from regular health concerns. It's natural to prioritize your health and make sure you're taking care of your body — but when health anxiety becomes so consuming that it interferes with your daily functioning, it may be part of a larger anxiety disorder (via Cleveland Clinic). Those with a health anxiety disorder might see a doctor and be reassured that everything is okay, but continue to worry.

Physical symptoms experienced during somatic symptom disorder can be unrelated to any identifiable medical cause, but they can be related to an actual diagnosis (via Mayo Clinic). Someone can experience specific symptoms, like pain or shortness of breath, or more general symptoms like fatigue. Symptoms can range from mild to severe, but any identifiable medical cause is usually not as significant as what's assumed.

No matter the symptoms, they're always accompanied by excessive thoughts, feelings, and actions that impact daily life and functioning. This can look like constantly worrying about potential illness, interpreting any normal physical sensations as a sign of severe illness, and fearing that physical symptoms are more serious than they actually are. Even when someone with SSD sees a medical professional and receives negative tests or treatment, they will often believe that it's not adequate. Other symptoms include fearing that physical activity will bring harm, constantly checking the body for abnormalities, repeated health care visits that don't provide peace of mind, being unresponsive to treatment, and being unusually sensitive to medication side effects.

While there's no one cause for somatic symptom disorder, there are a few contributing factors (via Verywell Mind). Many experts believe that it's closely linked to childhood trauma and abuse. Those who experienced parental neglect or lacked emotional closeness may not have had as much emotional awareness as children, which can contribute to the development of SSD (via Cleveland Clinic). Since women are often exposed to more trauma and abuse than men, this could explain why more women are affected by SSD. Risk factors for SSD include experiencing drug and alcohol abuse, living through chronic illnesses in childhood, and having other mental health disorders, like depression (via Verywell Mind).

The COVID-19 pandemic might also contribute to the development of SSD, according to the Cleveland Clinic. Those who test positive for COVID-19 may be worried about developing long COVID, which is still relatively unknown. The influx of news stories, changing health mandates, and general uncertainty could exacerbate health anxiety and concerns.

In order to be diagnosed with SSD, there are specific criteria that need to be met (via Mayo Clinic). There must be one or more physical symptoms causing distress, excessive thoughts, or constant anxiety about the symptoms, and these concerning symptoms must persist for at least six months.

The goal of treating SSD is to improve symptoms and increase functioning in daily life. This can be done by utilizing talk therapy, or psychotherapy, which can not only help improve the anxious feelings but the physical symptoms as well. Specifically, cognitive behavioral therapy (CBT) is often used in treating SSD. This can help you to examine your beliefs about your health, learn how to cope and reduce stress, reduce avoidance due to physical distress, reduce preoccupation with symptoms, and address depression and any other mental health disorders. Antidepressant medication may also be helpful in alleviating depressive symptoms that often occur with SSD.

The first step in getting better is acknowledging that you need help, according to Verywell Mind. Treatment can include medical professionals, but making lifestyle changes is also very effective in improving your quality of life. In fact, studies show that when receiving proper treatment and care, 50-75% of people with SSD will see their symptoms improve.

The first thing you can do is work with your medical provider to establish a trusting relationship (via Mayo Clinic). Developing a regular schedule for visits is important for discussing your concerns and making sure you're heard. You can also work with them to set limits on tests and evaluations. It may be useful to only seek advice and care from one doctor, rather than multiple providers. Practice stress management techniques regularly to relax your system, such as progressive muscle relaxation. Make sure you're getting regular physical activity to improve both your physical symptoms and mood. It's also important to maintain social connections and stay involved in work, rather than waiting for symptoms to resolve. Lastly, avoid alcohol and recreational drugs, as these can make your care more difficult to manage.