Understanding Somatoform Disorder
Somatoform disorder, commonly known as somatic symptom disorder (SSD) is a mental health condition characterised by physical pain brought on by emotional distress.
It can also cause a person to catastrophise every physical symptom they have and firmly believe that they have a serious medical condition even when they have been assured that they don’t.
Somatoform disorder may be difficult to diagnose as the symptoms range from specific to general, and from mild to severe.
For example, one person with somatoform disorder might present with severe tightness in the chest, while another person with somatoform disorder might present with general fatigue.
Some of the most common complaints associated with somatoform disorder are:
- Physical pain in one or more parts of the body
- Neurological issues
- Digestive and stomach issues
- Symptoms of sexual dysfunction
Someone suffering from somatoform disorder might visit their healthcare provider regularly trying to find reasons behind their symptoms and tend not to believe when they are told there are no serious conditions to worry about.
When patients repeatedly visit their healthcare provider with medically unexplained physical symptoms, they will usually be investigated for underlying mental health conditions as certain mental health issues can be co-occurring alongside somatoform disorder, these include:
- Body dysmorphic disorder
- Eating disorder
How can stress cause physical symptoms?
Everyone suffers from some form of stress at some point in their lives, but it’s how you deal with stress that is important.
Many people complain that stress causes headaches, fatigue, or palpitations, however, the physical symptoms caused by stress usually go away when the stress goes away, or the person has taken some time to calm down.
For many people, however, that stress does not go away – leading them to develop more symptoms which then causes even more stress.
Chronic stress has been proven to weaken the immune system as it can raise catecholamine and suppressor T cells levels which make you more at risk of infections (1).
It is important to note that a person suffering from somatoform disorder is not making up their illnesses and worrying symptoms – they are genuinely suffering from physical symptoms brought on by excessive stress.
The problem is getting them to believe that it is, in fact, stress that is the leading cause of their symptoms.
What are the different types of somatoform disorder?
Somatoform disorder is a mental health condition that can present itself differently from person to person. Some of the different types of the disorder are:
1. Persistent pain
- The patient will present with persistent and distressing pain in one or more parts of their body
- The cause of the pain cannot be discovered by a physical examination
- The pain was not caused by injury
2. Dissociative disorder
- The patient will present with symptoms of a serious neurological disorder such as loss of vision or deafness
- Some patients may present with weakness or partial paralysis
- Examinations show no signs of any neurological reason for the symptoms
- The patient will present with minor symptoms and be convinced that their symptoms are the result of a much more serious illness, for example, they may believe a simple headache is caused by a brain tumour.
- Most people with hypochondriasis will admit that their symptoms are minor but fear that they are caused by something more serious.
- They spend a lot of time stressing themselves out about their symptoms.
4. Body dysmorphic disorder (BDD)
- This causes the person to focus on one or more parts of their body and finding flaws with those body parts.
- The flaws that they find are often unnoticeable to anyone else but themselves.
- It is most often associated with the face.
5. Chronic fatigue syndrome (CFS)
- The person will complain of consistent fatigue after exerting minimal mental or physical effort.
- They will also have other complaints such as frequent dizziness, muscle aches, insomnia and/or headaches.
What causes somatoform disorder?
There is no clear cause of somatic symptom disorder, however, certain factors may make you more susceptible to suffering from it. These include:
- Biological factors: While both men and women can suffer from the disorder, women are more likely to present with somatic symptoms and more severe symptoms than men (2).
- Childhood physical or sexual abuse: Studies have shown that there is a link between suffering from physical or sexual abuse as a child and developing somatic symptom disorder in later life (3).
- Childhood neglect: Having emotionally unavailable parents in childhood has been shown to be linked to an increased risk of developing somatic symptom disorder as an adult (4).
- Negative personality: Having a negative personality and focusing on the worst possible outcome of every scenario can lead to excessive stress levels which are linked to somatic symptom disorder.
- Other environmental factors: Other factors such as learned behaviour from watching a parent with the same disorder or genetics can also lead to an increased risk of suffering from somatoform disorder.
How do you treat somatoform disorder?
Treatment for somatoform disorder can be difficult as the patient strongly believes there is a physical reason for the symptoms while the doctor believes otherwise.
Some people with somatic symptom disorder feel that their doctor does not believe them or has not tried hard enough to find a physical illness that is causing their symptoms.
It can be beneficial to refer the patient to be evaluated by a mental health professional, however, many patients feel that their healthcare provider is simply dismissing them in this case.
As somatoform disorder is often a condition of an underlying mental health condition such as depression or anxiety, treating those conditions can sometimes lessen the severity of the somatoform disorder.
Psychotherapy such as cognitive behavioural therapy can also be beneficial in helping to resolve symptoms of somatoform disorder as it trains the patient to change to a more positive way of thinking.
However, treatment can be time-consuming and stressful for both the patient and the healthcare provider.
Studies have shown that being patient and understanding, scheduling regular follow-up visits, and establishing a long-term relationship with the patient can help ease some of the fear and anxiety associated with somatoform disorder (5).
Can somatoform disorder be prevented?
If you are worried that you may be developing somatic symptom disorder, it is important to seek help sooner rather than later.
If you allow the condition to go untreated, your symptoms may get worse and take longer to treat.
You should also begin cognitive behavioural therapy as this can change the way you think and could prevent somatic symptom disorder from developing further, especially if it is in the early stages.
Recognising your stress triggers and taking appropriate steps to manage your stress levels can also be beneficial if you believe you may be at risk of developing somatic symptom disorder.
Finally, don’t become complacent. If you are managing your stress levels and taking steps to have a more positive outlook on life, stick with what you are doing as long as it is working.
If you stop your treatment you may begin to spiral towards a mental health condition that greatly impairs your quality of life.