Do You Have a Fear of Falling III? Understanding Somatic Symptom Disorder

Somatic Symptom Disorder (SSD) occurs when a person is overly focused on physical symptoms like pain, weakness, or shortness of breath. This focus causes significant distress and interferes with daily life. The person may have excessive thoughts, worries, or behaviors related to their symptoms, even if a medical cause can't be identified. However, the symptoms are real to the person, and they believe they are ill, not pretending to be sick.

Signs and Symptoms

Physical symptoms that people with SSD may have include:

• Pain (the most commonly reported symptom).

• Fatigue or weakness.

• Shortness of breath (dyspnea).

The physical symptoms may be mild to severe, and there may be one or multiple symptoms. They may be due to a medical condition or have no clear cause.

How people think, feel and behave in response to these physical symptoms are the main signs of somatic symptom disorder. People with SSD may:

• Feel extreme anxiety about their physical symptoms.

• Feel concerned that mild physical symptoms are signs of serious conditions.

• See their healthcare provider for multiple diagnostic tests and exams but not believe the results.

• Feel that their healthcare provider doesn’t take their physical symptoms seriously enough.

• Go from one healthcare provider to another or seek treatment from multiple providers at once.

• Spend excessive amounts of time and energy dealing with health concerns.

• Frequently seem unusually sensitive to drug side effects.

• Become dependent on others, demanding help and emotional support, and become angry when they feel their needs aren’t met.

• Have trouble functioning day to day because of thoughts, feelings and behaviors about their physical symptoms.

  
  

  Approximately 30% to 60% of people with somatic symptom disorder also have anxiety and/or depression.

  
  

People with SSD often visit primary care doctors rather than mental health professionals and may struggle to accept that their concerns are excessive, even when tests show they do not have a serious illness. This condition often begins before the age of 30.

What causes somatic symptom disorder?

Researchers believe there are many biological, environmental and psychological factors that can contribute to the development of SSD, including:

• Childhood physical and sexual abuse.

• Poor awareness of emotions or emotional development during childhood. This can be the result of parental neglect or a lack of emotional closeness.

• Excessive anxiety and attention to bodily processes and possible signs of illness.

Treatment

Treatment for SSD aims to help the person manage their symptoms and maintain normal functioning. Regular visits to a trusted healthcare provider are essential. The doctor provides support, reassurance, and careful monitoring to avoid unnecessary tests and treatments. Psychotherapy, or talk therapy, can help the person change their thinking and behavior, cope with pain, manage stress, and improve their daily life. If depression or anxiety is also present, medications like antidepressants or anti-anxiety drugs may be helpful.

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.

Psychotherapy

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:

• Examine and adapt your beliefs and expectations about health and physical symptoms

• Learn how to reduce stress

• Learn how to cope with physical symptoms

• Reduce preoccupation with symptoms

• Reduce avoidance of situations and activities due to uncomfortable physical sensations

• Improve daily functioning at home, at work, in relationships and in social situations

• Address depression and other mental health disorders

Family therapy may also be helpful by examining family relationships and improving family support and functioning.

Medications

Antidepressant medication can help reduce symptoms associated with depression and pain that often occur with somatic symptom disorder.

Lifestyle and home remedies

While somatic symptom disorder benefits from professional treatment, you can take some lifestyle and self-care steps, including these:

• Work with your care providers. Work with your medical care provider and mental health professional to determine a regular schedule for visits to discuss your concerns and build a trusting relationship. Also discuss setting reasonable limits on tests, evaluations and specialist referrals. Avoid seeking advice from multiple doctors or emergency room visits that can make your care more difficult to coordinate and may subject you to duplicate testing.

• Practice stress management and relaxation techniques. Learning stress management and relaxation techniques, such as progressive muscle relaxation, may help improve symptoms.

• Get physically active. A graduated activity program may have a calming effect on your mood, improve your physical symptoms and help improve your physical function.

• Participate in activities. Stay involved in your work and in social and family activities. Don't wait until your symptoms are resolved to participate.

• Avoid alcohol and recreational drugs. Substance use can make your care more difficult. Talk to your health care provider if you need help quitting.

  
  

Related Disorders

• Illness Anxiety Disorder: Formerly known as hypochondriasis, this condition involves a constant worry about having or getting an illness, even without significant physical symptoms. People with this disorder frequently check themselves for signs of illness and take extreme precautions.

• Conversion Disorder: Also known as functional neurological symptom disorder, this condition affects a person's perception, sensation, or movement, with no physical cause. Symptoms like numbness, blindness, or difficulty walking can appear suddenly and may last for varying durations. Psychotherapy may help if symptoms persist.

• Factitious Disorder: In this condition, a person fakes or induces illness in themselves or others, such as a child in their care, to assume the "sick role" and receive care and attention. Unlike malingering, where someone fakes illness for material gain, factitious disorder is driven by a psychological need for attention.