Somatic Symptom Disorder

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KEY POINTS

• Somatization disorder is a mental health problem in which you have many physical symptoms in different parts of your body that cause you distress. The symptoms may or may not have a medical cause.
• Treatment may include medicines, therapy, and learning ways to manage stress.

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What is somatic symptom disorder?

Somatic symptom disorder (SSD) is a mental health problem in which you have many physical symptoms in different parts of your body but no physical cause can be found.

SSD usually starts in the teen years or in early adulthood. More women than men develop this disorder. This disorder is usually lifelong, with periods of getting better and getting worse.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• SSD tends to run in families. Stressful life events and situations also play a part. You may be at higher risk due to problems such as abuse, financial stresses, or the death of loved ones.
• Problems in your family when you were growing up may increase your risk. For example, if you were abused as a child, you may have learned that people take care of you when you are sick or injured. Your risk is also higher if your parents abused drugs or alcohol.
• People with this disorder may have physical changes in their brain. This may cause you to be very sensitive stress, pain, or minor changes in breathing or heart rate.

What are the symptoms?

Symptoms may include:

• Feeling pain in many parts of the body such as chest or stomach pain, joint pain, or headaches
• Having nervous system symptoms, such as trouble seeing, hearing, tasting, smelling, talking, swallowing, or moving
• Often having bloating, vomiting, diarrhea, or trouble eating

Women may have irregular periods or pain with menstruation, sexual intercourse, or urination. Men may have problems with erections.

If you have this disorder you may insist on medical treatments or even surgeries without getting better before you are diagnosed.

How is it diagnosed?

Your healthcare provider or a mental health therapist will ask about your symptoms, medical and family history, and any medicines you are taking. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to help make a diagnosis.

How is it treated?

Medicine

Several medicines may help treat this disorder, and may also help if you have depression or anxiety. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Therapy

There are several kinds of therapy that can help.

Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn positive ways to think and act. You may need to understand how you benefit from being sick before you can get well. For example, you may get extra attention and care from family and friends. Or you may be avoiding work or other responsibilities by being sick. CBT may help you find ways to get care and attention without having to be sick.

Support groups can help you understand that you are not alone. Groups also provide a safe place to share feelings.

Family members may also find therapy useful.

Other treatments

You may try many herbal and dietary products help control various symptoms. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe. Before you take any supplement, talk with your healthcare provider.

Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and therapy.

How can I take care of myself?

• Get support. Ask for patience and support from friends and family. Understanding the problem and making the correct diagnosis may take months. Patience and counseling over time are the most helpful. Consider joining a support group in your area.

  If your friend or relative has one of these problems, don't insist that he ignore physical symptoms. Your loved one may withdraw from you if he feels pressured.

• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and don't skip meals. Low blood glucose can make you feel more nervous. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions. Regular exercise can help calm you and make it easier for you to deal with stress.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others. Also seek immediate help if you have chest pain or trouble breathing.

For more information, contact:

• The National Alliance on Mental Illness (NAMI)
  800-950-6264
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/