Somatic symptom disorder, which used to be called somatization or somatoform disorder,
involves having physical symptoms that aren’t explained by any known physical or mental
disorder - in other words, symptoms that can’t be explained.
That said, individuals aren’t ‘faking’ the symptoms, these symptoms are real and
often made worse by the fact that they cannot be scientifically explained.
And this is pretty different from situations where an individual with a factitious disorder
might fake an illness or injury in order to get attention.
The diagnosis requires that individuals experience some set of unexplained physical, or somatic,
symptoms for at least 6 months.
The symptoms experienced by individuals with this disorder, though, can be incredibly varied,
everything from pain to gastrointestinal problems to sexual symptoms.
And although the somatic symptoms are chronic, the exact location, kind, and severity of
the symptoms typically changes over time.
The one symptom that does often persist over time is pain, and because it’s persistent
and has no clear underlying cause, it can be particularly hard to treat.
Somatic symptom disorder often causes cognitive symptoms as well, and these include persistent
thoughts and feelings about their symptoms—usually a lot of worry and anxiety, and sometimes
even catastrophic thoughts about death.
More often than not, it is these cognitive symptoms in response to the physical symptoms,
more than the physical symptoms themselves, that become a basis for this diagnosis.
In fact, clinicians rate the severity of somatic symptom disorder based on patient experience
with these cognitive symptoms, not the physical ones.
The condition is considered mild if there’s only one cognitive symptom like ruminating
a lot on the symptoms.
It would be considered moderate if there are two or more cognitive symptoms like rumination
as well as anxiety.
And it would be considered severe if there are two or more cognitive symptoms, as well
as multiple physical symptoms or one severe symptom, like severe pain.
These cognitive and physical symptoms often disrupt an individual’s daily life as well
as their relationships.
Unfortunately, the diagnosis can be tricky and confusing given that the symptoms shift
over time and that there is no clear underlying scientific explanation.
Historically, it was thought that somatic symptom disorder was the result of a person
having too much psychological stress, and that “excess stress” bubbled over and
led to bodily symptoms.
A current theory is that individuals with this disorder are extremely sensitive to changes
in their bodies and that common experiences like indigestion might be amplified in these
individuals.
One everyday example of this would be how different individuals might perceive the same
amount of spiciness very differently, for some it’s tasty and for other people the
exact same amount of spice is perceived as pain.
Now, treatment of somatic symptom disorder is aimed at diminishing the cognitive symptoms,
and this is often done through cognitive-behavioral therapy.
The goal here is to encourage individuals to engage in behaviors that they think are
limited because of their physical symptoms, in order to show them what they are able to
do.
All right, as a quick recap: somatic symptom disorder involves physical symptoms that cannot
be scientifically explained by any known physical or mental disorder, and the most common one
is pain, and these physical symptoms often lead to cognitive symptoms like rumination
and anxiety
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