Somatic Symptom Disorder

What is Somatic Symptom Disorder?

Somatic Symptom Disorder is a mental health condition marked by an intense preoccupation with physical symptoms that leads to significant emotional distress and disruption in daily life. The symptoms themselves are real, but the level of concern and response to them is disproportionately heightened, whether or not an underlying medical condition is present.

How Does Somatic Symptom Disorder Feel?

For the Person with Somatic Symptom Disorder:

Constant Worry: You spend most of your time thinking about your physical symptoms and what they might mean.

Fear of Serious Illness: Even normal body sensations feel like signs of serious disease.

Never Feeling Reassured: Even when doctors say you're okay, you still worry that something is seriously wrong.

Checking Your Body: You frequently examine yourself for signs of illness or changes.

Multiple Doctor Visits: You see many different doctors, hoping someone will find what's wrong.

Feeling Misunderstood: You might feel like doctors don't take your concerns seriously.

Impact on Daily Life: Worry about symptoms makes it hard to work, socialise, or enjoy activities.

For Family and Friends

Families often experience:

Frustration: It's hard to understand why someone can't be reassured by normal test results.

Exhaustion: Constantly dealing with medical appointments and health worries is draining.

Walking on Eggshells: You might avoid talking about health topics or activities that might trigger worry.

Financial Stress: Multiple medical visits and tests can be expensive.

Feeling Helpless: You want to help but don't know how to ease their fears.

What Causes Somatic Symptom Disorder?

The exact cause of somatic symptom disorder isn't clear, but several factors may contribute:

Risk Factors

Having anxiety or depression

Having a medical condition or recovering from one

Being at risk of developing a medical condition (like family history)

Experiencing stressful life events, trauma, or violence

Having experienced past trauma, such as childhood sexual abuse

Having a lower level of education and socio-economic status

Possible Contributing Factors

Genetic factors: Increased sensitivity to pain or physical sensations

Family influence: Learning patterns of focusing on physical symptoms

Personality traits: Tendency toward negative thinking

Emotional processing problems: Difficulty recognising or dealing with emotions

Learned behaviour: Getting attention or care when having symptoms

Signs and Symptoms

Physical Symptoms

Specific sensations like pain or shortness of breath

General symptoms like fatigue or weakness

Single symptoms, multiple symptoms, or changing symptoms

Mild, moderate, or severe

Pain is the most common symptom, but any physical symptom can be involved.

Thoughts, Feelings, and Behaviours

excessive reactions may include:

Constant worry about potential illness

Viewing normal physical sensations as signs of severe illness

Fearing that symptoms are serious, even without evidence

Thinking that physical sensations are threatening or harmful

Feeling that medical evaluation has not been adequate

Fearing that physical activity may cause damage

Repeatedly checking your body for abnormalities

Frequent healthcare visits that don't relieve concerns

Being unresponsive to medical treatment

Having more severe impairment than expected

Health Impact and Complications

Somatic symptom disorder can be associated with:

Physical and Functional Problems

Poor health

Problems functioning in daily life, including physical disability

Problems with relationships

Problems at work or unemployment

Mental Health Complications

Other mental health disorders like anxiety, depression, and personality disorders

Increased suicide risk related to depression

Financial problems due to excessive healthcare visits

Getting Help

When to See a Doctor

Because physical symptoms can be related to medical problems, it's important to be evaluated by your primary care provider if you aren't sure what's causing your symptoms.

See a healthcare provider if:

Physical symptoms are causing significant distress

You're constantly worried about your health

Normal activities are affected by health concerns

You're visiting doctors frequently without relief

Family or friends are concerned about your health focus

Treatment Approaches

Cognitive Behavioural Therapy (CBT): Helps change thought patterns and behaviours related to physical symptoms.

Stress Management: Learning techniques to manage stress and anxiety.

Regular Medical Care: Working with one primary doctor to coordinate care and avoid unnecessary tests.

Gradual Activity Increase: Slowly returning to normal activities despite symptoms.

Medication: Antidepressants or anti-anxiety medications may help with underlying mental health conditions.

Somatic Symptom Disorder vs. Other Conditions

Different from Hypochondria (Illness Anxiety Disorder)

Somatic Symptom Disorder: Focus is on the distressing physical symptoms themselves

Hypochondria: Focus is on fear of having a serious disease

Different from Factitious Disorder

Somatic Symptom Disorder: Symptoms and concerns are genuine, not deliberately created

Factitious Disorder: Person deliberately creates or fakes symptoms

Different from Malingering

Somatic Symptom Disorder: No conscious deception or external benefit sought

Malingering: Deliberately faking symptoms for clear benefits like money or avoiding work

Supporting Someone with Somatic Symptom Disorder

For Families

caring for a loved one:

Accept that symptoms cause real distress

Don't dismiss their concerns as "all in their head"

Encourage mental health treatment

Avoid constantly talking about symptoms

Support gradual return to normal activities

Take care of your own mental health

Helpful Approaches

Living with Somatic Symptom Disorder

Coping Strategies

Work with a trusted primary care doctor

Practice stress reduction techniques

Stay active within reasonable limits

Focus on function rather than symptoms

Build a support network

Follow treatment recommendations

Building Recovery

Learn about the condition

Develop healthy coping skills

Address underlying anxiety or depression

Gradually increase activities

Practice mindfulness and relaxation

Maintain social connections

Prevention and Early Intervention

Prevention Strategies

If you have anxiety or depression, seek professional help as soon as possible

Learn to recognise when you're stressed and practice stress management

If you think you have somatic symptom disorder, get treatment early

Stick with your treatment plan to prevent relapses

Early Warning Signs

Increasing focus on physical symptoms

Multiple doctor visits for the same concerns

Avoiding activities due to health fears

Constant body checking or symptom monitoring

Difficulty being reassured by normal test results

Important Facts

Physical symptoms are real: Not imagined or faked

It's the reaction that's the problem: Not the symptoms themselves

It's treatable: Many people improve with proper care

Early treatment helps: The sooner treatment starts, the better

Family support matters: Understanding and support aid recovery

Key Takeaways

Somatic Symptom Disorder is a real mental health condition where people have genuine physical symptoms, but their reaction to these symptoms is much stronger than usual and interferes with their daily life.

The most important things to remember are:

• The physical symptoms are real and cause genuine distress
• The problem is the excessive focus and worry about the symptoms
• Treatment can help people learn to manage their reactions and improve their quality of life
• It's not about "faking" illness or seeking attention
• With proper treatment and support, people can learn to function better despite their symptoms

If you or someone you know is struggling with constant worry about physical symptoms that interferes with daily life, it's important to seek help from healthcare providers who understand somatic symptom disorder.

References

1. Mayo Clinic Staff. (2026). Somatic symptom disorder: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/somatic-symptom-disorder/symptoms-causes/syc-20377776 ↑

2. National Centre for Biotechnology Information. (2023). StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532253/ ↑

3. Kurlansik, S. L., & Maffei, M. S. (2016). Somatic symptom disorder. American Family Physician, 93(1), 49–54. https://www.aafp.org/pubs/afp/issues/2016/0101/p49.html ↑