Many people now have a good grasp of the basics of mental disorders like depression, even if they don’t quite get the tolerance and acceptance aspect.
However, during May’s Mental Health Month, it’s important to also recognize other less common mental disorders, such as somatic symptom disorders like illness anxiety disorder and somatic symptom disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these disorders all are characterized by “the prominence of somatic symptoms associated with significant distress and impairment.”
"Somatic" means “of, relating to, or affecting the body especially as distinguished from the germplasm or the psyche,” according to Merriam-Webster’s online dictionary.
People with somatic symptom disorders (previously labeled as somatoform disorders) were thought to have medically unexplained physical symptoms, suggesting that any physical pain was all in their head.
However, in the new DSM-5, there is more lenience in the diagnosis of people who may have a medical diagnosis but also present with psychological issues. This helps avoid the issue of separating the body from the mind and suggesting that there was no basis for feeling physical symptoms.
“The new classification defines the major diagnosis, somatic symptom disorder, on the basis of positive symptoms (distressing somatic symptoms plus abnormal thoughts, feelings and behaviors in response to these symptoms),” according to the DSM-5.
Patients who suffer from somatic symptom disorder experience multiple somatic symptoms that cause distress or “significant disruption of daily life.”
They tend to have anxiety associated with their health and symptoms, and go to the doctor frequently, though oftentimes they have no actual medical diagnosis or cannot find relief with treatment.
People who suffer from illness anxiety disorder, also known as “hypochondria” or “hypochondriasis,” don’t actually have any somatic symptoms, or they usually only have mild symptoms. If they do have a medical condition, they tend to be overly preoccupied with their health status.
They are also focused on the potential of “having or acquiring a serious illness,” according to the DSM-5.
This disorder is accompanied by excessive anxiety about health, and individuals with this disorder tend to either go to the doctor frequently or completely avoid medical care.
Stacy Harp, a marriage and family therapist with a Master’s degree in clinical psychology, said in an email that she believes somatic disorders are actually fairly common.
“The general public should be aware that physical pain is often caused by emotional pain,” Harp said. “Our minds and bodies are connected, so when one part of your body hurts, other parts of your body also hurt.”
Although the Internet can be helpful in finding information about medical conditions and a medical or mental health professional nearby, it can also be harmful for people who have the above conditions.
“The main reason is because information is so readily available, and when a person is worried and under a lot of stress, if they have already gone to a doctor and had that doctor dismiss them and tell them that all of their pain is ‘in their head,’ that person isn't going to just listen to the doctor, they will do their own research until they find something that validates their suffering,” Harp said.
Harp said in her experience working with clients, she often noticed them suffering from high levels of stress, and they also had “unresolved loss and grief and often trauma from childhood that wasn't resolved.”
She believes that there needs to be more education on what happens to the body during the aging process, which would help people worry less about common, normal symptoms.
In addition, Harp believes that women tend to suffer more often from these somatic symptom disorders due to hormonal imbalances and difficulties with regulation of emotions.
For people who do suffer from somatic symptom disorders, Harp said the best treatment option is cognitive behavioral therapy.
Jeanette Raymond, a licensed psychologist, said in an email that she believes the above conditions can be caused by suppressing emotions for a long period time. Avoiding emotional expression can lead to physical symptoms and pain, since there is no place for those emotions to go.
In some cases, the only way people ever got attention as children is when they had physical ailments to complain about, so in order to get that desired attention they cause themselves to have physical pain, and once they receive attention they are able to make it disappear.
Expressing feelings without shame, and having a family member, friend or caring person understand and accept those feelings, can help make that pain go away.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder: Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
Merriam-Webster. Somatic. Web. May 15, 2014.
Harp, Stacy. Email interview. May 13, 2014.
Raymond, Jeanette. Email interview. May 13, 2014.
Reviewed May 15, 2014
by Michele Blacksberg RN
Edited by Jody Smith