Curated and updated for the community by APA
Somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness).
See definition, symptoms, & treatment
Peer support refers to people with the same types of problems helping each other. The concept of peer support has been used for many years among people with addictions, for example in Alcoholic Anonymous where people with “lived experience” help others to recover. The use of peer support with people with mental illness is more recent, particularly peer support in a professional capacity as part of the mental health care team.
Since rapid changes and uncertainty can be stressful for anyone regardless of political persuasion, it’s important to remain aware of our stress levels and proactively manage them.
You may be familiar with online access to your medical records and possibly to your doctor’s notes. More than 12 million Americans now have online access to their health care provider’s clinical notes. This access is referred to as OpenNotes.
American Chronic Pain Association
Canadian Institute for the Relief of Pain and Disability
How can family members best support and help someone with somatic symptom disorder?
Somatic symptom disorder is a complex illness that calls for consistent and reassuring relationships with confident and supportive healthcare providers. Often at the center is uncertainty and lack of trust in one’s own ability to tell the difference between normal bodily sensations and those that signal harm. It can be very challenging for individuals, family members and healthcare professionals alike to tell if new symptoms relate to a major illness or routine feelings of discomfort.
Further complicating the picture is the fact that often people with the disorder have ongoing chronic illnesses which can change and worsen over time. The art of managing somatic symptom disorders is therefore balancing the need for a prudent medical evaluation with over-diagnosis and over-treatment. This balance can only be achieved through a trusting relationship with a knowledgeable clinician, usually a primary care provider or primary care team.
Family members can assist an individual with somatic symptom disorders with ongoing support and understanding, and encouragement of stable and consistent healthcare relationships. Additionally, family members can help to follow treatment plans that aim to avoid urgent and emergent medical care settings in favor of outpatient appointments with a consistent provider. Family can also assist the person suffering to track and record symptom information for later discussion with his/her provider. Family members can also play a valuable role in reassurance and communication with the person’s healthcare team. Read More
My wife has been diagnosed with somatic symptom disorder. She continues to get angry with doctors and can’t accept that they can’t find anything physically wrong. She doesn’t want to consider that “it’s all in her head.” What can I do to get her to accept help?
As mentioned above, the name of the game is balancing prudent medical investigations and treatments with over-diagnosis and treatment. The ultimate shared fear of patients and healthcare providers dealing with somatic symptom disorders is that we’ve all gotten it wrong – that we’ve missed a rare disease and caused undue suffering and/or death as a result. Put another way – that we’ve identified something as being “all in their head” when, in fact, they weren’t “making it up”. Experienced clinicians reassure their patients that, though the tests run so far have been normal, it doesn’t necessarily mean that what the patient is experiencing isn’t happening. I frame normal lab tests as reassurance that nothing catastrophic is going on, highlight the number of diagnoses that we’ve “ruled out” as a result and pledge support to continue to work with the patient to improve functionality and monitor symptoms for any change in quality or quantity warranting further investigation.
It’s important to also acknowledge the toll these symptoms can take in loss of functioning, and to express empathy with the shared fear and confusion that inevitably occur with these disorders. Spouses and family members can take the same approach. Avoid direct confrontation about the truthfulness of the symptoms and help the person identify creative and practical solutions and coping strategies that can minimize the problems caused by the symptoms. Recognizing the emotional toll of feeling isolated through this process and encouraging attention to mental health concerns that could be framed as “side effects” of these symptoms may be a segue into more formal mental health treatments. Furthermore, spouses can help through the profession of unconditional love and support. Read More
About the Expert:
Erik Vanderlip, M.D., M.P.H. Assistant Professor, Departments of Psychiatry, Medical Informatics University of Oklahoma School of Community Medicine
Martin is a 31-year-old married male who has been seen by Dr. Smith, a primary care physician who practices near Martin’s work. Martin began to see Dr. Smith three months ago after abdominal pain he had been experiencing for about a year was becoming progressively worse. Martin noticed that the abdominal pain would come on intermittently, was located everywhere in his abdomen and was not consistently related to food intake. Read More
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FEB 23, 2017
Adam Maier-Clayton says mental illness has ruined his life and he wants to die. The 27–year–old Windsor, Ont., man suffers from depression, anxiety and a psychiatric condition called somatic symptom disorder, which leaves him in extreme pain with no clear physical cause.
FEB 16, 2017
Despite whatever a traumatic situation entailed, the result is often chaos in the mind and emotions of the person who experienced the traumatic event. In fact, our perceptions of the event itself could lead to symptoms of trauma. This article highlights some of the ways trauma can complicate treatment and the importance of being open to the ways it can affect diagnosis and treatment recommendations.
FEB 1, 2017
As our understanding of diseases continues to expand, George Merrin explains what psychosomatic illnesses and injuries are and why there is so much mystery around them. Somatoform Symptom Disorder (SSD) is a mental illness which causes bodily symptoms such as pain. The difference between psychosomatic and somatoform disorders is that in the latter no physical damage is done.
American Academy of Family Physicians
National Association of Pediatric Nurse Practitioners - Parent Caregiver Information
National Institutes of Health/National Library of Medicine – Somatic Symptom Disorder
Physician Review By:
Reviewed by Ranna Parekh, M.D., M.P.H.