What is psychosomatic illness?
Psychosomatic is defined as concerning or involving both mind and body. Psychosomatic illnesses can be classified in three general types. The first type includes people who have both a mental (psychiatric) illness and a medical illness, and these illnesses complicate the symptoms and management of each other. The second type includes people who have a psychiatric problem that is a direct result of a medical illness or its treatment, such as having depression due to cancer and its treatment.
The third type of psychosomatic illness is somatoform disorders. Somatoform disorders are psychiatric disorders that are displayed through physical problems. In other words, the physical symptoms people experience are related to psychological factors rather than a medical cause.
Somatoform disorders are the focus of this article and include the following:
Body dysmorphic disorder is an obsession or preoccupation with a minor or imaginary flaw, such as wrinkles, small breasts, or the shape or size of other body parts. Body dysmorphic disorder causes severe anxiety and may impact a person’s ability to function normally in daily life.
Conversion disorder is a disorder in which a person experiences neurological symptoms that affect his or her movement and senses and that do not appear to have a physical cause. Symptoms can include seizures, blindness or paralysis.
Hypochondriasis is an obsession or fixation with the fear of having a serious disease. People with hypochondriasis misconstrue normal body functions or minor symptoms as being serious or life threatening. For example, a person with hypochondriasis may become convinced that he or she has colon cancer when having temporary flatulence after eating cabbage.
Somatization disorder is a disorder in which a person experiences physical complaints, such as headaches, diarrhea, or premature ejaculation, that do not have a physical cause.
The exact cause of somatoform disorders is not completely understood. Somatoform disorders are thought to be familial, meaning that genetics may play a role. Somatoform disorders may also be triggered by strong emotions, such as anxiety, grief, trauma, abuse, stress, depression, anger or guilt. People who suffer from somatoform disorders will generally not recognize the role these emotions play in their physical symptoms. However, they are not intentionally producing these physical symptoms or making up their physical problems. Their physical symptoms are real, but are caused by psychological factors.
Women are more likely than men to have a somatoform disorder. Symptoms usually begin before age 30 and persist for several years. The severity of the symptoms may vary from year to year, but there are rarely times when symptoms are not present. Examples of somatoform symptoms include digestive problems, headaches, pain, fatigue, menstrual problems, and sexual difficulties.
Currently, there is no cure for somatoform disorders. Treatment focuses on establishing a consistent and supportive relationship between the patient and his or her primary care doctor. Often, referral to a psychiatrist can help people with somatoform disorders manage their symptoms. While treatment can be difficult, people who suffer from somatoform disorders can lead normal lives even with continuing symptoms.
Somatoform disorders are generally not considered life-threatening conditions. However, they can lead to episodes of major depression and suicide attempts. Seek immediate medical care (call 911) if you, or someone you are with, have or express any thoughts about hurting yourself or committing suicide.
Seek prompt medical care if you experience symptoms of mild to major depression, including sleep problems, persistent feelings of sadness or emptiness, feelings of hopelessness or worthlessness, constant fatigue, irritability, and loss of interest in activities or hobbies.
What are the symptoms of psychosomatic illness?
Somatoform disorders are the major forms of psychosomatic illness. The physical symptoms of somatoform disorders are real. However, they have psychological roots rather than physical causes. The symptoms often resemble symptoms of medical illnesses. As such, people suffering from somatoform disorders may undergo extensive testing and medical evaluations to determine the cause of their symptoms.
Somatoform disorders include somatization disorder, hypochondriasis, body dysmorphic disorder, and conversion disorder. These disorders can cause difficulties in everyday life, including social, academic and occupational problems.
Common symptoms of body dysmorphic disorder
People who suffer from body dysmorphic disorder become obsessed with minor flaws in their physical appearance or may see flaws where none exist. Common concerns include hair loss; the size and shape of features, such as the eyes, nose or breasts; weight gain; and wrinkles. Symptoms and associated behaviors of body dysmorphic disorder may include:
Anxiety and depression
Avoiding being seen in public and withdrawal from social situations
Avoiding mirrors
Constantly checking yourself in a mirror
Seeking reassurance from others about your looks
Common symptoms of conversion disorder
Symptoms of conversion disorder usually look like neurological problems and can include:
Blindness or double vision
Impaired balance or coordination
Inability to speak (aphonia)
Loss of sensation
Paralysis or weakness
Seizures
Urinary retention
Common symptoms of hypochondriasis
Hypochondriasis is the condition of thinking that normal body functions or minor symptoms represent a serious medical condition. A person with hypochondriasis can interpret a headache as a brain tumor or muscle soreness as a sign of impending paralysis. Typical symptoms of hypochondriasis include:
Anxiety and depression
Feeling that their doctor has made a mistake by not diagnosing the cause of their symptoms
Repeated doctor visits until a diagnosis is made
Seeking constant reassurance from friends and family about their symptoms
Common symptoms of somatization disorder
Somatization disorder is characterized by physical symptoms without a physical cause. Symptoms of somatization disorder include:
Digestive symptoms, such as nausea, vomiting, abdominal pain, constipation, and diarrhea
Neurological symptoms, such as headache and fatigue
Pain
Sexual symptoms, such as pain during intercourse, loss of sexual desire, erectile dysfunction, and extremely painful periods in women
Symptoms that might indicate a serious or life-threatening condition
People with somatoform disorders are at risk for suicidal thoughts and actions. Seek immediate medical care (call 911) if you, or someone you are with, have attempted to hurt or kill oneself or have had thoughts about hurting or killing oneself.
People with somatoform disorders are also at risk of developing major depression. Seek prompt medical care if you, or someone you are with, have any of these symptoms:
Changes in eating habits, such as overeating or loss of appetite
Difficulty concentrating or remembering things
Fatigue or lack of energy
Feelings of hopelessness, guilt or worthlessness
Irritability and restlessness
Loss of interest in activities and hobbies including sex
Persistent feelings of sadness or emptiness
Sleep problems, such as insomnia or excessive sleeping
What causes psychosomatic illness?
The exact cause of somatoform disorders, which are the major type of psychosomatic illness, is not known. Somatoform disorders tend to run in families and may have a genetic component. Somatoform disorders may be a coping strategy, a learned behavior, or the result of a personality characteristic. They may also be linked to problems with nerve impulses that carry false signals to the brain. While the cause of somatoform disorders is not known, the symptoms are real to the person experiencing them. They are not imagined or made up.
Triggers of somatoform disorders may include strong emotional or psychological experiences, such as:
Abuse
Anger
Anxiety
Depression
Grief
Guilt
Stress
Trauma
What are the risk factors for psychosomatic illness?
Because the exact cause of somatoform disorders, the major types of psychosomatic illness, is not known, it is difficult to identify specific risk factors. However, somatoform disorders are thought to run in families. If a member of your family has suffered from a somatoform disorder, you may also be at risk of developing a somatoform disorder. Other risk factors include:
History of sexual, emotional or physical abuse
Major childhood illness
Poor or reduced ability to show or express emotions
How is psychosomatic illness treated?
Treatment of somatoform disorders, which make up the majority of psychosomatic illnesses, can be challenging. After ruling out physical causes of your symptoms, it generally focuses on establishing a trusting, supportive relationship between you and your primary care doctor. Your doctor will recommend regular checkup appointments as one of the most important parts of your treatment.
Psychiatric treatment of somatoform disorders
Your primary care doctor may refer you to a psychiatrist for help in managing your disorder. Psychotherapy, specifically cognitive-behavioral therapy, may be effective in relieving some of the underlying psychological factors that are causing your physical symptoms. Learning to manage stress in a healthy way through stress management techniques may be part of your therapy. If a specific mental disorder, such as depression, can be identified, treatment with medications may also help.
Symptomatic treatment of somatoform disorders
Symptoms of a somatoform disorder may continue despite efforts at cognitive-behavioral therapy. When this occurs, treatment can be aimed at providing symptomatic relief and helping people live normal lives. Medications can be used to help provide relief from symptoms, such as headache, fatigue, pain, and digestive problems. However, medications may not be needed in all cases.
What you can do to improve your disorder
You may be able to help control your somatoform symptoms by:
Following the treatment plan you and your healthcare professional design specifically for you
Keeping your regularly scheduled checkup appointments
Practicing stress management techniques
What are the potential complications of psychosomatic illness?
If you have a psychosomatic illness, specifically a somatoform disorder, you are at increased risk of:
Difficulty functioning effectively in everyday life, such as in school, at work, and in relationships
Disability
Lower quality of life
Major depression
Suicidal thoughts or actions
You can best treat your somatoform disorder and lower your risks of complications by following the treatment plan you and your healthcare professional design specifically for you. This includes keeping your regularly scheduled checkups and therapy appointments.
