Somatic symptom disorder (SSD) treatment

SSD, also referred to as ‘somatisation disorder’ or ‘somatoform disorder’, is a chronic mental health condition that is characterised by excessive levels of distress in response to one or several bodily symptoms, which can include pain and lethargy and may involve one of more organs or systems in your body.

SSD patients commonly have co-existing mental health disorders, including depression (up to 60% patients), anxiety disorders (up to 50%), personality disorders (up to 50%) or alcohol and substance misuse. SSD is common, representing the most prevalent disorder in general practice. In primary care, up to 30% of visits from patients may be with unexplained medical symptoms.

The physical complaints that you may experience if you have SSD can last for years, and can result in significant disruption to your daily functioning. A diagnosis of SSD will be given if the excess worry over your physical health is having an adverse effect on other aspects of your life. These preoccupying thoughts, feelings and behaviours relating to your health will be severe enough to cause work or relationship difficulties.

There are different kinds of related disorders which may be present if you have SSD, including:

Illness anxiety disorder (hypochondriasis) - people with illness anxiety disorder share many of the same signs and symptoms as someone with SDD. Similar preoccupations with physical health are involved, where even minor health complaints can be viewed as a serious medical problem.

Examples include believing a general headache is a sign of a brain tumour, with self-diagnosis, searching online around your symptoms often exaggerating such distress instead of helping the cause.

Conversion disorder - if symptoms of SSD include persistent worries over neurological problems such as hearing loss, fatigue or general weakness, then conversion disorder is a diagnosis which may be given when such symptoms cannot be linked to a clear medical cause.

Body dysmorphic disorder (BDD)

A disproportionate belief that a part of your body is abnormal or noticeable can take over the life of someone who struggles with BDD. These thought process and subsequent behaviours to cover up perceived abnormalities such as minor skin blemishes can also lead to severe health anxiety and SSD.

The relationship between the mind and the body is complex and not fully comprehended, but it is believed that mental health conditions such as stress, anxiety or depression may contribute to the physical pain and others symptoms that you may feel with SSD.

When you experience somatisation, you are often expressing an underlying mental or emotional problem as physical symptoms. The physical symptoms which are generally experienced in people with SSD can include:

• Headaches
• Abdominal symptoms
• Pain in various parts of the body
• Fatigue
• Shortness of breath
• Weakness

While pain is the most widely reported symptom of SSD, the distinction between SSD and associated health problems involves the disproportionate thoughts, feelings and behaviours that you have in response to these physical complaints. It is this level of health anxiety which underpins the distress of SSD, and is what ultimately stops you from functioning as usual in your everyday life.

Thoughts, feelings and behaviours which can be experienced if you have SSD can include:

• Persistent worry about potentially having a serious health condition
• Viewing common or minor physical complaints or sensations as a sign of severe illness
• Feeling that any medical evaluation by a GP or otherwise is insufficient
• Believing that physical activity may harm your body further
• Regularly checking your body for abnormalities
• Visiting health centres and general practices on a regular basis
• Being unusually sensitive to medical treatment or medications

It is important to remember that it is your thought processes in response to specific physical symptoms that are impacting your daily life, and it is this aspect of SSD which Priory can assist with, when you visit us for therapeutic treatment.

SSD affects people of all ages, although it is more common in women than in men, and usually begins to develop before the age of 30. The prevalence of people affected is difficult to determine because many people will never receive a formal diagnosis, with people often seeking repeated medical consultations which fail to find a definite medical cause. SSD is more frequent in cultures where people are not used to talking about mental health problems.

The defining cause of SSD is unknown, but research has indicated that early childhood experiences, along with cultural and environmental factors, may play a role in its manifestation. These may include:

Genetics - inheriting a biological sensitivity to pain can cause you to be more aware of physical sensations and issues in your body, which may lead to the symptoms of SSD and associated health anxiety, as opposed to someone with a higher threshold of pain.

Family and environmental - experiences during childhood may cause your attitudes towards physical health to altered.

If your parents regularly worried about your health when you were younger and this resulted in regular trips to the doctor without huge cause for concern, then this behaviour can become ingrained and mimicked as you get older.

Personality traits - if you tend to view life situations in a negative manner as opposed to a positive mind-set, then this view could be adversely applied to your perception of your own physical health. Negative thoughts can occupy your mind and lead you to wrongly identify physical symptoms as being representative of something more serious.

Difficulty processing emotions – if you are experiencing emotional issues, or even symptoms of stress, anxiety or depression, this can cause you to avoid challenging why you feel this way, instead focusing excessively on how you are feeling physically.

Sufferers may turn to alcohol or drugs to self-medicate and ease the burden of their somatic symptoms. However, excessive drug and alcohol intake, as well as a job role or personal circumstances causing significant amounts of stress, can make the symptoms of SSD worse.