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Help With Somatic Symptom Disorder

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 dizziness, that results in major distress and/or problems with daily activities. The individual has excessive worries, feelings and behaviors relating to the physical (somatic) symptoms.Sometimes people experience the symptoms even though they do not have a diagnosed medical condition. Other times people experience more concern about symptoms than would be expected with their diagnosed medical condition. Even though they do not have a diagnosed medical condition or experience the symptoms out of proportion to their diagnosed condition, they truly experience the symptoms (that is, not faking the illness).

See definition, symptoms, & treatment

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Rituals and superstitions among athletes, and non-athletes, are very common and are typically harmless. In fact, they are at times helpful for athletes facing unpredictability in their sport and these rituals and superstitions can help them feel more in control. People may jokingly or offhandedly refer to these behaviors as OCD-like, referring to obsessive-compulsive disorder (OCD). However, they are not the same as OCD, a potentially debilitating mental health disorder.

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Suicide Prevention is a Community Effort

September is National Suicide Prevention Awareness Month, and all month long you’ll see the American Psychiatric Association (APA) and our allied groups sharing their knowledge and resources to foster education and confront the stigma around this topic.

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

vanderlip-expert.jpg

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’s Story

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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MAY 9 2019

Doaktown hockey star overcomes mysterious illness that put im in a wheelchiar

CBC.ca

In February, Brayden went to the Hospital for Sick Children in Toronto, where he was diagnosed with somatic symptom disorder, a mental illness caused by major emotional distress. That disorder was caused by his initial cerebellitis diagnosis. "The somatic symptom disorder is brought on by a stressor, and it's just the way your body deals with it," Colford said. "Instead of having a mental breakdown, his body reacted."  Once he received the diagnosis, Brayden immediately started to improve and accept what his body had gone through.

APR 25 2019

IBS Therapy Should Target Multiple Factors

Medpage Today

Multi-focal therapy may be a better way to resolve the symptoms of irritable bowel syndrome (IBS), according to a study reporting that visceral hypersensitivity, abnormal colonic transit, and psychological factors are all implicated in the stepwise exacerbation of IBS. "These factors have a cumulative effect on gastrointestinal and non-gastrointestinal symptoms, as well as on QoL [quality of life] in patients with IBS and are therefore relevant treatment targets," wrote Magnus Simrén, MD, of the University of Gothenburg in Sweden, and colleagues in Gastroenterology.

FEB 11, 2018

When the Mind Fails to Heal

Canadian Lawyer Magazine

Somatic symptom disorder, or SSD, is a psychological condition in which an injured person, though physically healed, is still in pain,. Personal injury lawyers, on the plaintiff and insurance-defence side, say they are increasingly dealing with claimants diagnosed with somatic symptom disorder, previously known as somatoform disorder. The proliferation in diagnoses of this psychiatric condition and recognition by the courts in personal injury cases marks the increasing recognition of mental illness in society, though it remains difficult to win damages for what is a mysterious and hard-to-define condition.

is problem.