Somatic Symptom Disorder

What is a somatic symptom disorder?

Having a somatic symptom disorder means that you experience physical symptoms that affect your daily life and cause you significant distress. Although you genuinely feel these symptoms and they can be very distressing, a clear medical cause that explains everything is not always found.

One of the main characteristics is that the symptoms, and the worries about them, demand a great deal of attention and energy. As a result, they can have a major impact on how you feel and what you are able to do or not do in a day. It is, as it were, an interplay between body and mind, in which tension, thoughts and feelings can intensify or perpetuate the symptoms.

This doesn’t mean that it’s ‘all in your head’, but rather that psychological factors play an important role in how the symptoms are experienced and how they are managed. Fortunately, help is available to learn how to cope with this differently.

How can you recognise a somatic symptom disorder?

You can recognise a somatic symptom disorder by a combination of physical symptoms and the way you focus on them. Symptoms may include:

• You have been experiencing physical symptoms for a long time, such as pain, fatigue, dizziness or gastrointestinal problems.
• You worry a great deal about your health or what the symptoms mean.
• You are often preoccupied with your body, for example by constantly checking your symptoms or thinking about them a lot.
• You regularly seek medical help or reassurance, or conversely avoid activities for fear that your symptoms will worsen.
• The symptoms and worries have a significant impact on your daily life, such as work, social contacts or leisure activities.
• It is difficult to focus your attention on anything other than the symptoms.

Not everyone will recognise themselves in all these points. It is mainly about the overall picture: the symptoms in combination with how much they affect your thoughts, feelings and daily functioning.

Different types of somatic symptom disorders

Somatic symptom disorders can manifest in various ways. Sometimes the physical symptoms are the main focus, whilst at other times it is primarily the anxiety or the impact on daily life. The main types are:

• Somatic symptom disorder: This involves long-term physical symptoms that affect your daily life, along with significant worry and preoccupation with these symptoms.
• Health anxiety disorder (hypochondria): This form is primarily characterised by a fear of being seriously ill, even when there are few or no physical symptoms. The worry and anxiety take centre stage.
• Conversion disorder (functional neurological disorder): This involves physical symptoms such as paralysis, speech difficulties or seizures, without any medical explanation being found. Psychological factors play a significant role.
• Physical symptoms exacerbated by stress or emotions: Sometimes there is a physical cause, but stress, tension or emotional problems make the symptoms worse. For example: someone with stomach ache or Crohn’s disease may experience additional discomfort due to stress, or fatigue may persist for longer due to tension.

These conditions are similar because they all relate to the interaction between body and mind and how symptoms are experienced and interpreted.

What can you do yourself?

If you recognise symptoms of a somatic symptom disorder, there are a number of things you can do yourself to better understand your symptoms and cope with them more effectively.

• Write down your symptoms and concerns: Make a note of when symptoms occur, how long they last, and what you feel or think at the time. This will help you get a clearer picture and better understand what is going on.
• Pay attention to your thoughts: Notice when you’re worrying about your symptoms. Ask yourself: “Is this thought helping me right now?” or “Is there any evidence that this is actually dangerous?”
• Stay active in your daily life: Try to carry on with your daily activities as much as possible, even when you have symptoms. Avoiding them can actually make the symptoms worse.
• Relaxation and stress reduction: Try breathing exercises, walking, hobbies or mindfulness. This can help reduce stress and make symptoms less intense.
• Maintain a healthy lifestyle: Get enough sleep, eat and exercise regularly, and be moderate with alcohol or caffeine. A healthy routine supports both body and mind.
• Talk about it: Share your experiences and concerns with someone you trust. It helps to put your thoughts into perspective and feel supported.

How does treatment help?

If you recognise yourself in the symptoms described above, professional help can significantly improve your quality of life. Treatment for somatic symptom disorder aims to help you better understand your physical symptoms and improve your day-to-day functioning. The focus is not only on reducing the symptoms themselves, but above all on learning to deal differently with the thoughts, feelings and physical signals that exacerbate the symptoms.

During treatment, you will learn:

• To gain insight into how your symptoms and worries are linked
• To recognise which thoughts, emotions or situations exacerbate the symptoms
• To understand how worrying, anxiety or avoidance perpetuate the symptoms
• To practise, step by step, ways to cope better with symptoms and resume daily activities
• To develop greater confidence in your own ability to cope with tension and physical symptoms

In addition, we work on building resilience and learning helpful strategies to make symptoms and worries less burdensome.

The aim of treatment is not always for the physical symptoms to disappear completely — after all, the body is sending signals — but for the symptoms to no longer limit or control your life.

The costs of treatment are covered by most health insurers if you have a referral from your GP and if you have a somatic symptom disorder as defined by the DSM-5.

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