Imagine you have a slight stomach ache, or you just feel unwell. What do we usually do? Maybe we rest a bit, or we take a paracetamol and wait it out. But do you think that this small symptom could be the beginning of a serious illness, perhaps cancer? Do you feel a lot of pressure and fear when you think about it? After going to one doctor and being told "nothing is wrong", you can't believe it and go to several more doctors? If so, the topic we are going to talk about today may be very important to you. Let's talk about a mental health condition called `Somatic Symptom Disorder` (SSD).
Simply put, what is Somatic Symptom Disorder (SSD)?
This may seem like a complicated topic, but let me explain it to you simply. `Somatic Symptom Disorder` (SSD) is a mental health condition. What happens here is that a person actually has one or more physical symptoms. But the stress, anxiety, and fear they experience about those symptoms are abnormally high.
The important thing is that this is not an "imagined illness." That is, the patient is not faking it. He or she is actually experiencing pain, fatigue, or other physical discomfort. The problem lies in the person's response to that discomfort. For example, a doctor may run tests and say, "This is normal gastritis, nothing to worry about," but a person with SSD may think, "No, the doctor couldn't diagnose my condition, I have something more serious, maybe colon cancer." This excessive fear and anxiety can disrupt their entire day, their entire life.
The most important thing to remember: In SSD, the problem is not the physical symptom itself. It is the excessive, uncontrollable thoughts, feelings, and behaviors that develop around that symptom.
Are there other mental states like this? Let's learn the difference.
Yes, sometimes this condition can be confused with other similar mental conditions. Let's see what the main differences are. To understand this clearly, see the table below.
| Mental state | Main feature | Simply put... |
|---|---|---|
| Somatic Symptom Disorder (SSD) | There are actually physical symptoms (e.g., pain, fatigue). There is excessive anxiety and fear about it. | "I can't do any work because of this stomach ache. This must be a dangerous illness." |
| Illness Anxiety Disorder (Formerly known as Hypochondriasis) | Often there are no physical symptoms , or only very mild ones. However, there is an intense fear that they will develop an illness or that they already have it. | "I don't have any problems right now. But I think there's a big chance I could get cancer. I think about it all the time." |
| Conversion Disorder (Functional Neurological Symptom Disorder) | Symptoms related to the nervous system (e.g., numbness, seizures, inability to speak) occur, but medical tests cannot find any physical cause . | "Suddenly my legs went numb. No matter what tests the doctors did, they couldn't find a cause." (There may not be much fear about the symptom here). |
What are the symptoms of SSD condition?
There are two parts to understanding this condition. One is the physical sensations, and the other is our mental and behavioral responses to them.
1. Physical Symptoms
These can be anything, but the most common are:
- Pain: This is the main and most commonly reported symptom. It can be any type of pain, such as headaches, stomachaches, backaches, or joint pain.
- Fatigue or extreme fatigue: Feeling tired all the time for no reason.
- Difficulty breathing: A feeling of heaviness in the chest, a feeling of suffocation.
These symptoms may actually be caused by a medical condition (e.g. gastritis), or they may have no clear cause.
2. Excessive thoughts, feelings, and behaviors
This is the essence of SSD status. If someone shows these things, you should be concerned:
- Excessive fear and anxiety: Constantly feeling excessive fear and anxiety about one's physical symptoms. Frequent thoughts such as, "I wonder if this little headache is a brain tumor."
- Thinking the worst: Thinking that even a minor symptom is a sign of a very serious illness.
- Frequent switching of doctors: Going from one doctor to another, rather than trusting one doctor, is like "doctor shopping." Sometimes, you may be treated by several doctors at the same time.
- Distrust of test results: No matter how many tests you take and are told "there is no problem," you are still not satisfied with the results and think, "There must have been a mistake in the test."
- Misconceptions about the doctor: Feelings like, "My doctor doesn't care about me, he doesn't understand my illness."
- Wasting time and energy: Spending too much time and energy researching, reading about your health problems on the internet, and seeing doctors.
- Dependence on others: Constantly asking others to help and take care of you. Getting angry when that help is not received.
- Impairment of daily functioning: These symptoms and thoughts about them can completely disrupt daily activities, work, and family life.
Why does someone have this condition?
There is no single cause for this. Researchers believe that a combination of genetic, environmental, and psychological factors play a role. Some of the main risk factors identified are:
- Harsh childhood experiences: Especially physical or sexual abuse during childhood.
- Neglect from parents: Lack of proper guidance, love, and care to recognize and manage emotions during childhood.
- Mental health problems: Already suffering from another mental health condition, such as depression or anxiety. About 30% - 60% of people with SSD may have both or one of these conditions.
- Personality traits: People with certain personality disorders are at higher risk of developing this condition.
- Drug or alcohol use: Addiction to drugs or alcohol.
- Attention: The habit of paying excessive attention to even small changes in one's body.
How does a doctor diagnose this condition?
When you go to the doctor to tell him about your physical symptoms, the first thing he does is to check if there are any physical causes for those symptoms. If necessary, he will order a physical examination, blood tests, or other ``scans''.
After these tests,
1. If no physical cause can be found for your symptoms,
2. Or, if the doctor finds that your anxiety and stress are much greater than the severity of the illness, even if you have a physical illness,
He or she may refer you to a mental health specialist, such as a psychiatrist.
A mental health professional will confirm this condition by looking at a few specific criteria. To be diagnosed with SSD, a person must have one or more physical symptoms that interfere with daily life for at least 6 months . In addition, they must have at least one of the following in response to those symptoms:
- Excessive and persistent thinking about the severity of one's symptoms.
- Constantly feeling anxious about one's health or symptoms.
- Spending too much time and energy researching their own symptoms and health problems.
What are the treatments for this?
The good news is that there are treatments for this condition. The main goal of treatment is to help manage the physical symptoms while also treating the associated psychological issues.
- Psychotherapy: This is the main and most effective treatment method. Here too, a method called `Cognitive Behavioral Therapy` (CBT) is very effective.
- Medication: In some cases, a doctor may prescribe medications such as antidepressants to help manage underlying depression or anxiety. In addition to improving mood, these medications have also been found to help relieve physical symptoms such as pain, fatigue, and insomnia.
- Build a trusting relationship with one doctor: Keep the same doctor as your primary care physician. This can help prevent unnecessary tests and doctor visits.
- See your doctor on time: See your doctor on scheduled days to talk about your physical symptoms and how you are coping with them.
- Connect with a mental health professional regularly: See a psychiatrist or counselor regularly to manage your mental symptoms, such as anxiety and fear.
- Exercise and ways to reduce stress: Engaging in activities like yoga, meditation, and light exercise can be good for your mind as well as your body.
- Somatic Symptom Disorder (SSD) is not a "made-up illness." It is a real mental health condition associated with real physical symptoms that requires treatment.
- In this situation, the main problem is not the physical symptoms, but the excessive anxiety, fear, and behavioral problems that arise as a result.
- Frequent doctor shopping and unnecessary tests can make the situation worse. It is very important to maintain a trusting relationship with the same doctor.
- Talk therapy, especially CBT, is a very effective treatment for managing this condition.
- Don't be afraid to talk openly with your doctor about your physical symptoms, as well as your fears and anxieties about them. Getting the right help is the first step to recovery.
CBT simply helps you identify and change the distorted (incorrect) thought patterns you have about your symptoms. For example, instead of thinking, "I have a headache because I have a brain tumor," you can practice thinking more rationally, such as, "Maybe it's because I didn't drink enough water." This will help you:
- Reduce fear and anxiety about symptoms.
- Stop constantly thinking about your physical problems.
- Find ways to stay social and active, even in pain.
- Carry out your daily tasks well.
Things you can do yourself and the future outlook
SSD can often be a chronic condition. This means that symptoms may subside for a while and then recur. However, with proper treatment, most people can manage their symptoms and live a normal life.
If you have been diagnosed with this condition, following these steps will greatly help your recovery:
If you are feeling so overwhelmed by your physical symptoms that you are unable to function in your daily life, don't suffer alone. See your doctor as soon as possible. Remember, this is a treatable condition, just like any physical illness.
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