Somatic symptom disorder: Definition, causes, and symptoms

Somatic symptom disorder (SSD) is a condition in which a person has excessive thoughts and feelings relating to physical symptoms. SSD may cause anxiety and negative emotions.

Read on to learn more about SSD, including the causes, symptoms, diagnosis, and treatment. We also explain when to speak to a doctor.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), SSD is a type of mental illness that causes excessive feelings, thoughts, or behaviors that center around at least one somatic (physical) symptom. People may refer to SSD as hypochondria or illness anxiety disorder.

For a diagnosis of SSD, the negative thoughts and emotions must last for at least 6 months and cause one or more of the following symptoms:

  • exaggerated or persistent thoughts concerning the severity of symptoms
  • spending excessive time and energy on treating or handling symptoms or potential health concerns
  • persistently high anxiety concerning health or symptoms
  • physical symptoms that last for at least 6 months or more, significantly disrupt daily life, and cause distress
  • taking excessive actions to reduce the risk of perceived danger or harm

In the DSM-V, SSD replaced other mental health conditions, including:

  • somatization disorder
  • hypochondriasis
  • pain disorder
  • undifferentiated somatoform disorder

One key differentiation between SSD and the above former DSM-IV disorders is that people with SSD do not need to experience unexplainable symptoms.

Another difference from the former conditions is that SSD causes at least one chronic physical symptom. Additionally, it accompanies excessive, persistent negative feelings, thoughts, and emotions.

Currently, the cause of SSD is unknown. However, research suggests that people with SSD may have an intensified awareness of bodily symptoms and sensations. They may also perceive symptoms in a different way or describe feelings in a physical way.

In addition, these individuals may have the tendency to view these symptoms negatively or as a sign of medical illness.

In some cases, SSD is related to diagnosed medical conditions. However, to have the condition, someone must also develop associated persistent, pervasive negative emotions, thoughts, or actions.

In other cases, SSD is related to an undiagnosed medical condition, but this does not make it any less real.

No one knows why SSD really occurs, but research suggests that risk factors may include:

  • sexual, emotional, or physical abuse
  • childhood neglect
  • a chaotic lifestyle
  • a history of substance and alcohol abuse
  • having an axis II personality disorder, such as obsessive-compulsive disorder
  • psychosocial stressors, such as reduced occupational functioning and unemployment
  • genetic factors

People with SSD experience excessive anxiety and persistent negative emotions, feelings, and behaviors in relation to at least one chronic, disabling, or distressing physical symptom. Some common physical symptoms associated with SSD include:

  • increased heart rate
  • gastrointestinal problems
  • muscle tension, stiffness, and cramps
  • pain
  • trouble breathing or shortness of breath
  • weakness

To diagnose SSD, a doctor will ask the person about all of their symptoms, take their medical history, and perform a physical exam.

The doctor will typically then run a series of diagnostic blood, imaging, and other laboratory tests

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