What Is Somatic Symptom Disorder?
Somatic Symptom Disorder (SSD) is a mental health condition where individuals experience significant physical symptoms—like pain, fatigue, or gastrointestinal problems—that cause distress and interfere with daily life.
What sets SSD apart is that the distress and focus on these symptoms are excessive, persistent, and disproportionate to any medical findings.
While the physical symptoms are real and can be very uncomfortable, they may not be fully explained by a medical condition, or the person’s emotional reaction to them is unusually intense.
SSD was introduced as a diagnosis in the DSM-5 (2013) and retained in the DSM-5-TR (2022), replacing older terms like “somatization disorder.”
Key Symptoms of Somatic Symptom Disorder
Individuals with SSD often:
- Experience one or more distressing physical symptoms (e.g., pain, fatigue, stomach issues)
- Spend excessive time and energy worrying about their health
- Frequently visit doctors or seek medical reassurance
- Feel that their symptoms are serious and possibly life-threatening
- Have symptoms that interfere with daily activities like work, relationships, or social life
Other emotional symptoms include:
- Anxiety about health
- Feeling misunderstood by doctors
- Frustration or hopelessness about finding relief
Importantly, SSD is not “faking” symptoms—the physical sensations and distress are real, even if medical explanations are limited.
Somatic Symptom Disorder vs. Other Related Conditions
vs. Illness Anxiety Disorder (Hypochondriasis)
- SSD: Focuses on physical symptoms that cause distress
- Illness Anxiety Disorder: Worries about having an illness, even with few or no physical symptoms
vs. Conversion Disorder (Functional Neurological Symptom Disorder)
- SSD: Involves a variety of bodily symptoms
- Conversion Disorder: Involves neurological symptoms like paralysis or seizures without a neurological cause
vs. Factitious Disorder
- SSD: Symptoms are not intentionally produced
- Factitious Disorder: Symptoms are deliberately faked or induced
Causes and Risk Factors
The exact cause of SSD is multifactorial, involving a combination of:
- Biological factors:
- Increased sensitivity to physical sensations
- Pain perception differences
- Psychological factors:
- History of anxiety or depression
- Tendency toward negative thinking
- Environmental factors:
- Stressful life events
- Childhood trauma, including abuse or neglect
- Family history of chronic illness
SSD is slightly more common in women than men and often begins before age 30, although it can occur at any age.
How Somatic Symptom Disorder Is Diagnosed
Diagnosis involves:
- Thorough medical evaluation to rule out physical illness
- Clinical interviews focused on:
- Symptom patterns
- Emotional responses to symptoms
- Impact on daily life
- DSM-5-TR criteria, which include:
- At least one distressing somatic symptom
- Excessive thoughts, feelings, or behaviors related to the symptoms
- Symptoms persistent for more than 6 months
SSD diagnosis does not require symptoms to be medically unexplained, unlike older definitions. Instead, focus is on excessive distress and dysfunction.
Treatment for Somatic Symptom Disorder
Treatment aims to reduce distress and improve daily functioning, rather than eliminating physical symptoms completely.
Psychotherapy
- Cognitive Behavioral Therapy (CBT):
- Helps challenge catastrophic thinking
- Teaches coping skills for symptom management
- Mindfulness-Based Therapy:
- Encourages awareness without judgment
- Psychoeducation:
- Helps patients understand the mind-body connection
Medication
- Antidepressants (SSRIs, SNRIs): Useful for co-occurring anxiety or depression
- Medication is generally not used to treat physical symptoms directly unless a clear medical cause exists.
Collaborative Care
- Regular appointments with the same healthcare provider
- Coordinated care among mental health and medical professionals
- Avoiding unnecessary medical tests
Living with Somatic Symptom Disorder
Living with SSD can be challenging, but recovery is possible with:
- Support from understanding healthcare providers
- Learning to recognize and manage triggers
- Developing healthy coping strategies
- Building supportive relationships
People with SSD can lead fulfilling lives with proper treatment and self-care.
