Somatic Symptom Disorder: Symptoms, Causes, Treatment

Somatic symptom disorder (SSD) is a mental health condition that causes obsession over physical symptoms you experience. This condition goes beyond just causing health anxiety. People with SSD excessively focus on any symptoms they may be experiencing (like pain or fatigue) and have distressing thoughts and feelings about them. 

People with somatic symptom disorder believe they have a medical condition causing their symptoms. While these symptoms are real, they may not always be associated with any underlying conditions. 

An estimated 5-7% of people in the United States have SSD—making it a common reason people seek support from a healthcare provider. People assigned female at birth are more likely to experience the condition.

It’s normal to be concerned or worried when you feel unwell or have concerning symptoms. However, you may have SSD if your physical symptoms cause you to feel, behave, or respond in the following ways despite reassurances from your healthcare provider:

• You have extreme anxiety or distress about your symptoms
• You believe a serious medical condition is causing your symptoms
• You put a lot of time and energy into researching the symptoms or searching for remedies
• Your thoughts and feelings about your symptoms disrupt your ability to function
• You do not believe your test results are correct
• You feel your healthcare provider is not taking your symptoms and your concerns seriously

It is unclear what causes some people to develop somatic symptom disorder. Experts believe it stems from an increased awareness of body sensations or changes and a high tendency to associate such sensations with a health condition.

Risk Factors

While anyone can develop SSD, some people may have a higher risk. Common risk factors for this condition include:

• Genetics
• Substance use disorder (SUD)
• Family history of SSD
• Childhood neglect and trauma
• Tendency to see things from a negative perspective
• Psychosocial stressors, such as unemployment, poverty, or discrimination
• Personal history of specific personality disorders

Some clues may cause a healthcare provider to suspect SSD. They may observe that your past healthcare concerns were not resolved despite receiving standard medical care or notice that you have been seeking care from several healthcare providers for the same symptoms. Your provider may order certain tests, such as imaging scans, urinalysis, and blood tests, to rule out underlying health conditions. 

Your primary care provider may also refer you to a psychiatrist or psychologist to make an official diagnosis. According to the American Psychiatric Association, you may have a diagnosis for SSD if you:

• Experience one or multiple physical symptoms
• Have at least one symptom that is constantly present
• Notice symptoms are disrupting your daily life
• Feel extreme thoughts, behaviors, or feelings about the symptoms
• Spend significant time and energy on matters related to your symptoms and overall health
• Began experiencing symptoms at least six months ago

Treating somatic symptom disorder can be challenging because some people don’t believe their provider is giving them correct answers or offering the best standard of care. This can be especially difficult if you are experiencing symptoms and haven’t received an official diagnosis. 

Treatment can help you manage your symptoms and improve your daily functioning. You will often need to have regular consultations with your healthcare provider, through which they will offer the needed support and reassurance. Common treatment options include therapy, medications, and lifestyle changes.

Therapy

Cognitive behavioral therapy is a therapy that can help treat SSD. This form of talk therapy can teach you how to:

• Limit extreme focus or obsession on your symptoms
• Reframe your thoughts and beliefs to a more positive perspective
• Figure out what improves and worsens your symptoms
• Manage stress in a healthy way and improve your daily living

Medications

Some healthcare providers may want to limit prescribing medications, as no specific medications are approved to treat this condition. In cases where SSD co-occurs with other mental health conditions like anxiety and depression, your therapist may recommend low doses of antidepressants or anti-anxiety medications. They may increase the dosage of these medications as needed. 

Lifestyle Changes

Your healthcare provider may encourage lifestyle changes to improve your quality of life and lower anxiety or distress about your physical symptoms. These stress management techniques include the following:

• Get at least seven hours of sleep per night
• Engage in regular exercise
• Participate in social activities and hobbies
• Spend quality time with your loved ones

Little is known about how to prevent SSD. Experts recommend counseling for people who are prone to developing the condition, as it can help them deal with stress or reduce their symptoms.

Some conditions can share overlapping symptoms with SSD or co-exist with the disorder. These conditions include:

• Generalized anxiety disorder (GAD), which causes persistent fear, worry, and stress
• Illness anxiety disorder, which causes constant worry about your health and excessive fear about getting sick 
• Factitious disorder, which may cause someone to fake their symptoms or induce self-harm as a way to seek attention or sympathy 

Somatic symptom disorder is a mental health condition that causes extreme anxiety or distress about the physical symptoms you might be experiencing. It’s normal to feel worried when you’re unwell or experiencing concerning symptoms, but this condition causes an elevated level of stress that can disrupt your life.

If you receive a diagnosis for SSD, treatments like therapy, medications, and lifestyle changes can help you manage your symptoms.