We all have those nights when a small discomfort in your body — perhaps a headache or a twitchy eyelid — makes you reach for your phone and google what the symptom is about; and, of course, after landing on some shady “medical website”, you read the most horrifying explanation for that small discomfort, and suddenly you’re wide awake at 3 a.m., looking up doctors near you who can treat this supposedly fatal illness you now think you have.
Most of the time, though, this turns into a funny and relatable story by morning — either the small symptom has gone away, or we realise that our worry was a bit silly. However, for some people, the concern about their health over just a minor symptom might be so persistent and distressing, that it turns into a disorder itself.
What is a Somatic Symptom Disorder?
People with a Somatic Symptom Disorder (also known as somatoform disorder) focus on one or more physical symptoms excessively, in a way that is disproportionate to the seriousness of the symptom. They experience constant high levels of anxiety and seek medical help, sometimes devoting an extremely large amount of time and energy into the health concern, which lasts at least 6 months. Generally, the concern isn’t explained by an actual medical condition, but regardless of whether an illness is indeed present or not, the anxiety about it can be so upsetting and unceasing that it disrupts one’s daily life.
Is Somatic Symptom Disorder “Hypochondriasis”?
Although “hypochondriasis” is a more commonly known word for someone who worries too much about their health (see this clip of Jennifer Lawrence humorously describing her “hypochondriac” behaviour), the term is in fact no longer included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, it’s partially subsumed under Somatic Symptoms Disorder; in addition, people who experience health anxiety without any physical symptoms are classified under Illness Anxiety Disorder (although this has been under review).
Other types of Somatic Symptom Disorders include (but are not limited to) Conversion Disorder and Factitious Disorder.
What is the cause of Somatic Symptom Disorders?
There is no one clear cause, but the following factors may play a part:
1. Family influence, including genetic (for example, heightened sensitivity to pain) and environmental (for example, excessive health concerns from family members may cause someone to learn to interpret symptoms as serious). Those who have a family history of a disease may also experience greater anxiety about developing it.
2. Cognitive factors, such as negative thinking, which lead to an overly pessimistic perception of a physical problem; or problems with processing emotions, which shift the focus to physical syndromes rather than the underlying emotional cause
3. Traumatic or stressful life events: Sometimes, the disorder is linked to post-traumatic stress disorder (PTSD)
4. Anxiety or depression, although it’s hard to say which causes which
5. Having or recovering from a medical condition
Various other factors can contribute to a Somatic Symptom Disorder. However, as it is a psychological disorder, the focus of treatment lies in the mental rather than physical aspect.
How is it treated?
Cognitive-behavioural therapy (CBT), which helps people challenge distorted thoughts, improve emotional regulation and develop personal coping strategies, is the most widely used method of treatment for somatoform disorders.
By learning to reduce stress, cope with physical symptoms and deal with other issues such as depression and anxiety, people with Somatic Symptom Disorders can take steps to reduce their over-fixation on health problems and improve their quality of life.
How can I care for someone with this disorder?
Whether someone is exhibiting actual disordered behaviour or not, it’s important to be at least compassionate toward their anxiety. Most of the time, that anxiety stems from other parts of life that are causing them (perhaps unconscious) distress, so seeking professional help from a psychologist to address the underlying emotion is a good idea.
As a friend or family member, you might also help this person identify when, or under what situation, their health concerns tend to be triggered — is it at nighttime? When work gets stressful? Be a supportive presence for them if or when they experience such anxiety. You can also try to involve them in relaxing practices such as meditation, exercise, or healthy group activities that can ease anxiety in general; anyway, it’s a good idea for anyone to do those things!
Finally, the development of the COVID-19 pandemic has undoubtedly made many of us more concerned about our health; nowadays, a cough feels a little more sinister than it used to be. Although it’s good to stay vigilant, we shouldn’t overlook the mental distress that can be brought about by an excessive, even crippling, concern for one’s health. Now is the time to be ever more mindful of our and others’ mental well-being.