What are somatoform disorders?
Somatoform disorders are manifested by physical complaints that the person affected can describe very clearly, but for which there is no organic cause on medical examination. A striking feature of somatoform disorders is the repeated visits to the doctor by those affected with the request for a thorough medical history. A negative result causes the patient to visit the next doctor in frustration, with whose diagnosis they are again dissatisfied. Those affected feel misunderstood and become increasingly desperate. Their clinical picture has often existed for years, depressive states or depression may have developed until the issue is finally addressed from the psychological side. However, this requires the cooperation of the patient, which can only succeed on the basis of a trusting doctor-patient relationship.
Somatoform disorders manifest themselves with a wide variety of symptoms. In most cases, the symptoms originate in the autonomic nervous system, i.e. they cannot be controlled or managed by the person concerned. The following organs and systems can be affected:
- Heart and cardiovascular system
- Stomach and intestinal tract
- Urogenital area
- Lungs and breathing
Some sufferers also complain of sweating, hot flushes or general restlessness. Somatoform disorders are divided into the following categories
- Hypochondriacal disorder
- Somatization disorder
- Somatoform pain disorder
Hypochondriacal disorder affects both men and women. Although physically healthy, they are convinced that they are suffering from a serious illness. They over-interpret certain physical symptoms and are always dissatisfied with the diagnoses made by the doctors treating them. We speak of hypochondria when the extensive and anxiety-ridden preoccupation with one’s own body lasts for more than six months, the affected person does not want to accept that there is no physical illness behind their symptoms and they also refuse any psychotherapeutic help.
In the case of somatization disorder, sufferers have persistent complaints such as fatigue, stomach, bowel, bladder or heart problems. The symptoms have persisted for at least six months and the disorders are caused by the autonomic nervous system. Self-medication, frequent visits to the doctor and searching for “healers” are usually part of this disorder.
In somatoform pain disorder, sufferers complain of persistent, severe pain in a part of the body for which there is no physical cause. The location and character of the pain can change, the pain can lead to sleep disorders and affect everyday life as a whole. In discussions with doctors, sufferers do not admit to psychological causes as possible triggers.
Somatoform dysfunction - causes and risk factors
There are a whole range of possible causes for a somatoform disorder and one must always assume a combination of different factors. A genetic predisposition may exist because somatoform disorders are frequently observed in some families. Traumatic experiences in childhood or growing up with a chronically ill family member who received more attention as a result can promote the development of a somatoform disorder. Probably play
- persistent stress,
- anxious self-observation of physical symptoms and
- mental processes that are expressed through physical complaints,
play a not insignificant role in the development of the clinical picture. Normal bodily processes are perceived sensitively, interpreted and evaluated as a sign of a serious illness. The doctor’s statements are not really reassuring and the next doctor is consulted. Self-observation exacerbates the discomfort, and constantly calling in new specialists and diagnoses does nothing to de-escalate the situation. Those affected find it difficult to break out of this vicious circle.
People with an anxious and insecure personality structure, who often feel at the mercy of others and worthless, are more susceptible to somatoform disorder. An inability to express one’s emotions appropriately can also contribute to an illness.
Symptoms of somatoform disorder
Somatoform disorders manifest themselves through physical symptoms that the person suffering from the disorder is unable to influence or control voluntarily. The phenomena she describes are real and are not faked. They usually concentrate on one organ, which they indicate as the center of the complaints, but this can also change over time. The functional disorders become noticeable with
- Chest pain, heart complaints, feeling of pressure,
- Abdominal pain, stomach complaints, constipation or diarrhea, irritable bowel symptoms,
- Irritable bladder, pain when urinating, lower abdominal pain,
- Shortness of breath, feeling of pressure, shortness of breath or hyperventilation,
- Circulatory problems,
- Sensations such as cold hands, which are interpreted as a sign of an impending heart attack.
Somatoform disorders – diagnosis with us
It is not so easy to make a correct diagnosis of a somatoform disorder. If you consult your family doctor when your symptoms first occur, they will first want to carefully rule out all physical causes. Magnetic resonance imaging or computer tomography, for example, can be used to examine the head. The detailed examinations and the subsequent declaration that they cannot find anything organic can of course already lead to an initial disgruntlement in the doctor-patient relationship. However, if no organic triggers can be found with careful diagnostics, you should be open to further discussions with us.
Somatoform dysfunctions - prevention, early detection, prognosis
If a somatoform disorder remains untreated, the person affected usually visits many doctors. She makes use of expensive diagnostics, which do not reassure her, but undermine her trust in doctors over time and strengthen her convictions. This can result in sick leave and even incapacity to work. The sooner a connection is established between body and soul, the better it is for the sick person.
Somatoform disorders cannot be prevented. If this disease has already occurred in your family, then you should be alert and inform yourself at an early stage. Develop an awareness of your mental health and seek appropriate treatment at an early stage if you are diagnosed with a somatoform disorder.
Somatoform disorder – early detection
A certain sensitivity to the fact that physical complaints also have a psychological component helps to obtain psychological support at an early stage. If you are experiencing somatoform symptoms, take the time to discuss the psychological aspects of your complaints with us. If nothing can be found on the physical level, do not hesitate to come to us. The earlier this disorder is treated, the greater the chance that it will not be permanent.
Somatoform disorder – prognosis
The course of a somatoform disorder also depends on the behavior of the doctors. If they only focus on the physical diagnosis for a long time and write the sick person off as ill, the disorder can quickly become chronic. It is always advisable to look at possible psychological causes for the symptoms described. There are only estimates of the frequency of somatoform disorders. Probably a good fifth of all people who visit their GP suffer from this disorder. According to one study, around 60 percent of them are women. If psychotherapeutic treatment can be started in time, the prognosis for somatoform disorder is quite good.
Somatoform disorder – progression
If the doctors succeed in persuading the sick person to cooperate and take the psychological component of the disorder into account, much is gained. Somatoform disorder usually begins between the ages of 16 and 30, often around the age of 25. According to the Ärzteblatt, the majority of those affected who do not undergo treatment usually become unable to work after three years due to their symptoms. It has also been shown that treatments that require the active cooperation of the patient are more effective than surgery and drug treatments.
Somatoform disorder - treatment, therapy
A somatoform disorder should be treated as early as possible so that the symptoms do not become entrenched. An important basis for therapeutic work is a good relationship of trust between the patient and us. Remain open to recognizing the psychological causes behind your complaints. Allow yourself to get to know the connections between your physical symptoms and mental stress.