Somatic symptom disorder – causes, symptoms, diagnosis, treatment, pathology

Somatic symptom disorder, which used to be
called somatization or somatoform disorder, involves having physical symptoms that aren’t
explained by any known physical or mental disorder – in other words, symptoms that can’t
be explained. That said, individuals aren’t ‘faking’
the symptoms, these symptoms are real and often made worse by the fact that they cannot
be scientifically explained. And this is pretty different from situations
where an individual with a factitious disorder might fake an illness or injury in order to
get attention. The diagnosis requires that individuals experience
some set of unexplained physical, or somatic, symptoms for at least 6 months. The symptoms experienced by individuals with
this disorder, though, can be incredibly varied, everything from pain to gastrointestinal problems
to sexual symptoms. And although the somatic symptoms are chronic,
the exact location, kind, and severity of the symptoms typically changes over time. The one symptom that does often persist over
time is pain, and because it’s persistent and has no clear underlying cause, it can
be particularly hard to treat. Somatic symptom disorder often causes cognitive
symptoms as well, and these include persistent thoughts and feelings about their symptoms—usually
a lot of worry and anxiety, and sometimes even catastrophic thoughts about death. More often than not, it is these cognitive
symptoms in response to the physical symptoms, more than the physical symptoms themselves,
that become a basis for this diagnosis. In fact, clinicians rate the severity of somatic
symptom disorder based on patient experience with these cognitive symptoms, not the physical
ones. The condition is considered mild if there’s
only one cognitive symptom like ruminating a lot on the symptoms. It would be considered moderate if there are
two or more cognitive symptoms like rumination as well as anxiety. And it would be considered severe if there
are two or more cognitive symptoms, as well as multiple physical symptoms or one severe
symptom, like severe pain. These cognitive and physical symptoms often
disrupt an individual’s daily life as well as their relationships. Unfortunately, the diagnosis can be tricky
and confusing given that the symptoms shift over time and that there is no clear underlying
scientific explanation. Historically, it was thought that somatic
symptom disorder was the result of a person having too much psychological stress, and
that “excess stress” bubbled over and led to bodily symptoms. A current theory is that individuals with
this disorder are extremely sensitive to changes in their bodies and that common experiences
like indigestion might be amplified in these individuals. One everyday example of this would be how
different individuals might perceive the same amount of spiciness very differently, for
some it’s tasty and for other people the exact same amount of spice is perceived as
pain. Now, treatment of somatic symptom disorder
is aimed at diminishing the cognitive symptoms, and this is often done through cognitive-behavioral
therapy. The goal here is to encourage individuals
to engage in behaviors that they think are limited because of their physical symptoms,
in order to show them what they are able to do. All right, as a quick recap: somatic symptom
disorder involves physical symptoms that cannot be scientifically explained by any known physical
or mental disorder, and the most common one is pain, and these physical symptoms often
lead to cognitive symptoms like rumination and anxiety Hey guys, just wanted to give a big special thanks and shoutout to Nurse Nacole for helping with this video, if you haven’t yet definitely check out her Channel otherwise as always subscribe to our channel you can help also sports on patreon and tell your friends about some social media guys like


  1. Hi, I always see your videos they help me a lot thanks .
    Please can you explain in details the hypo and hyperparathyrodism

  2. I know someone who has this, her hand is stuck in a fist except her forefinger, and she can't move it whatsoever, only the one finger. It really gets in the way of her everyday life 🙁

  3. Can you make a video on the menstrual cycle please? I learn a lot from your videos.
    Thanks in advance!

  4. So that's what you look like. Your voice doesn't match your structure IMO. Not that it's a bad thing.

  5. really very easy way and very informative lecture . someone in a workshop said utube is a form of university i agreed with him. i was feeling anxious when i opened dsm v to prepare my class presentation, this lecture help me a-lot i am sure now if i open dsm v for further detail it would be easy for me …………… thank u so much

  6. They are not faking illness, consciously, but they need to be distracted from themselves, from their ego. They need to get absorbed with issues not relating to them, as getting involved with other people's problems and issues. They need to forget about " their situation " and totally blend with others . Perhaps, hypnosis may work but I expect the harder one may forget about himself, the better. These patients need to be put in conditions where survival is primordial and it is NOT related to how they feel…burning pains or whatever……we have not tried, hard enough to get them out of their cocoon as the world seems to totally revolve helplessly around them. They want out of the pain because they only focus on themselves. A little hypochondria goes a long way and out of control, all for attention and I expect it is also unconscious from their part. Very tragic we have not been able to get them out of their state. I think it is doable. Suicide is never an option and it is cowardly. Put these people where suffering is real and not somatic, where people die of war wounds and no help is around. If they have any humanity and compassion, they will get out of themselves and forget about their issues. Distraction is everything. Our society is focussing on political correctness and " pain control ". We are enablers, so what can we expect from that ?

  7. Hi. I am 41. I'm reading my high school emotional evaluation papers n iep. It has 'somatic complaints ' as an issue over n over again. Like every person that evaluated me. I've never read these papers until today as they were hidden away in my parent's safe for the last 25 years. I still have them only now it's coupled with a really damaging disease called sarcoidosis. Several surgeries under my belt to remove granulomas from eyes, lungs, spine. I had no idea this thing was real. Somatic I mean. I thought I am broken. Well I'm am broken, but i feel alittle less crazy for feeling these symptoms all of my life. So how now do I tell the difference between somatic pain and disease pain since ive always had pain? Can I heal at this age?

  8. I really hope that more research goes into this, been struggling with for over 4 years now. I've had all the bones in my feet broken at once before but the pain from my disorder (usually affects my knees and shoulders) is worse than that tenfold.

  9. OK, so what if you've been diagnosed with this disorder yet you have abnormal test results? Abnormal in different areas where you need several specialists because the results could mean several different things yet they can't figure it out so you get diagnosed with this. I know the mind is powerful but you can't create abnormal blood tests or white matter lesions on your brain! I feel this diagnosis is going to result in a lot of mystery illness patients getting stigmatized as crazy and will continue to suffer due to this. The mental health community has to much power and influence over the medical community due to doctors not being trained to think outside the box and be able to treat more than the common cold. Pseudo tumor for instance; if researchers would have not thought outside of the box these people would have been labeled crazy because no one knew of it before recent years. I believe some things are stressed induced but it seems everything is getting shoved in this category because insurance companies don't want to pay, doctors want to rush patients out the door so they can squeeze in as many as they can in one day, and the pharmaceutical companies can continue to get richer off of purposefully misdiagnosed patients being prescribed mental meds!

  10. Thank you so much for making these videos. The brief yet descriptive sketch of the disorder helps me a lot with exams. I will try my best to promote this channel as much as possible.

  11. I've been diagnosed with fibromyalgia, myofascial pain syndrome, chronic prostatitis/chronic pelvic pain syndrome, ADHD, OCD, C-PTSD, GAD, and MDD. I'm always worried I'm developing multiple forms of cancer etc. Maybe I have this?!?!?!

  12. It’s very frustrating to see different euphemisms for female hysteria. Please read the book Doing Harm by Maya Dusenbery.

  13. I have this. It’s terrible to have, because my pain is often undermined, even by my family. I’m not taken seriously, and I’m told to “just relax” and “it’s all in your head”. My symptoms include 24/7 nausea, and abdominal cramps and bloating. I’m underweight because I cannot eat a full meal without feeling like I’m going to throw up. It’s a real thing, and it causes serious issues.

  14. my mother was diagnosed with this because she had pain that no one could figure out, and she was labeled as "drug seeking" and was constantly in severe pain. One day she just didn't wake up. She was only 49. At her autopsy it was found she had a spinal malformation that was pressing on nerves and causing the pain she reported for 25 years. I think a lot of shit doctors use this dx to hoist their ineptitude as physicians on their patients.

  15. Probably an official label given from crappy doctors that don't diagnose something that is real. After a while, you develop cognitive symptoms because you are suffering with no help and paying a boatload of money for doctors that don't know how to do anything but push crappy toxic pharmaceuticals. Been there. Doctors will kill you faster than the disease you are seeking to eliminate. "It's all in your head"…("um, I don't know what's wrong because all I learned in med school was pill pushing and was never taught about how the human body works…I just treat symptoms, not the cause…I just give as many people as I can, some statin drugs and SSRI drugs…suggest they use toxic sunscreen, do mammograms, colonoscopies, etc.") Big racket…modern medicine, lol!!!

  16. I am diagnosed with this. I am autistic and this is one of the diagnosis I got when attempting to get an adult autism diagnosis. I'm not crazy and neither are you.

  17. Somatic pain as a mis-diagnosis attracts awful quack doctors like a f***ing moth to a flame, it can be a very dangerous mis-diagnosis which can be easily reached by mistake and can do a lot of damage to a patient for years who is suffering from a standard painful injury which sometimes will be completely missed by X-ray & MRI. For example, a patient breaks his back and right leg, he develops a limp and shifts most of his weight on his left leg, couple of years pass and his left: ankle, knee & hip degrade, become painful and noisy, along comes Dr Quack, the patient is complaining of pain in these joints, Dr Quack notices that the patient broke his back and as the patient is complaining of a sore foot this idiot doctor declares that the pain in the foot is nerve pain relating to the prior spinal injury, the patient does not have a sore back and never complains of a sore back but is subjected to half a dozen back operations and as the pain in his leg is getting worse! because the injuries have been ignored, Dr idiot then declares the pain is somatic conversion disorder/chronic pain and as such then completely removes all the powerful painkillers the patient is using for leg pain leaving the patient with a pile of untreated injuries for years! No painkillers and no where to go for help! leaving the patient completely f**ked! for 20 years!

  18. i have a friend with conversion disorder and he is suicidal. i want to help him as much as i can :'(

  19. Studying for step 2 CK and I seem to mix this condition with Illness Anxiety Disorder. I think this helped. Thanks!

  20. I was thinking that if somebody was diagnosed with something that was thought to be produced by psychiatric somotization meant that they were being told that they were faking all of this to get attention as would be seen in Munchausens. As in if somebody was being diagnosed with psychiatric somotization, the Physician was saying, "Oh, You're faking this, you want attention, you want all these unnecessary treatments, and that you want unneccasy attention. You ain't gettin it."

  21. I’m constantly having chest pains and weird tingly feelings by my lungs and the doctors tested everything and there is nothing wrong with me… it really blows because I feel like I am dying and panic attacks and anxiety make it a lot worse.

  22. I have this and for almost two years I had hospital visits after hospital visits and yet nothing could be found on scans. I was almost too embarrassed to even go anymore because I thought I was crazy. It wasent till they started asking questions about my life that it got figured out

  23. This is such a cop out diagnosis. Well since we don't know what's wrong with you, here, have some "antidepressants". That should work!

  24. I wonder the only treatment option said in the video is seriously no antidepressant nothing only CBT ….???wtf??

  25. I feel like have ssd.. I've been losing a lot of weight because I felt sick and full very fast and the doctors couldn't find any physical problems. It's also unlikely that I have an eating discorder because none of the symptoms applies to my. Do you think my stomach ache is caused by ssd?

  26. My brother had terrible asthma in the late 50s and early 60s, I do believe she enjoyed the adulation and sympathy she must of got from people for looking after him, she lost her first husband just after the 2nd world war this I believe started the poor me syndrome, she knew by yelling at my nice father and vile shouting that it would make my brother start wheezing along with heavy smoking in his presence, he was saved when the invented the quarter zone medication at the great Ormond hospital for children in London, I remember when my dad (who she hated) had I back operation and a big chance that he could end up a cripple I over heard her say that "she would push him around in a wheel chair and care for him" that's what indicated to me in respect that when the sickness of the mind was discovered that she may have it, at one point in there marriage she never spoke to him for 7 years she gave him a dogs life and me, but our house was clean and organized but full of hate, I ended up a chronic alcoholic full of anger, judgment, fear, self centeredness and all forms of spiritual disease, I'm recovered now ain't had a drink for 10 years, hope this post opens up a few doors for some one

  27. I don’t feel pain I feel like if I don’t do somthing, somthing bad I. Going to happen or if I close close somthing the right way I have to do it as many times as I have to do I have ocd

  28. I have severe pain in back Neck and some time headache alo
    I am alo taking medicine of ssd but when the medicine finished , pain become severe plzz suggest me some solutions😢😢

  29. Unpopular opinion, but this seems to me a bs diagnosis doctors came up with for those who can't diagnose someone who actually has a problem. I have a hard time believing this actually exists. I've been told my symptoms are stress related, then years later I'm having trouble walking, amongst other things and the doctors have yet to find a cause. I'm not going to give up because my gut is telling me it's not in my head.

  30. Could you have a psychosomatic disorder if the symptom that you have can be physically seen, touched or observed?????

  31. I’m not sure that this is actually a real thing docs! Before landing on this dx I think docs should do a tilt table test and beighton score to rule the very common yet very rarely diagnosed POTS and EDS which often misdx as somatic or anxiety. This is doctor teaching channel, please teach them to listen to the patient! Teach them humility! To never stop LEARNING!! Perhaps you folks don’t possess all the answers along with the tests in which to discover said answers. Speaking from personal experience there is something that will drive a normal person to near insanity or even clinical insanity. That is to be experiencing (often invisible) life disrupting, painful, chronic symptoms you seek help for and have professionals you put faith in tell you the tests are normal so it’s all in your head, then find out many years later only by your own research and confirmed by your doctor that actually they just didn’t do the right tests, you are very ill and were born with over a dozen orphan diseases that 100+ doctors NEVER caught despite a massive medical history. I was branded somatic or “stress” for decades (and my poor mother was scared away from seeking answers for my non stop screaming in pain during the first 3 years of life after she was accused of munchausens by proxy. They said it was colic, which surely doesn’t fit. mastocytosis reaction to her breastfeeding..) if anyone who is a doctor or becoming one reads this please just remember that there are some people out there who are suffering from chronic problems that may not fit into nice little diagnostic boxes or show up on the standard tests. No doctor ever assessed my vitals supine or standing, nor was my hypermobility assessed. Those were the keys to unlock the mystery

  32. i need someone to talk to, someone whos been going through this for a long while now.
    Please DM me. Please. Its pointless talking to someone who hasnt been through this.

  33. Im partially blind from this. Pretty scary shit. Its even worse because I know its not real but literally am partially blind from it

  34. I have this but I also have fibromyalgia, and a few mental disorders as well. so its hard to know what's what sometimes

Leave a Reply

(*) Required, Your email will not be published