Somatic Symptom Disorder

Diagnosis

Diagnosis of somatic symptom disorder typically begins with a physical exam and any tests recommended by your healthcare provider. These steps help identify whether a medical condition may be causing your symptoms. You may also be referred to a mental health professional for a more detailed evaluation.

During a psychological assessment, you may be asked about your symptoms, fears, stressors, relationship challenges, avoidance behaviors and family history. You might also complete self-assessments or questionnaires and discuss alcohol, drug or substance use.

Criteria for diagnosis
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) highlights key features used to diagnose somatic symptom disorder. These include:
• One or more troubling somatic symptoms, such as pain or fatigue, that interfere with daily life
• Excessive and persistent thoughts about the seriousness of symptoms, high health-related anxiety, or spending too much time and energy focused on symptoms
• Ongoing symptoms that cause concern for more than six months, even if the specific symptoms change over time

Treatment

Treatment focuses on improving symptoms and helping you function more effectively in daily life. Psychotherapy is often the primary approach, with medications added when needed.

Psychotherapy
Cognitive behavioral therapy (CBT) is especially helpful for reducing physical symptoms linked to stress and health anxiety. CBT can help you:
• Reevaluate beliefs and expectations about symptoms and health
• Learn effective stress-reduction techniques
• Build coping skills for managing physical discomfort
• Lessen preoccupation with symptoms
• Reduce avoidance of activities or situations that trigger discomfort
• Improve functioning at home, work, in relationships and in social settings
• Address coexisting mental health concerns such as depression

Family therapy may also be recommended to strengthen family support and improve overall functioning.

Medications
Antidepressants may be used to reduce symptoms of depression and pain often associated with somatic symptom disorder. If one medicine is not effective, your doctor may suggest switching to a different medication or combining treatments. It may take several weeks to notice improvement after starting a new medicine. Always discuss medication choices, side effects and potential risks with your healthcare provider.