SSD, also referred to as ‘somatisation disorder’ or ‘somatoform disorder’, is a chronic mental health condition that's characterised by excessive levels of distress in response to one or several bodily symptoms. These can include pain and lethargy and may involve one or more organs or systems in your body.
SSD patients commonly have co-existing mental health disorders, including depression (up to 60% patients), anxiety disorders (up to 50%), personality disorders (up to 50%) or alcohol and substance misuse. SSD is common, representing the most prevalent disorder in general practice. In primary care, up to 30% of visits from patients may be with unexplained medical symptoms.
The physical complaints that you may experience if you have SSD can last for years, and can significantly disrupt your life. A diagnosis of SSD will be given if the excess worry over your physical health is having an adverse effect on other aspects of your life. These preoccupying thoughts, feelings and behaviours relating to your health will be severe enough to cause work or relationship difficulties.
There are different kinds of related disorders which may be present if you have SSD, including:
Health anxiety - people with health anxiety share many of the same signs and symptoms as someone with SDD. Similar preoccupations with physical health are involved, where even minor health complaints can be viewed as a serious medical problem.
Examples include believing a general headache is a sign of a brain tumour, with self-diagnosis, searching online around your symptoms often exaggerating such distress instead of helping the cause.
Conversion disorder - if symptoms of SSD include persistent worries over neurological problems such as hearing loss, fatigue or general weakness, then conversion disorder is a diagnosis which may be given when such symptoms can't be linked to a clear medical cause.
When you experience somatisation, you're often expressing an underlying mental or emotional problem as physical symptoms. The physical symptoms that people with SSD may experience include:
While pain is the most widely reported symptom of SSD, the distinction between SSD and associated health problems involves the disproportionate thoughts, feelings and behaviours that you have in response to these physical complaints. It's this level of health anxiety that underpins the distress of SSD, and is what ultimately stops you from functioning as usual in your everyday life.
Thoughts, feelings and behaviours that you might experience if you have SSD can include:
SSD affects people of all ages, although it's more common in women than in men, and usually begins to develop before the age of 30. The prevalence of people affected is difficult to determine because many people will never receive a formal diagnosis, with people often seeking repeated medical consultations which fail to find a definite medical cause. SSD is more frequent in cultures where people aren't used to talking about mental health problems.
The defining cause of SSD is unknown, but research has indicated that early childhood experiences, along with cultural and environmental factors, may play a role in it developing. These may include:
Genetics - inheriting a biological sensitivity to pain can cause you to be more aware of physical sensations and issues in your body, which may lead to the symptoms of SSD and associated health anxiety, as opposed to someone with a higher threshold of pain.
Family and environmental factors - experiences during childhood may cause your attitudes towards physical health to be altered.
If your parents regularly worried about your health when you were younger and this resulted in regular trips to the doctor without huge cause for concern, then this behaviour can become ingrained and mimicked as you get older.
Personality traits - if you tend to view life situations in a negative way, then this view could be adversely applied to your perception of your own physical health. Negative thoughts can occupy your mind and lead you to wrongly identify physical symptoms as being representative of something more serious.
Difficulty processing emotions – if you're experiencing emotional issues, or even symptoms of stress, anxiety or depression, this can cause you to avoid challenging why you feel this way, instead focusing excessively on how you're feeling physically.
Sufferers may turn to alcohol or drugs to self-medicate and ease the burden of their somatic symptoms. However, excessive drug and alcohol intake, as well as a job role or personal circumstances causing significant amounts of stress, can make the symptoms of SSD worse.
Priory has been helping to treat people with SSD for many years. We know that everyone's situation is different, which is why we ensure that you receive a treatment plan that's tailored to your individual needs.
The type and length of SSD treatment is dependent on your circumstances and the severity of your condition. Once you've discussed options for treatment, fully understood how SSD is impacting on your life, and worked out what you want your treatment goals to be, you can be treated as an outpatient, which means that you will visit Priory for hourly sessions with your consultant, psychologist or therapist at a convenient time.
If your condition is particularly severe, a structured treatment approach, which can include staying at one of our Priory hospitals for the duration of your treatment, may be recommended. Inpatient treatment allows you to take part in a psychological group programme as well as regular sessions with your consultant, while day care packages are also available.
In terms of the specific mental health treatment options that are used to treat SSD, psychotherapy, also known as ‘talk therapy’, is believed to be particularly helpful when trying to improve daily functioning and the associated symptoms of SSD.
Evidence-based talking therapies such as cognitive behavioural therapy (CBT) can indirectly help to improve the physical symptoms experienced during SSD, due to the link between psychological distress and bodily complaints. In addition, CBT can be helpful if you're struggling with a co-occurring mental health condition such as depression or anxiety. Another therapy that can be used to treat SSD is integrative therapy, because this looks at the family history of the person with SSD, to see whether health worries are something that the person has been exposed to within their family and upbringing.
CBT is a commonly used talking therapy for SSD. It's an action-based approach that helps you to understand the condition further, as well as the reasons behind why you might be experiencing the emotional and physical problems that are associated with it.
Our experienced therapists will help you learn techniques that are geared towards more positive thought processes in relation to your condition, which may include:
Mindfulness is accepted as an additional treatment to CBT for reducing the symptoms of SSD. This involves elements of CBT, with the addition of psychological methods that can teach you to be present in the moment, as opposed to dwelling on what may or may not happen in the future.
Using breathing and meditation techniques, you'll begin to learn how to clear your mind of negative thoughts which may be contributing to your health anxiety, as well as associated symptoms of depression.
Medication can be used alongside therapy for SSD. This can be particularly effective if you're experiencing symptoms of health anxiety or depression that are commonly associated with the condition.
It's important to remember that it can take several weeks to notice improvement in symptoms when you're taking medication such as antidepressants.
