Somatic symptom disorder (SSD) is characterized by chronic anxiety surrounding the belief that a serious illness is present, based only on mild physical symptoms. This is different from phantom pains, in which the individual feels real pain for a medically inexplicable reason, also differing from pretending to be sick to get out of an exam. Rather, adolescents struggling with SSD feel normal physical reactions and misinterpret them as ailments. For example, they might interpret a headache to be a brain tumor, a stomachache to be an ulcer and fatigue to be indicative of cancer.
In order for SSD to be diagnosed, somatic symptoms must significantly interfere with an individual’s daily functioning. These symptoms and acute anxiety interfere with both the academic and social lives of children struggling with the disorder since so much time and energy is focused on the fear of having a life-threatening illness. Many times, children with SSD refrain from physical activity out of fear that it will cause irreparable damage to their bodies or exacerbate their perceived physical illnesses. A child with a diagnosed disease — whose obsessions and preoccupations with it make the condition more debilitating than the physical symptoms alone — can also be diagnosed with SSD.
Children struggling with SSD typically have one of two extreme views on physicians. Some fear going to the doctor, afraid that he or she will confirm the presence of a serious, life-threatening medical condition. Others develop obsessions with having their perceived illnesses confirmed, going to doctor after doctor after being continually told that they are healthy. This typically does not apply to those who have been diagnosed with physical illnesses exacerbated by extreme anxiety surrounding the symptoms. Regardless, children and teenagers with SSD often seek constant reassurance from parents and authority figures that they are not dying or, on the other end, validation that they need to see a medical professional.
A common sign of SSD in adolescents is the frequent researching of medical conditions and diseases on the Internet. The accessibility of medical information on websites today leads to individuals commonly self-diagnosing based on limited knowledge provided by these sites. Merely looking up information on these sites is not indicative of SSD, as this is common and somewhat inevitable with technological advances. However, obsession over information gleaned and an individual’s unwavering belief in his or her self-diagnosis is a red flag for the disorder.
Individuals with depression and/or anxiety are at higher risk for developing SSD than the general population. In general, females are more likely than males to develop the disorder. However, a 2006 study entitled “Somatic symptoms in children and adolescents with anxiety disorders” found that male and female youth concurrently struggling with anxiety are equally likely to have somatic symptoms. The study also determined that youth with generalized anxiety disorder (GAD) are much more likely to struggle with SSD than those without GAD and that participants ages 12 and older are more likely to exhibit somatic symptoms than younger participants.
Limited information is available on the prevalence of SSD nationwide, since it is a relatively new disorder first defined in the revised Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 2013. SSD replaced a series of related disorders included in past versions of the DSM, including somatization disorder, undifferentiated somatoform disorder, hypochondriasis and pain disorder. A key part of diagnosis for some of these disorders was that physical symptoms could not be medically explained. The newly revised DSM recognizes that somatic symptoms can be present with a concurrent medical condition or result from misinterpretation of normal physical reactions. Most of these related disorders now fall under SSD and symptoms must be present for at least six months prior to diagnosis.
SSD is treatable with cognitive behavioral therapy (CBT), exposure therapy and, in some cases, prescription medication. If you or your child is struggling with somatic symptoms, help is available. Sovereign Health Rancho San Diego is a facility that specializes in treating adolescents and teenagers struggling with mental health disorders, substance abuse and dual diagnosis. Call 866-615-7266 to speak with a professional today.
Written by Courtney Howard, Sovereign Health Group writer