Somatic Symptom Disorder: Understanding the Reality Beyond Physical Symptoms

Our body signals us through various physical symptoms when we are unwell, but what if the symptoms persist even after the medical examination reports come normal? Such cases are linked with Somatic Symptom Disorder (SSD). It is a complex medical condition that primarily affects people who experience persistent physical symptoms even after the medical evaluation fails to provide any relevant cause or explanation. While it is easy to overlook SSD, it is crucial to consider it a significant disorder that can significantly impact an individual’s social, personal, and professional life.

Defining the Disorder

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) introduced Somatic Symptom Disorder as a distinct mental disorder with diagnostic criteria. The condition refers to an individual’s persistent somatic complaints and excessive worry about the severity of the symptoms. The condition initially surfaced as Somatoform Disorder in DSM-III, which further progressed to become Somatic Symptom Disorder in DSM-5. SSD includes individuals with persistent and recurrent physical symptoms that are accompanied by significant impairment in functioning and severe emotional distress.

Symptoms and Diagnosis

Individuals with SSD report various symptoms, such as pain, fatigue, gastrointestinal issues, and sensory disturbances. In some rare cases, individuals experience symptoms that resemble those of a medical illness, such as heart disease, neurological disorders, or autoimmune disorders. Symptoms typically cause significant functional impairment and emotional distress. Such symptoms often take up excessive time, energy, and financial resources, leaving individuals with severe disruption in their regular daily activities.

The DSM-5 lists various diagnostic criteria for SSD, such as:

  • Individuals should experience one or more somatic symptoms that are distressing or result in significant disruption of daily life.
  • Continuous thoughts, feelings, or behaviors related to these somatic symptoms, which cause significant distress or impairment in social, occupational, or other critical areas of functioning.
  • The symptoms should persist for at least six months.
  • The individual experiences anxiety, worry, or disproportionate concern about the severity of the somatic symptoms.

Diagnosis of SSD is often challenging, and the disorder is underdiagnosed due to various reasons. Individuals typically seek medical attention for their physical symptoms, leading to a delay in the diagnosis of SSD. It is essential to rule out any potential medical explanation for the somatic symptoms before diagnosing SSD. The diagnosis process usually involves a thorough physical examination, medical history evaluation, and laboratory tests to identify any medical causes. In some rare cases, the clinician might recommend testing for psychological problems, such as depression or anxiety, to diagnose SSD better.

Etiology and Associated Factors

SSD is a problem that has no known underlying biological factors. The disorder is usually linked to psychological factors that influence an individual’s perception and experience of physical symptoms. SSD is often seen in individuals who have a history of trauma, anxiety, or depression. Additionally, it is common in individuals with a pre-existing medical condition that has not received adequate treatment.

The exact etiology of the disorder is relatively unknown, but various associated factors have been identified, such as:

  • Substance abuse
  • History of childhood trauma or abuse
  • Long-standing illness or chronic pain
  • Stressful life events
  • Presence of somatic symptom disorder in family history

Treatment and Prognosis

Treatment of SSD primarily involves a comprehensive approach that incorporates both psychological and medical interventions. Due to the disorder’s complexities, interdisciplinary teams comprising professionals such as psychologists, psychiatrists, and medical specialists are involved in providing treatment.

Treatments for SSD include:

  • Cognitive-behavioral therapy (CBT): It is a structured psychological intervention that aims to reduce the severity of the symptoms associated with SSD. The goal of CBT is to change the way individuals behave, think, feel, and perceive their symptoms.
  • Psychotropic medication: Medications such as antidepressants and anxiolytics are prescribed to individuals with SSD to manage associated anxiety or depressive symptoms.
  • Pain management techniques: Individuals who experience chronic pain syndromes are recommended for pain management techniques, such as physical therapy, acupuncture, or massage therapy.
  • Relaxation techniques: Techniques such as meditation, deep breathing, and mindfulness are often recommended to reduce anxiety and help manage symptoms.

The prognosis of SSD varies from individual to individual. With appropriate treatment and management, individuals with SSD can achieve a better quality of life. Additionally, denial of the disorder can cause a delay in the diagnosis and exacerbation of the symptoms, leading to additional social, professional, and personal impacts.


Somatic Symptom Disorder is a severe medical condition that can impact individuals’ social, professional, and personal life. The condition’s complexities require a comprehensive approach to diagnosis and management, involving interdisciplinary teams. Early diagnosis and intervention are crucial in managing the symptoms associated with SSD effectively. With proper treatment and management, individuals with SSD can maintain an improved quality of life and reduce the impact of physical symptoms on their daily life.


What is Somatic Symptom Disorder?

Somatic Symptom Disorder is a mental health condition in which a person experiences physical symptoms that cannot be explained by any medical condition or substance. It is a disorder that causes persistent distress and impairment in daily life. Individuals with this disorder may become overly concerned with their symptoms and often visit multiple doctors to seek a diagnosis.

What are the symptoms of Somatic Symptom Disorder?

The symptoms of Somatic Symptom Disorder vary depending on the individual, but common symptoms include pain, fatigue, weakness, gastrointestinal problems, and breathing difficulties. The symptoms often persist for months or even years despite medical treatment. In addition to physical symptoms, individuals with this disorder may also experience anxiety, depression, and stress.

How is Somatic Symptom Disorder treated?

There is no specific cure for Somatic Symptom Disorder, but treatment typically focuses on managing the symptoms and addressing the underlying psychological factors that may be contributing to the disorder. This can include psychotherapy, cognitive-behavioral therapy, stress management techniques, and medications such as antidepressants or anti-anxiety medications. A multidisciplinary approach involving medical professionals and mental health professionals can be helpful in managing this condition.


1. Rief, W., & Barsky, A. J. (2018). Psychobiology of somatic symptoms and related disorders. Academic Press.

2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

3. Creed, F., & Guthrie, E. (2010). Psychological symptoms and psychosocial problems in somatization and somatoform disorders. Journal of psychosomatic research, 68(5), 359-370.