Somatization Disorder

This means that the body (“soma”) reacts with physical symptoms due to a psychological cause.  It used to be called “psychosomatic”.  Patients may be casually dismissed as “hypochondriacs” by their friends (and medical providers), but that’s inappropriate.  It’s a rather severe form of Anxiety, with or without Depression.  Here are some examples:

1.  A 50-year-old woman had unusual body pains.  They didn’t fit a pattern of any disease, her physical exam and lab tests were normal.  I inquired about stress in her life, she denied any.  A good friend who was with her confirmed that my patient was always calm, and there weren’t any issues at all.

I asked the friend to leave the room.  Then I barely began to explain how stress can cause physical symptoms, “For example, if a person had been previously abusedโ€ฆ”  I never got to finish, tears streamed down the patient’s face.  She began speaking fast, non-stop, about how as a teen “my best friend sold meโ€ฆ”  Fortunately we had a therapist available on-site.

2.  An excellent pediatrician I once worked with had a 10-year-old patient with chronic abdominal pain.  All exams and tests were normal.  The most likely reason was psychological, but the boy’s father was irritated, impatient for a physical diagnosis.  My pediatrician friend told me, “The father, he looked, maybe, like an alcoholic?  So I said, ‘For example, let’s say somebody at home is drinking all dayโ€ฆ,’ and Dad’s eyes dropped immediately to the floor.”

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