What is psychosomatics and psychosomatic disorders

Psychosomatics what is it?

Psychosomatics (“psycho” – soul, “soma” – body) is a term that in a broad sense refers to various interactions between the physical state and the psyche. In other words, our physical condition affects our psyche: a person who has been suffering from high blood pressure for many years may feel depressed, have significant physical limitations that affect the quality of life.         

At the same time, the mental state affects our physiology: at least once, everyone wanted to stay at home and not go to school or work so much that they started to have a little sore throat, headache, or started to feel sick, or had a fever. These are normal manifestations of the interaction between body and mind .          

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

Quite a common story: a young man, anxious, with an analytical mindset, not inclined to track his emotional experiences, first turns to a therapist for hypertension. She did not pass no matter on which antihypertensive drugs. Then he is prescribed antidepressants – and the hypertension disappears.          

Do psychological problems affect illness? I have heard that asthma is a psychosomatic illness. It’s true?    

Another part of psychosomatics is the research and complex treatment of physical diseases, which can be aggravated by psychological factors. In recent years there are more data ( including false), that many disorders that are usually considered the physical, psychological components are expressed.    

In reality, the relationship between the psyche and cardiovascular diseases, eczema and psoriasis, gastrointestinal problems has been proven . In these cases, there is a clear, well-studied, and treatable or controllable biological problem. Therefore, the psyche in these cases plays a secondary rather than primary role – it provokes and aggravates the condition.          

Moreover, there is little or no scientific data on the reliable influence of the psyche in cases of allergies and other respiratory diseases, vision problems, arthritis, hepatitis, HIV / AIDS, diseases of the spine and bones, tumors and cancer.      

In the cases described, there is a clear biological mechanism (metabolic disorders, autoimmune reactions) that causes psychological changes. The psyche, in turn, aggravates the physical condition.  

It happens so that psychological problems cause physical problems, which will not have been would be otherwise. Such disorders are called somatoform disorders. We will tell you more about some of them in the article.       

Symptoms of psychosomatic disorders

As part of different types of somatoform disorders, like building blocks, there are separate groups of symptoms – they are called syndromes. The most typical for the diagnosis are the following:  

Conversion syndrome

Most often, conversion manifests itself in a malfunction or complete loss of function of a particular part of the body (for example, vision, limbs, deafness, tics) without physical impairment. 

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

There was a catastrophe in which the boy died. The whole family grieves. But the worst of all for the grandmother: her legs give up. Naturally, she was sent for all possible examinations, the doctors unanimously say that there is no physical disorder. Only a psychotherapist could make a diagnosis. The problem is in the psyche: this is how she experienced grief, transforming psychological pain into bodily symptoms.       

Dysmorphophobic syndrome

Such a symptom of a psychosomatic disorder can be expressed in a deep confidence in the presence of one or another physical disability – for example, excessive weight, curvature of certain parts of the body, and an unpleasant odor. The person believes that others see the flaw and laugh at it.    

Accordingly, he makes great efforts to “correct”: he chooses certain clothes, drastically loses weight, carefully examines himself in the mirror, takes a lot of photographs to “train” the facial expression that hides the “flaw”.  

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

In our time, there is a lot of dysmorphophobia, it is reinforced by unrealistically processed photographs and social networks in general. A classic example is a young girl who has difficulties in her work, in her personal life, who is tormented by anxiety. She decides that all problems are due to a (imaginary) hip defect. Does liposuction. Emotional relief comes, life is getting better. But it lasts a month. Then the euphoria passes, depression sets in, problems return to life. And a new hypothesis arises – all problems will go away if the (imaginary) breast defect is corrected. And this process will never stop by itself – everyone has heard about people who have performed dozens of operations to correct contrived defects.                 

Depressive syndrome

It is logical that a person in such a state is depressed, although he can hide his state. 

Asthenic syndrome

It takes a lot of energy to withstand such a psychological burden. Therefore, a person is quickly exhausted, experiencing headaches and other vegetative symptoms. 

If there is a disease (even imaginary), the person will seek help and treatment. He goes to doctors, receives many appointments, sometimes comes to surgery. Therapists, endocrinologists, surgeons promise recovery – but it does not come. Nothing helps, and he again asks for help.           

Competent doctors see that everything is useless and recommend contacting a psychiatrist or psychotherapist. But convincing a person that the problem is in the psyche is not always easy. After all, it is much easier to be treated by a therapist than by a psychiatrist.        

What is psychosomatic illness?

In the International Classification of Diseases (ICD-10), several types of somatoform disorders are distinguished. The most common ones are:  

  1. Somatisation disorder.
  2. Hypochondriacal disorder.
  3. Persistent somatoform pain disorder.

Somatisation disorder

The person presents many physical complaints that are frequently changing, recurring and not amenable to standard diagnosis and treatment. This lasts at least two years and is accompanied by difficulties in work, communication and personal life. People begin to limit themselves in various fields of activity, become irritable or depressed.       

Alla Vladimirovna says that these people really need psychotherapy, but it is they who are disposed towards psychotherapists with special distrust:    

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

People with somatisation disorder almost never see a psychologist or psychiatrist. They are ready for anything – take any dietary supplements, homeopathy, go to physiotherapy, acupuncture, whatever. But to psychologists – nor for that. Good therapists themselves sometimes prescribe rest and a mild antidepressant for them – and this helps precisely because it solves psychological problems for a while.                

Hypochondriacal disorder

In many respects like a psychosomatic disorder, but in addition to a variety of symptoms, patients are confident that patients with severe, progressive disease. However, doctors can not find anything from them.      

When a person is proved that one disease does not exist (for example, cancer), the patient quickly “switches” to another disease (for example, tuberculosis). Then he can go back to the first version, and so on forever.    

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

Many have learned from childhood that health and physical complaints are encouraged by adults. They were immediately left at home, allowed to watch TV or not do their homework. And in adulthood, often after a stressful situation, such a person comes to the therapist with complaints that not only constantly change, but also do not make up a complete picture. From recent example: a young man, spoke to the therapist with complaints of diarrhea, non-specific pain in the head, back and abdomen. Then the “circles of hell” began: he is prescribed endless examinations, his complaints multiply, but he does not get better . In this case, everything ended well, he turned to me, and we began to understand the psychological background. The condition immediately became more stable.                          

Persistent somatoform pain disorder

There are no many scattered complaints, the person suffers from periodic excruciating pain, more often in one area. Diagnostic tests can not detect physical disorders or diseases.   

Pain occurs after an emotionally traumatic or problematic situation, and the patient receives significant medical and social support and assistance.   

Alla Vladimirovna says that there are many such cases in the practice of dentists: 

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

The patient had a tooth removed, a nerve was touched. There was pain that had a physiological basis. The defect was corrected, but the pain does not go away . Moreover, it spreads to other teeth, and then to the entire jaw. The patient I remember now drank handfuls of pain relievers, and they did not help. He was referred to a psychotherapist, and the pain went away with psychotropic drugs and psychotherapy.             

Psychosomatics and how to treat?

Treatment of somatoform disorders, as well as somatic diseases with a known psychosomatic component, should be comprehensive. They consist of at least two components , which means that a team of specialists should work.     

Physicians of the somatic direction should conduct a comprehensive diagnosis and prescribe medications (in cases where a somatic illness is confirmed). It is possible that treatment will not be needed for the disease that the patient was afraid of, but for the problems that arose as a result of interventions that he required unnecessarily.      

A psychiatrist prescribes medications to combat depression, anxiety and stabilize mood.  

Although patients are rarely ready to receive such help, the most important component is the help of a psychotherapist or counseling psychologist. The most effective are cognitive-behavioral therapy, biofeedback therapy, teaching relaxation techniques and auto-training, assertiveness and social skills training, behavioral interventions aimed at short-term solutions to life’s difficulties.    

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

Often it all starts with asthenia (weakness, fatigue), which entails behavior, which then worsens the somatic state, which in turn worsens the psychological one. When a person is sad and has no strength, what does he do first? Goes to bed, gets out of business, shuts itself off from people. Against this background, both the stomach and the head ache. And such a person will not deal with mental pain, but with physical pain , although the opposite is necessary. Why? Because psychotherapists are referred to as “brains”. But in fact, this is the person who will talk to you about what worries you, and not laugh at it, not blame it, not devalue it.                            

What not to do if a psychosomatic disorder or symptoms appear? 

  1. To turn to fortune-tellers, psychics, “psychologists” who promise to cure from just one fabulously expensive technique. It will bring relief, but short-term. And in the long term, this has a detrimental effect on treatment. The person will once again make sure that no one can help him and will completely give up.         
  2. Afraid to go to a psychiatrist or psychologist . That would not have advised these experts, you can always abandon what they offer. Their task is to explain in an understandable way why they suggest certain assignments or exercises.        
  3. Trying to diagnose online . In the work of Jerome K. Jerome, Three Men in a Boat, Excluding a Dog, it is excellently described how the heroes read a medical encyclopedia and come to the conclusion that they are seriously ill and are probably dying. It’s the same with the internet . If something really bothers you, it’s best to see a professional.         

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