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Somatic Symptom Disorder

Somatic symptom disorder involves focusing too much on physical symptoms such as pain or tiredness. This focus causes major emotional distress and makes it hard to function. You may or may not have another medical condition that causes these symptoms. But how you think, feel and behave because of the symptoms can be extreme.

You might often think the worst about your symptoms. You may seek medical care often, searching for a reason for the symptoms, even when other serious conditions have been ruled out. You also might spend so much time and energy focusing on your symptoms that it’s hard to function, sometimes leading to more challenges in your life.

If you have somatic symptom disorder, you may have a lot of emotional and physical distress. Treatment can help ease symptoms, help you cope and make your quality of life better.

Symptoms of somatic symptom disorder may include:

  • Specific symptoms, such as pain or shortness of breath.
  • General symptoms, such as feeling very tired or weak.
  • Symptoms not related to any medical cause.
  • Symptoms related to a medical condition but that are more severe than usually expected.
  • One symptom, many symptoms or symptoms that change over time.
  • Mild, moderate or severe symptoms.

Pain is the most common symptom. But whatever your symptoms, you have constant stressful thoughts, feelings and behaviors related to those symptoms. This can make it hard to live your daily life and sometimes can be disabling.

For somatic symptom disorder, the way you think about and react to symptoms and how they affect your daily life are more important than which physical symptoms you have.

People with somatic symptom disorder often:

  • Constantly worry about possible illness or how much the symptoms affect them.
  • View usual physical sensations as a sign of severe illness.
  • Fear that symptoms are serious even when illness has been ruled out.
  • Think that physical sensations are threatening or harmful.
  • Believe that they need more medical evaluation and treatment, but healthcare visits and treatments don’t lessen their concerns.
  • Fear that physical activity may cause damage to their bodies.
  • Constantly check their bodies for issues.
  • Limit or stay away from activities due to the stress of symptoms.
  • Talk about having more-severe disability than expected from a medical condition.

When to see a doctor

Because physical symptoms can be related to a medical condition, it’s important to have a healthcare professional look at you.

After a medical exam, if your healthcare professional believes that you may have somatic symptom disorder, you can talk about a referral to a mental health professional who can work with you and your healthcare team. A mental health professional can help you understand your condition and learn how to lessen your symptoms to make your quality of life better.

When it’s a loved one

If a loved one has somatic symptom disorder, it can be hard to accept that a serious illness isn’t the cause and that the person can still function in life despite the symptoms. Encourage the person to follow through on a mental health referral. Think about going along so you both can learn tips and strategies to help ease symptoms.

The exact cause of somatic symptom disorder isn’t clear, but factors may include:

  • Genetics and biology, which may cause higher sensitivity to pain, for example.
  • Family influence, both genetic and environmental.
  • Personality traits, such as negativity.
  • Having a hard time processing emotions or feelings, leading to a focus on physical symptoms.
  • Learned behavior, such as gaining attention from illness or avoiding activities due to pain, which can worsen the level of disability.

Risk factors for somatic symptom disorder include having:

  • Anxiety or depression.
  • A medical condition or recovering from one.
  • The risk of developing a medical condition, such as having a strong family history of an illness.
  • Stressful life events, trauma or violence.
  • Past trauma, such as sexual abuse or childhood trauma.

Somatic symptom disorder can be linked with:

  • Poor health.
  • Trouble functioning in daily life, including having physical disability.
  • Trouble in relationships.
  • Work troubles or unemployment.
  • Other mental health conditions, such as anxiety or depression.
  • Increased suicide risk related to depression.
  • Money concerns due to a lot of healthcare visits.

Little is known about how to prevent somatic symptom disorder. But these suggestions may help.

  • Get professional help for anxiety or depression that can happen due to somatic symptom disorder.
  • Learn how to identify stress and how it affects your body.
  • Practice stress management and relaxation techniques.
  • Choose healthy routines, such as healthy sleep habits, regular physical activity and social activities.
  • Get treatment early if you think you have somatic symptom disorder.
  • Follow your treatment plan to help keep symptoms from getting worse or coming back.

To make a diagnosis of somatic symptom disorder, you’ll likely have a physical exam and any tests your healthcare professional recommends. Your healthcare professional can help find out whether you have any health conditions that need treatment.

Your healthcare professional also may refer you to a mental health professional, who may:

 
  • Do a mental health exam by talking with you about your symptoms, fears or concerns; stressful situations; and situations you may be avoiding due to somatic symptoms. You also may talk about relationships and your family history.
  • Have you fill out forms or answer questions to learn about your anxiety, mood and physical symptoms.
  • Ask you about alcohol, drug or other substance use.

A mental health professional may diagnose somatic symptom disorder if:

  • You have one or more somatic symptoms, for example, pain or extreme tiredness, that cause distress or issues in daily life.
  • You constantly think about how serious your symptoms are, you’re very anxious about your health or symptoms, or you spend too much time and energy on your symptoms or health concerns.
  • You have symptoms that worry you for more than six months, even if symptoms vary.

The goal of treatment is to ease your symptoms and help you function better in daily life. Talk therapy, also called psychotherapy, can be helpful for somatic symptom disorder. Sometimes medicines may be added, especially if you feel depressed.

Talk therapy

Physical symptoms can be related to mental health distress and a high level of health anxiety. Talk therapy — specifically, cognitive behavioral therapy, also called CBT — can help ease physical symptoms and help you function in daily life.

CBT can help you:

  • Think differently about health and physical symptoms.
  • Learn how to manage stress.
  • Learn how to cope with physical symptoms.
  • Focus less on symptoms and lessen the number of activities you no longer do because of your symptoms.
  • Take part in activities even if you have physical symptoms.
  • Make daily functioning at home, at work, in relationships and in social situations better.
  • Treat depression and other mental health conditions.

Family therapy also may be helpful by examining family relationships and making family support and functioning better.

Medicines

Antidepressant medicine can help ease symptoms linked with depression and pain that often occur with somatic symptom disorder.

If one antidepressant doesn’t work well for your depression, your healthcare professional may recommend switching to another or adding certain medicines to boost how well antidepressants work. Keep in mind that it can take several weeks after starting a medicine to notice depression symptoms easing.

Talk with your healthcare professional about medicine options and the possible side effects and risks.

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  3. Somatic symptoms and related disorders. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Feb. 26, 2025.
  4. Pilipenko N. Somatic symptom disorder in primary care: A collaborative approach. Journal of Family Practice. 2022; doi:10.12788/jfp.0384.
  5. Lowe B, et al. Persistent physical symptoms: Definition, genesis, and management. Lancet. 2024; doi:10.1016/S0140-6736(24)00623-8.
  6. What is somatic symptom disorder? American Psychiatric Association. https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder. Accessed Feb. 26, 2025.
  7. Expert Q&A: Somatic symptom disorder. American Psychiatric Association. https://www.psychiatry.org/patients-families/somatic-symptom-disorder/expert-q-and-a. Accessed Feb. 26, 2025.
  8. Sauer KS, et al. Somatic symptom disorder and health anxiety: Assessment and management. Neurologic Clinics. 2023; doi:10.1016/j.ncl.2023.02.009.
  9. Levenson JL. Somatic symptom disorder: Epidemiology, clinical features, and course of illness. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2025.
  10. Levenson JL. Somatic symptom disorder: Assessment and diagnosis. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2025.
  11. Levenson JL. Somatic symptom disorder: Treatment. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2025.
  12. Mental health medications. National Alliance on Mental Illness. https://www.nami.org/about-mental-illness/treatments/mental-health-medications/. Accessed Feb. 27, 2025.
  13. Medical review (expert opinion). Mayo Clinic. May 19, 2025.

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