Somatoform disorders: diagnosis and treatment

In principle, the diagnosis of a somatoform disorder can only be considered after the organic causes of the problems have been clearly excluded. At the same time, there must be an explanation for the reported difficulties that has a psychological basis.

Whether the problems last longer or have appeared only recently, the doctor may indicate further examination in order not to overlook their organic cause (if any). However, it would not be reasonable for the affected person to demand all the tests that are available.

The doctor must carefully consider which examination methods could be beneficial and which (especially repeated) examinations are rather contraindicated . Functional physical difficulties are often caused by various physical, mental and social factors. In the diagnosis and treatment of somatoform disorders, it is also important for the patient to think about the possible causes and interrelationships of their problems.

How is a somatoform disorder diagnosed ?

If a somatoform disorder is suspected, the doctor first takes a detailed medical history . During the anamnestic interview, the patient is also asked about psychologically burdensome factors (e.g. at work, in the family or regarding his state of health). The doctor will also be interested in whether the person has recently experienced a traumatic event (e.g. death of a loved one, loss of job, etc.). Here it is important to realize that psychosomatic reactions often appear with a certain delay. This makes it difficult for the sufferer to realize that their symptoms may be related to some significant life event. The history interview is followed by a physical examination.

Depending on the indicated difficulties, the doctor may indicate some other tests (e.g. laboratory blood test , ECG , etc.). Doctors of various specialties may be involved in the diagnosis process. It often takes quite a long time for the sufferer to learn the cause of their difficulties.

How is the therapy of somatoform disorder carried out?

Somatoform disorders tend to have a different course and severity, so their therapy may also differ:

• If therapy is started at an early stage , it consists of visits to a psychotherapist or clinical psychologist , who tries to calm the sufferer – in the sense that it is not a physical illness .
• In the case of long-lasting, very poorly perceived difficulties, the patient is directed to more detailed information and self-help, perhaps also within the framework of psychoeducation .
• In severe cases, psychotherapy is recommended (in this case, for example, the application of behavioral therapy , psychoanalysis or hypnotherapy methods ). At the same time, the therapist can also use attention training techniques, or different methods of training for managing everyday situations.

The use of drugs is rather not recommended for somatoform disorders, however, a doctor may prescribe antidepressants in some circumstances . Physiotherapy or occupational therapy can also help . If therapy is started in time, the chronic course can sometimes be prevented. The course of a somatoform disorder can be negatively affected by avoidance behavior (for example, a person tries to “conserve strength” so that his supposed illness does not worsen), undergoing unnecessary examinations and treatments. The problems and their therapy should be evaluated in detail at regular intervals by an expert (in the sense of “Is the current therapy working?” or “Which problems are currently in the foreground?”).

Therapy requires patience. It is advisable to set therapeutic goals gradually. In the course of therapy, a person may discover their hidden reserves, and coping strategies may also develop.

What can I do alone?

As part of the therapeutic conversation, the patient will clarify with the therapist which specific measures will suit him. The patient can then observe what works particularly well for them and try to incorporate these measures into their daily life. For example, it can be:

• general striving for a healthier lifestyle (enough exercise, healthy nutrition , “care” for the soul, enough sleep),
• involvement in social life (e.g. contact with friends, leisure activities),
• active cooperation with the therapist,
• attention training
• thinking about possible life changes that could have a beneficial effect (possibly even a change of job),
• searching for serious information about somatoform disorders,
• involvement in self-help group activities.

In general, it can be summarized that such measures help, which make a person feel that he is doing something for himself. This often requires perseverance and a lot of willpower, but if you persevere, success will almost certainly come. Experts recommend that the disabled set goals gradually and approach them with small steps.

Who can I contact?

If you suspect that you suffer from psychosomatic problems, the best advice is from a psychiatrist or psychotherapist. You can also contact a clinical psychologist.