What it is
Somatic Symptom Disorder (SSD) involves one or more distressing physical symptoms (pain, fatigue, GI issues, dizziness, etc.) plus excessive thoughts, feelings, or behaviors related to those symptoms (worry, frequent checking/visits, avoidance). The symptoms are real and can coexist with medical conditions; the disorder refers to the disproportionate distress and impairment.
SSD is treatable and benefits from both medical and psychological approaches.
Common signs and symptoms
- Persistent physical symptoms that are distressing or disruptive
- High health-related anxiety and frequent healthcare use (or avoidance)
- Time-consuming symptom checking, research, or activity restriction
- Impact on work/school, exercise, relationships, and mood
- Can co-occur with diagnosed conditions (e.g., IBS, migraine, fibromyalgia) and still be SSD if worry/behaviors are excessive
Why it happens
- Heightened interoceptive sensitivity: noticing normal sensations intensely
- Catastrophic interpretations and fear of symptoms
- Deconditioning and avoidance increase pain/fatigue over time
- Stress, trauma, and mood disorders amplify symptom perception
- Healthcare fragmentation can reinforce worry if care is uncoordinated
What helps
- Collaborative care
- Choose a primary clinician to coordinate evaluation and avoid redundant tests
- Set scheduled, proactive follow-ups rather than urgent symptom-driven visits
- Evidence-based therapies
- CBT for somatic symptoms: reframing interpretations, pacing activity, graded exposure to feared movements/sensations
- ACT: focusing on values and function alongside symptoms
- Pain-focused approaches: CBT for pain, physical therapy, gentle graded exercise
- Medications (targeting co-occurring issues)
- SSRIs/SNRIs can help anxiety/depression and sometimes pain amplification
- Sleep interventions (CBT-I) to reduce fatigue and pain sensitivity
- Skills and lifestyle
- Activity pacing: balanced cycles of activity and rest; avoid boom-bust patterns
- Relaxation and breath training; consistent sleep schedule
- Reduce excessive symptom monitoring and internet searching
When to seek help now
- Symptoms cause significant impairment or increasing medical use without clarity
- New red-flag symptoms (e.g., chest pain, severe shortness of breath, neurologic deficits) need medical evaluation
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I have ongoing [pain/fatigue/GI symptoms] and high worry. I’d like coordinated care, CBT for somatic symptoms, and guidance on activity pacing and sleep.”
Outlook
With coordinated care and skills-based therapy, many people reduce distress, improve function, and experience fewer urgent visits—even if some symptoms persist.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; Crisis Text Line (text HOME to 741741)
- Find care: Psychology Today (filter for CBT for somatic symptoms/ACT; pain psychology); FindTreatment.gov; NAMI HelpLine
- Condition-specific education: NIH and reputable specialty sites (e.g., IBS, migraine, fibromyalgia associations)
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Verify in-network therapy, integrated pain programs, PT/OT coverage; prior authorization; copay/coinsurance, deductible, out-of-pocket max
- Work/school supports: ADA accommodations (flexible scheduling, ergonomic adjustments); EAP; campus disability services
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.