Somatization: Background information when reading One Doctor

Somatization

This article relates to One Doctor

Somatization—the conversion of a mental state (such as depression or anxiety) into physical symptoms—is extraordinarily common, according to Dr. Brendan Reilly, who writes about it (among other health concerns) in his book One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine.

This broad medical term encompasses many illnesses, including recognized "somatic symptom and related disorders" described in the fifth, and most recent, edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

Somatization affects women and men of all ages and cultures. It's common for people suffering from somatization to complain, over a period of years, of multiple symptoms that have little or no physical cause, but because they either don't recognize the root origin of their symptoms or because they associate a negative stigma with mental health issues, they tend not to seek help from mental health professionals.

Somatic symptoms include—but aren't limited to—abdominal, back, or chest pain; diarrhea, headaches, dizziness, sexual problems, shortness of breath, palpitations and vision changes. These symptoms can cause considerable distress and may interfere with work and personal relationships.

A panic attack—which the Mayo Clinic defines as a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause—frequently occurs with somatic symptoms such as shortness of breath, palpitations and chest pain. These symptoms often land people in the hospital, and can be mistaken for heart attacks.

Unfortunately, once a heart attack is ruled out, many doctors tend to minimize the distress of someone having a panic attack—and somatization in general. As a result, a patient may seek help with other health care providers. These visits may lead to unnecessary, perhaps costly tests—and more frustration by the patient, family members, even the practitioner.

Empathy, awareness and understanding can help a doctor's intuition with somatic patients. Diagnosis may involve tests to identify or rule out possible diseases. For treatment, The New York Times Health Guide recommends that patients should have only one primary care provider, to avoid having too many procedures. If a patient is amenable, consulting a mental health professional can also help with the management of symptoms.

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This "beyond the book article" relates to One Doctor. It originally ran in October 2013 and has been updated for the November 2014 paperback edition. Go to magazine.