A Complete Guide to Somatic Symptom and Related Disorders

Somatic Symptom and Related Disorders (SSRD) is a category of mental health disorders characterized by excessive focus on physical symptoms—such as pain or fatigue—that cause significant emotional distress and impair daily functioning. These symptoms may or may not be explained by a medical condition, yet the individual’s suffering is real and deeply distressing. Somatic Symptom and Related Disorder (SSRD) affects individuals across different age groups and is often misunderstood, making timely diagnosis and effective intervention crucial.

 What are Somatic Symptoms and Related Disorders?

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), Somatic Symptoms and Related Disorders include conditions where individuals present with physical symptoms that are distressing and interfere with daily life.

In Somatic Symptoms and Related Disorders, the person’s suffering is genuine and not feigned or deliberately produced for external rewards. Instead, the symptoms are perceived as real and cause significant distress, even in the absence of a clear medical explanation.

Causes of Somatic Symptom and Related Disorders

1. Biological Factors

• Genetics: A family history of anxiety, depression, or somatic symptoms may increase susceptibility.
• Neurological Dysfunction: Dysregulation in pain perception or abnormal activity in areas of the brain involved in processing bodily sensations may play a role.

2. Psychological Factors

• Negative Affectivity: Individuals with a predisposition to experience negative emotions may interpret normal bodily sensations as threatening.
• History of Trauma: Childhood abuse, neglect, or family illness can predispose individuals to SSRD.

3. Social and Environmental Factors
Lack of social support, chronic stress, or learned behaviors (e.g., observing family members overreact to health issues) can also contribute.

Neurological Science and Intellectual Disability in SSRD
Even though Somatic Symptoms and Related Disorders is not considered an intellectual handicap, it is crucial to comprehend its neurological foundations. Studies using brain imaging techniques such as fMRI and PET scans show that individuals with Somatic Symptoms and Related Disorders often have heightened activity in brain regions responsible for:

• Pain perception e.g., anterior cingulate cortex)
• Emotional regulation (e.g., amygdala)
• Attention to bodily sensations (e.g., somatosensory cortex)

This altered neural processing suggests that individuals may genuinely experience exaggerated physical sensations due to neurological dysregulation.

In cases where SSRD co-occurs with intellectual disability, the difficulty in verbalizing emotional distress can lead to physical expressions or psychological problems. Cognitive limitations might make it harder to differentiate between physical and emotional sensations, exacerbating the symptoms.

 Psychological Factors Behind SSRD
The psychological underpinnings of Somatic Symptoms and Related Disorders are deeply rooted in emotion regulation and coping mechanisms:

• Health Anxiety: An excessive concern about health leads to a constant monitoring of the body.
• Alexithymia: Difficulty in identifying and expressing emotions may cause emotional distress to manifest physically.
• Cognitive Biases: People with SSRD often focus on worst-case scenarios, leading to hypervigilance toward bodily sensations.

Types of Somatic Symptoms and Related Disorders
The DSM-5 categorizes Somatic Symptoms and Related Disorders into several subtypes:

1. Somatic Symptom Disorder: characterized by persistent physical complaints accompanied by disproportionate and excessive thoughts, feelings, or behaviors related to those symptoms.

2. Illness Anxiety Disorder: Formerly referred to as hypochondriasis, this condition is characterized by a continual and disproportionate worry about possessing a severe illness, even in the absence of significant physical symptoms.

3. Conversion Disorder (Functional Neurological Symptom Disorder):  Neurological symptoms such as paralysis or seizures without a neurological basis.

4. Factitious Disorder: Intentional production or feigning of physical or psychological symptoms without obvious external rewards.

5. Psychological Factors Affecting Other Medical Conditions: A psychological factor significantly influences the course of an existing medical condition.

Signs and Symptoms of Somatic Symptom and Related Disorders
The symptoms of Somatic Symptoms and Related Disorders can vary depending on the subtype but generally include:

• Disproportionate anxiety or fear about health
• Difficulty accepting reassurance from healthcare providers

Impact on Individuals

• Social Isolation: Persistent symptoms and focus on illness can alienate individuals from social circles.
• Occupational Impairment: Frequent absences, reduced productivity, or job loss may result from ongoing health concerns.
• Emotional Distress: Anxiety, depression, and low self-esteem are common co-occurring conditions.

Treatment Through Counselling and Online Therapy Platforms
Psychotherapy, particularly cognitive-behavioral therapy (CBT), is the most effective treatment for SSRD. 

1. Cognitive Behavioral Therapy (CBT)
CBT addresses maladaptive thoughts and behaviors. For example, helping a person reframe “This pain must mean I have cancer” to “This pain is uncomfortable but not dangerous” can reduce anxiety and symptom severity.

2. Mindfulness-Based Therapy
Mindfulness techniques help patients become more aware of their bodies without judgment, which reduces fear-driven responses to physical sensations.

3. Psychoeducation and Family Therapy
Educating both the patient and their family about the disorder improves understanding and support, reducing stigma and resistance to treatment.

Online Counselling Through Platforms like TalktoAngel and Psychowellness Center
The emergence of online mental health services has made it easier to access therapy, especially for those hesitant to seek face-to-face counselling.

TalktoAngel
TalktoAngel is a well-known Indian online mental health platform offering online counselling for Somatic Symptom and Related Disorders, anxiety, and depression. It provides:

• Licensed clinical psychologists and psychiatrists
• Video/audio therapy sessions
• Multilingual services
• Specialisation in CBT and trauma therapy

TalktoAngel ensures confidentiality and convenience, making it a practical option for those suffering from SSRD who may also have mobility or travel issues due to their symptoms.

Psychowellness Center, Janakpuri (Delhi)
Situated in Janakpuri, Delhi, the Psychowellness Center offers both face-to-face and tele-counseling services. Key features include:

• Experienced clinical psychologists and psychiatrists
• Customised therapeutic plans based on assessment
• Specialized support for somatic symptoms and health anxiety
• Integration of psychotherapy with lifestyle counselling and mindfulness

They also focus on psychoeducation and involve family members in the healing process, which is critical for sustainable recovery.

Conclusion
A complicated and frequently misunderstood ailment, somatic symptoms and related disorders have a significant impact on a person’s mental and physical health. While its symptoms are real and distressing, the disorder stems from a combination of psychological and neurological factors. Early diagnosis and effective treatment—particularly through psychotherapy—can dramatically improve outcomes.

Platforms like TalktoAngel and Psychowellness Center, the best mental health wellness clinic in Delhi, are playing a vital role in making mental health services accessible, empathetic, and effective. With the right guidance and support, individuals suffering from Somatic Symptoms and Related Disorders (SSRD) can regain control over their lives and experience significant relief from their symptoms.

References 

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). [https://doi.org/10.1176/appi.books.9780890425596](https://doi.org/10.1176/appi.books.9780890425596)

(Primary source defining SSRD in DSM-5.)

• Barsky, A. J., & Borus, J. F. (1999). Functional somatic syndromes. *Annals of Internal Medicine*, 130(11), 910–921. [https://doi.org/10.7326/0003-4819-130-11-199906010-00016](https://doi.org/10.7326/0003-4819-130-11-199906010-00016)

(Discusses the clinical features and psychological basis of somatic disorders.)

•  Henningsen, P., Zipfel, S., & Herzog, W. (2007). Management of functional somatic syndromes. *The Lancet*, 369(9565), 946–955. [https://doi.org/10.1016/S0140-6736(07)60159-7](https://doi.org/10.1016/S0140-6736%2807%2960159-7)

(Outlines management approaches for SSRD and related syndromes.)

• Kirmayer, L. J., Groleau, D., Looper, K. J., & Dao, M. D. (2004). Explaining medically unexplained symptoms. *Canadian Journal of Psychiatry*, 49(10), 663–672. [https://doi.org/10.1177/070674370404901003](https://doi.org/10.1177/070674370404901003)

   (Explores cultural and psychological perspectives on SSRD.)