Psychosomatic Illness: Definition, Symptoms, and Treatment

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In a psychosomatic illness, emotional stress or other psychological problems play key roles in the course of the physical signs and symptoms. For example, depression can contribute to psychosomatic illness, especially when the body’s immune system has been weakened by severe or chronic stress.

A common misconception is that a psychosomatic disorder is imaginary or "all in the head." In reality, psychosomatic symptoms are real and require treatment, just as any other illness.

Unfortunately, the pervasive social stigma of psychosomatic illness prevents some people from seeking treatment. Stigma is also present in research and medical communities, partly because of the health professionals' own experiences. 

Psychosomatic Symptoms

Learning about how mental and emotional stress manifests physically can be helpful in reducing the effects of stress on your health. Common physical signs of stress include:

Sex-Based Psychosomatic Symptoms

Bodily signs of stress can vary between the sexes. For example, when stressed, people who are biologically female often report symptoms such as fatigue (despite getting enough sleep) and irritability, as well as signs such as abdominal bloating and menstrual changes. Signs and symptoms of stress in males, however, are more likely to include chest pain, increased blood pressure, and changes in sex drive. 

Age-Based Psychosomatic Symptoms

Signs and symptoms of stress also vary by age. Children often experience stress in a physical way because they haven’t yet developed the language to communicate how they feel. For example, a child who is having a hard time at school may have frequent stomachaches or headaches.

Stress in the teen years can be especially intense, particularly during periods of major social adjustment and hormonal shifts. Frequently, adults attribute signs of stress to typical "teen angst" rather than adolescent depression.

Older adults are also prone to depression as they contend with isolation, loss and grief, and health problems. If you are caring for an aging loved one, it's important to know the signs of depression in older adults

Psychogenic vs. Psychosomatic Pain

Psychogenic pain and psychosomatic pain both describe physical signs and symptoms, but their meaning is slightly different:

  • Psychogenic pain results from psychological disorders or issues such as mental or emotional stress. In other words, psychological problems are the main genesis of the pain.
  • Psychosomatic pain has a known physical source, but psychological issues such as anxiety play a role in how the pain progresses—for example, depression exacerbating an endocrine disorder.

Causes of Psychosomatic Illness

The exact mechanisms of stress are not completely understood, but researchers know that stress and depression can manifest as physical pain and illness. It’s a complex process, but here’s an analogy that might help.

Compare your body to a pressure cooker. If it's allowed to vent its steam, it works efficiently. If it can’t release steam, the pressure continues to build until the lid blows off. Now, imagine that the cooker is under pressure already and you apply more pressure to keep the lid on. When the container can no longer hold in all the pressure, it will break at its weakest point.

Like the pressure cooker giving way at the weakest point of its structure, stress-related illness is most likely to develop where your body is already weakened. 

Someone who is under stress and does not or is unable to vent their emotions will eventually reach an emotional breaking point. This may result in physical symptoms or trigger an episode of major depression.

In retrospect, you may recognize some warning signs that a break was coming. For example, if you tend to strain your neck, you might experience increased neck pain when you're stressed. Back pain, stomach trouble, and headaches are other common ways for stress to take up residence in your body. 

Stress can also compromise your immunity. For example, some people tend to catch colds, the flu, or other illnesses and infections when under pressure and may take longer to get better. 

Part of the body’s fight-or-flight response to stress is the release of certain chemicals, such as adrenaline, that can be very useful in a life-or-death situation. However, if the body has high amounts of these chemicals or they are released continuously over an extended period (such as with chronic stress), they may do more harm than good. 

Psychosomatic Illness Diagnosis

When you see a healthcare provider for physical symptoms, they look first for physical causes. If none is obvious, coming up with a diagnosis and treatment plan can be tricky. 

If you have a psychosomatic disorder, you might feel as if your provider is not taking your symptoms seriously, thinks you're making them up, or believes they're "all in your head." When unable to find a clear physical cause for your pain (such as an injury or infection), an astute healthcare provider may ask you how you feel emotionally.

The hope is that, if a source of stress can be identified, it can be treated—just as with an obvious physical injury or illness. When a clinician asks about stress in your life, for example, they're not implying that your pain is not real. Physical symptoms caused by stress are very real, but they're caused by a different mechanism than, say, a bone break. 

Treatment for Psychosomatic Illness

You may be referred to a mental health professional, but that doesn't mean your physical symptoms require only psychological treatment. Learning how to effectively manage stress is important, but this can take time. In the meantime, your clinician may treat your physical pain and other symptoms with medication, mindfulness therapy, or cognitive therapy.

Back to the example of neck pain: If it tends to worsen with stress, learning to deal with stressful triggers can certainly help—but the pain is real. Although the stress might start in your brain, it can cause the release of chemicals (such as cortisol) that produce inflammation in your neck muscles. This causes you very real physical pain that your healthcare provider can address.

Another way to think of psychosomatic illness is as a river that floods after a dam breaks. The most effective way to prevent more flooding is to fix the dam. However, the flooding that’s already happened must be dealt with while the dam is being repaired. 

Coping With Stress

There are actually different kinds of stress. Positive stress, also known as eustress, keeps life invigorating and interesting. It's the feeling that makes you want to get up in the morning and keeps you motivated. If you've ever enjoyed the thrill of a roller coaster ride or felt a sense of excitement and fulfillment when completing a project, you've experienced "good" stress.

On the other hand, if you've experienced a major loss, a big life change, or other negative stressors, you know what "bad" stress feels like. Just as with positive stress, you can feel negative stress in your mind and body. When you can identify your main sources of stress, you can learn coping mechanisms. One of the first and most important is to avoid holding in your feelings. Another is to avoid unhealthy strategies, such as overusing alcohol.

Healthy coping methods abound; it’s just a matter of finding what works best for you. Here are a few ideas to get you started. 

  • Be honest with others and yourself.
  • Confide in a friend.
  • Do something kind for someone else. (Be sure to do nice things for yourself, too.)
  • Eat a balanced diet, get regular exercise, and create a calming sleep ritual and space.
  • Explore fun outlets for stress, such as a dance class.
  • Join a support group.
  • Learn relaxation techniques.
  • Let go of grudges, patterns of thinking, or relationships that are unhealthy or negative for you.
  • Make time for leisure activities you enjoy.
  • Take a break if you're in a stressful situation.

Remember that everyone handles stress in their own way. Two people in the same stressful situation can react very differently. Once you understand the unique way stress affects you both emotionally and physically, you can work on developing healthy and effective ways to manage it.

A Word From Verywell

In dealing with psychosomatic illness and the physical effects of stress, learn to let go of what isn’t serving you. First, accept that you are human, and allow yourself some grace. Then, do the difficult but necessary emotional work, such as allowing yourself to feel emotions that are hard for you to confront.

Also let go of expectations and old guilt—the "shoulds" that have been guiding your behavior. You might benefit from giving up control in some areas of your life or easing off your tendency to strive for perfection.

Remind yourself that it’s OK to fall short of your goals as long as you are trying and doing your best. As you are identifying stress in your life, you may realize a big source is the pressure you put on yourself—and therefore, it's within your control to release.

Frequently Asked Questions

  • What does psychogenic pain mean and is it related to psychosomatic illness?

    Psychogenic pain occurs due to psychological rather than physical factors (such as breaking a bone or having arthritis). It describes pain that results from a person's emotions, fears, or beliefs. Psychogenic pain is related to psychosomatic illness in that a person's psychology plays a role in how they experience pain, making it feel better or worse.

  • Can psychosomatic pain be stopped or relieved?

    Yes! You can relieve and maybe even stop psychosomatic pain by developing healthy coping strategies and reducing your stress levels. By dealing with the psychological issues that trigger your pain, such as through therapy or medications, your symptoms can be reduced if not eliminated.

  • How do I know if my symptoms are psychosomatic?

    If the worsening of physical symptoms cannot be linked to new physical injury, illness, or disease, they might be psychosomatic. Your healthcare provider may run diagnostic tests to rule out medical causes. If none are found, you may be diagnosed with a psychosomatic illness. Getting this diagnosis as soon as possible is critical to starting treatment and improvement.

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