Somatization: Information Booklet for Patients & Caregivers

What is somatization?

When physical symptoms are caused by mental or emotional stress it is called somatization’. For example, many people have occasional headaches caused by mental stress. But, stress and other mental health problems can cause many other physical symptoms such as: chest pains, tiredness, dizziness, back pain, feeling sick diarrhea, penod problems, etc.

The term ‘psychosomatic’ means something similar to somatization, but includes other things

How can the mind cause physical symptoms?

The relationship between the mind and body is complex and not fully understood. When we ‘somatize’, somehow the mental or emotional problem is expressed partly, or mainly. as one or more physical symptoms. However, the symptoms are real and are not imagined. You feel the pain, have the diarrhea, etc.

How common is somatization?

It is very common. Sometimes we can relate the physical symptoms to a recent stress or to a mental health problem. For example, you may realize that a bout of neck pain or headache is due to stress. Anxiety and depression are also common reasons to develop physical symptoms such as palpitations, aches and pains, etc. Often the physical symptoms go when emotional and mental stresses ease. However, often we do not realize the physical symptom is due to a mental stress. We may think we have a physical disease, and may see a doctor about it.

Somatization and functional symptoms

Some doctors prefer to use the term ‘functional’ when no known physical cause can be found for a physical symptom. A ‘functional’ symptom means: a function of the body is faulty (for example, there may be pain or diarrhea), but we don’t know the cause. The cause may be due to mental factors (somatization), physical factors not yet discovered, or a combination of both. Another term which is used for such symptoms is ‘medically unexplained symptoms.

Somatoform Disorders

The Somatoform Disorders are the ‘extreme’ end of the scale of somatization. So, the physical symptoms persist long-term, or are severe, but no physical disease can fully explain the symptoms. They include somatization disorder, Hypochondriasis and conversion disorder. These are classed as separate mental health disorders as the cause of the symptoms is thought to be mental factors, but they cannot be fully explained by Depression. Substance Abuse, or other recognized mental health disorders

People with Somatoform Disorders usually disagree that their symptoms are due to mental factors, and are convinced the cause of symptoms is a physical problem.

Somatization Disorder

People with this disorder have many physical symptoms from different parts of the body. For example, headaches, feeling sick, abdominal pain. bowel problems, period problems, tiredness, sexual problems. The main symptoms may vary at different times Affected people tend to be emotional about their symptoms. So they may describe their symptoms as ‘terrible’, ‘unbearable’ etc, and symptoms can greatly affect day-to-day life. The disorder persists long-term although the symptoms may wax and wane’ in severity.

The cause is not known. It may have something to do with an unconscious desire for help, attention and care’. It runs in some families. The disorder usually first develops between the ages of 18 and 30. More women than men are affected.

It is difficult for a doctor to diagnose somatization disorder. This is because it is difficult to be sure that there is no physical cause for the symptoms. So, people with this disorder tend to be referred to various specialists, have many tests and investigations, but no physical disease is found to account for the symptoms.


This is a disorder where people fear that minor symptoms may be due to a serious disease. For example, that a minor headache may be caused by a brain tumor, or a mild rash is the start of skin cancer. Even normal bodily sensations such as tummy rumbling’ may be thought of as a symptom of serious illness. People with this disorder have many such fears, and spend a lot of time thinking about their symptoms

This disorder is similar to somatization disorder. The difference is that people with Hypochondriasis may accept the symptoms are minor, but believe or fear they are caused by some serious disease. Reassurance by a doctor does not usually help as people with Hypochondriasis fear that the doctor has just not found the serious disease.

Conversion Disorder

This is a disorder where a person gets symptoms which suggest a serious disease of the brain or nerves (a neurological disease). For example, blindness, deafness, weakness, paralysis, or numbness of arms or legs. The symptoms usually develop quickly in ‘response’ to a stressful situation. You unconsciously ‘convert your mental stress into a physical symptom

Conversion disorders tend to occur between the ages of 18 and 30. Symptoms often last no longer than a few weeks but persist long-term in some cases. Often there is only ever one episode and no treatment is needed once symptoms have gone. Some people have repeated episodes of conversion disorder from time to time.

Treatment for Somatoform Disorders

Treatment is often difficult as people with Somatization Disorders do not accept that their.. symptoms are due to mental factors: They may become angry or irritated with their doctors who cannot find the cause’ for their problems. Another difficulty that doctors may face is that people with somatization disorder, like everyone else, will develop physical

diseases at some point. So, every new symptom is a challenge to a doctor to know how far to investigate’.

Many people who are thought to have a somatoform disorder also have other mental health problems such as Depression, Anxiety or Substance Abuse. These may be partly a result of having the physical symptoms which are distressing. Treatment of these other mental health problems may improve the situation.

If the person can be convinced that mental (psychological”) factors may contribute to, or cause, the physical symptoms then they may accept a talking treatment such as Cognitive Behaviour Therapy. Talking treatments may help people to understand the reasons behind symptoms, aims to change any ‘false’ beliefs that they may have, and how to identify and deal with emotional issues.