The Difference Between a Somatoform Illness and a Chronic Illness
A Somatoform disorder can be characterized by symptoms that may suggest a medical condition is causing you issues. Yet in a Somatoform Disorder the symptoms are not explained by either a, "medical condition, substance use, or another mental disorder"(APA, 2013). And often include heightened worry and anxiety around your own health, and this often leads to hypersensitivity and preoccupied thoughts about your physical symptoms. (APA, 2013).
There are three types of Somatoform disorders, and they differ based on where they affect you most, physically and psychologically. With a somatoform disorder both areas are often involved. Yet, they can be easily confused with chronic illnesses that are hard to diagnose or are just not yet diagnosed. The different types of somatoform disorders are the following:
somatization disorder where there are, "multiple, recurrent, and clinically significant physical complaints across various body systems. Symptoms can include pain, gastrointestinal, sexual, and pseudo neurological symptoms" (APA, 2013).
Conversion Disorder that presents with primarily neurological symptoms like paralysis, blindness, or others. These typically are twofold as they both lack a neurological explanation and are triggered by stress. (APA, 2013).
Hypochondriasis can be seen as an anxiety disorder as it’s characterized by excessive fears around having a medical condition due to similarity of symptoms. Yet they importantly have little overlap in symptoms or no medical evidence (APA, 2013).
It’s important to note that these disorder types should be treated by both a doctor and therapist. The doctor to rule out the chronic illness or invisible illness possibility and the therapist to aid in anxiety, depression, and stress as support will help. A main difference here is that in a somatoform disorder symptom will go away after seeing a therapist and treating the mental health side while with a medical condition the symptoms continue.
The tricky part in determining between chronic illness and somatoform is the treatment by doctors as gaslighting can cause issues in the medical investigation process. With longitudinal studies we see a fluctuation in the presentation of somatoform symptoms, and they persist in spite of medications and medical treatments. Whereas with chronic illness symptoms they can fluctuate, yet they typically respond to treatments if diagnosed and properly referred through to specialists. However, if they have been treated as somatoform, they may never get a diagnosis due to what’s often felt as gaslighting by patients.
Both Somatoform disorders and Chronic Illnesses will have an impact on the quality of life of a person emotionally, physically, and productively. As emotionally they will have high levels of anxiety that feel distressing, and they may have a difficult time coping with the worry. As well as depression, as it's difficult to have high levels of worry and feel like no one gets it. Then physically, they will have a lot of physical issues they feel need addressing and will go to the Dr, or walk-in clinics frequently. This will lead into an impact on work through a decrease in their productivity and impact their day-to-day through a higher demand of appointments, as well as the physical impact of the symptoms themselves (Kroenke, K., & Swindle, R, 2000).
My main tips for managing and coping with both these disorders are going to be similar as for those with chronic illness and somatoform need to see a therapist. Living with chronic conditions can be very difficult and debilitating so getting the proper support to walk through these frustrations and worries is the best treatment. As a chronic illness therapist, I walk through these difficulties with both clients that have long term chronic conditions and somatoform disorders. And my tips for managing and coping would be to use a cognitive behavioural approach along side your medical investigations. CBT is found to be effective in treating anxiety, depression, chronic illnesses, and somatoform disorders. And using this approach I've seen those with chronic conditions learn to adapt to life with a disorder and learn to thrive, and in those with somatoform disorders I've seen total life changes.
Prevention strategies would focus on building proactive skills, like learning to cope with stress to build distress tolerance skills like through a Dialectical Behavioural Therapy approach. This helps us to gain awareness of our mental health and build skills that teach our nervous system to lower our cortisol and our stress response such as through mindfulness, interpersonal skills, and emotion regulation. When these are not skills, we have it can lead to great anxiety and stress. Depending on the ways that we internalize anxiety, it may affect our body through a chronic health disorder as cortisol can inflame our bodies or it can lead to a state of fear that presents as a somatoform disorder.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Kroenke, K., & Swindle, R. (2000). Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials. Psychosomatic Medicine, 62(6), 913–928.
