All in the mind? A guide to psychosomatic disorders

Written by: Dr Abrar Hussain
Published: | Updated: 03/12/2018
Edited by: Cal Murphy

The power of the human mind should not be underestimated. Is it possible for the mind to make us experience physical symptoms without actually having a physical disease? Respected psychiatrist Dr Abrar Hussain has the answers…

What are psychosomatic disorders?

Psychosomatic disorders are conditions where people experience persistent physical symptoms but medical tests are unable to identify a physical cause. The symptoms are real and distressing. They are also referred to as “medically unexplained symptoms”.

There are different types of psychosomatic disorders depending on the type of symptom or symptoms experienced. Some common examples of psychosomatic disorders are:

  • Dissociative seizures (also called non-epileptic attack disorder) – a condition in which people experience attacks resembling epilepsy but the brain electrical activity is not altered.
  • Irritable bowel syndrome – a condition where people have bowel symptoms including pain, bloating, constipation and diarrhoea but no physical cause can be found.
  • Chronic pain – a condition in which tissue damage has healed but the nerves continue to remain sensitive to pain.

If your symptoms are mainly neurological (nervous system related), the term used by doctors to describe this condition is “functional neurological disorder” or FND in short. In addition to dissociative seizures as described above, people with FND can experience other symptoms such as weakness in limbs, numbness, visual loss, speech difficulties and headaches.

Before the diagnosis of psychosomatic disorders can be confirmed, physical tests are usually carried out to rule out any physical cause. In most situations, physical examination and basic tests are sufficient to make a reliable diagnosis.

 

Causes of psychosomatic disorders

As tests are unable to identify a physical cause, these symptoms are thought to have a psychological origin. The mind is very powerful and there are strong links between the body and the mind. Psychological stress or traumatic experiences can sometimes be a trigger for the symptoms.

Sometimes, patients with psychosomatic disorders can also have depression and anxiety and this can increase the level of distress.

Common example of psychosomatic symptoms which most people reading this would have experienced are:

  • Headaches after a long day at work
  • Palpitations when feeling stressed
  • Butterflies in stomach when feeling anxious

 

Treatment of psychosomatic symptoms

The treatment of psychosomatic symptoms starts from a good assessment and a positive diagnosis. Understanding the diagnosis is quite important. Physical investigations are unlikely to help and may even increase risk of harm from the tests themselves. Looking up the symptoms online can raise anxiety levels.

Treatment is usually in the form of psychological therapy initially aimed at exploring the symptoms and its impact. Addressing past trauma can help some patients.

Treatment of depression and anxiety with medication can also be helpful to manage the symptoms in a better way. Depression can make people more sensitive to pain, so anti-depressants can help in this regard.

Some patients may need to see a team of professionals including psychiatrists, psychologists, physiotherapists and occupational therapists.

By Dr Abrar Hussain
Psychiatry

  • Accredited Cognitive Analytic Therapist
  • EMDR Europe Accredited Practitioner.


Dr Abrar Hussain is a consultant psychiatrist based in West London and Berkshire with a wealth of experience and expertise in many areas of his field. His specialties include depression, anxiety, traumatic stress and personality disorders, amongst many other areas of psychiatry. He has a special interest in the assessment and management of medically unexplained symptoms and functional neurological disorders. He runs a specialist service within the NHS for patients with co-morbid physical and psychological distress.

He completed his medical training in 2002 as a gold medallist and has since gone on to complete his post graduate training in psychiatry in London. He was awarded Membership of the Royal College of Psychiatrists in 2009. He is on the General Medical Council Specialist Register for General Psychiatry and Liaison Psychiatry.

In addition to his training in pharmacological (medicines) management, he is trained in psychological therapies. He is an Accredited Therapist in Cognitive Analytic Therapy (CAT), a form of psychological therapy based on relationships with self and others. He is also an EMDR Europe Accredited Practitioner. EMDR (Eye Movement Desensitisation and Reprocessing) therapy is a powerful approach aimed at processing traumatic experiences. 

As well as working full-time as a consultant psychiatrist, Dr Hussain dedicates time to mentoring for the Thames Valley and Wessex Leadership Academy. He leads training for junior psychiatrists sitting the Royal College of Psychiatrists examination as the Course Director for Cognitions for CASC course (www.cognitionsforcasc.co.uk).

He is actively involved in research as the Principal Investigator in the national multi-centre CODES trial. He has presented in national and international conferences and won prizes for his work. He has been invited to speak at a number of regional and national events. He has published several scientific papers in peer reviewed journals.

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