Somatic Symptoms of Anxiety (A brief guide)

In this guide, we will discuss the somatic symptoms of anxiety, related causes, risk factors and treatment options.

Somatic symptoms of anxiety

Somatic symptoms of anxiety are typically associated with somatization of anxiety and other psychiatric disorders, which can include but are not limited to abdominal pain, dyspepsia, chest pain, fatigue, dizziness, problems sleeping, and migraines/headaches.

According to Gelenberg, (2000) “Somatization refers to the phenomenon in which patients experience and express their feelings or emotions through physical complaints and distress.

This phenomenon may result from a variety of cultural, familial, and personal circumstances, including biases against expressing psychological discomfort.”

Anxiety disorders are widely known as the most common disorders, however, it has been said that they are insufficiently recognized and inadequately treated and it has become a matter of public health associated with high costs and high mortality rates.

In many cases, the somatization of anxiety possesses a challenging component when making an accurate diagnosis and early treatment. 

Many clinicians have suggested pharmacologic interventions necessary to treat anxiety in an effective way.

Some of the preferred choices are related to the use of benzodiazepines and older antidepressants, however, newer anxiolytic agents have become popular and available such as Selective Serotonin Reuptake Inhibitors and those with dual reuptake inhibition such as Venlafaxine XR, which are said to have less serious adverse effects and long-lasting improvement compared to the older medications.  

In addition, these newer antidepressants can provide a higher efficacy when treating comorbid illnesses such as depression. 

There are several and diverse anxiety disorders but they are mainly characterized by clinically significant levels of worry, apprehension, or panic that occurs when we perceive a situation, object or person to be threatening or harmful.

The reaction or behaviors tend to be out of proportion and unrealistic. 

“The emotional distress of anxiety is often accompanied by specific physical symptoms associated with a state of autonomic arousal, such as sweating, dizziness, and shortness of breath (most notable in patients with panic attacks), or more generalized somatic complaints, such as insomnia, restlessness, and muscle aches (commonly found in patients with generalized anxiety disorder [GAD]).”

Other related anxiety disorders include specific phobias, obsessive-compulsive disorder or OCD, posttraumatic stress disorder (PTSD), and acute stress disorder.

However, there are also medical conditions that have been suggested to be associated with anxiety such as neurologic conditions, thyroid dysfunction, and cardiovascular diseases. In addition, drug use or abuse, including benzodiazepine (BZD) and alcohol withdrawal or intoxication, also have been linked to clinically significant anxiety that should be distinguished carefully from medically-related causes before a treatment plan has been proposed. 

Identification and diagnosis is Key for finding effective treatment options

It is of vital importance to be assessed, diagnosed and treated specifically for the identified anxiety disorder.

This will allow having a higher probability of treatment success than if it is left untreated or misdiagnosed since it has been estimated that as many as 53% of individuals who meet the diagnostic criteria end up receiving an incorrect diagnosis and treatment. 

This is preoccupying since some clinicians tend to believe that the complaints are due to an existing underlying and unidentified medical condition, but when test results reveal no identifiable organic cause for the symptoms then they seem to tend to overlook within psychiatric causes.

For instance, in a study conducted in Great Britain, primary care physicians were able to diagnose anxiety, depression, or both significantly more often in patients who had psychiatric symptoms than in patients who had only somatic complaints (Gelenberg, 2002).

Another identified factor that can make diagnosing anxiety quite challenging is the high rate of comorbid psychiatric illnesses.

For example, depression has been suggested to co-occur with anxiety and when there is such comorbidity, there seems to be a higher risk for treatment withdrawal than either disorder alone, poor prognosis and greater risk of suicide.

What Is Somatic Symptom Disorder? 

According to psychiatry.org, somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, which results in major distress and a negative effect in their day to day functioning.

The individual has excessive thoughts, feelings, and behaviors relating to the physical symptoms. 

In some cases, physical symptoms may or may not be associated with a diagnosed medical condition, but many people believe they are experiencing symptoms because they are severely sick or ill.

Somatic symptom disorder is not a diagnosed condition that someone can have due to not being able to find a medical cause for the presentation of the symptoms, there is an emphasis put on the thoughts, feelings, and behaviors that are related to the illness and are way out of proportion when contrasted with real life.

What are the related symptoms?

According to the Mayo Clinic, symptoms associated with somatic symptom disorder may include:

• Specific sensations, such as pain or shortness of breath, or more general symptoms, such as fatigue or weakness
• Unrelated to any medical cause that can be identified, or related to a medical condition such as cancer or heart disease, but more significant than what’s usually expected
• A single symptom, multiple symptoms or varying symptoms
• Mild, moderate or severe

In addition, there could be a manifestation of a feeling of chest pain/tightening, excessive sweating, feeling restless or easily startled, diarrhea, heart palpitations, problems focusing or concentrating, insomnia, muscle tension, among others. 

Pain is one of the most common symptoms and complaints in clinical practice. Some people won’t associate their symptoms to anxiety, which in turn can cause severe distress and can be very disabling.

In addition, thoughts and behaviors related to somatic symptoms of anxiety can include (Mayo clinic):

• Being constantly worried about being ill
• Associating the normal physical symptoms and anxiety reactions with being severely ill. 
• Fear of having serious symptoms when there is no actual evidence. 
• Considering that the physical symptomatology can become threatening or harmful. 
• Considering that the physician attempts to address the health concern has been inadequate. 
• Fearing that physical activity may cause damage to your body
• Frequently visiting physicians to check there are no abnormalities or potential diseases. 
• Frequent health care visits that don’t relieve your concerns or that make them worse
• Being unresponsive to medical treatment or unusually sensitive to medication side effects
• Having a more severe impairment than is usually expected from a medical condition

Physical symptoms are a very real source of over worrying, however when having somatic symptom disorder, the way this gets interpreted and how you react to the symptoms can actually impact your daily functioning very negatively. 

Risk factors for somatic symptoms

Some of the risk factors for somatic symptoms include:

• Suffering from anxiety and/or depression
• Recovering from a medical condition or having one
• Having a family history of a medical condition or disease can put you at risk of developing one. 
• Having experienced trauma, neglect, abuse or violence 
• Having experienced past trauma, such as childhood sexual abuse
• Having a lower level of education and socio-economic status

Can the somatic symptoms be treated?

Cognitive Behavioral Therapy (CBT) has been proposed as the preferred therapeutic approach to somatic symptoms since they are characterized by excessive and often unrealistic worry.

CBT can help patients to develop self-monitoring strategies, where they learn to observe their anxiety (symptoms and behaviors) and to correct faulty response patterns. 

In addition, various relaxation techniques have been suggested to help to reduce the physiological expressions of hyperarousal and muscle tension.

This can involve mindful meditation and teaching breathing techniques.

Cranial electrotherapy stimulation (CES) is reported to be an effective treatment for anxiety. It is an FDA-approved, prescriptive, noninvasive electromedical treatment that has been shown to decrease anxiety, insomnia, and depression significantly.

Here is a quick list of the Best cranial electrotherapy stimulation devices that can lower symptoms of anxiety.

Moreover, psychotherapy can be combined with drug treatments to control the symptoms such is the case of benzodiazepines, SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), antipsychotics, and ß-blockers. 

However, it is important to consider each drug treatment separately since they can have certain side effects, becoming dependent and when discontinuing the treatment, the manifestation of severe withdrawal symptoms.

Also, they need to be prescribed considering the age, overall health of the individual and medical history since they can also worsen certain medical conditions. 

Also, nootropics are considered as a treatment for the cognitive symptoms of mental health conditions like anxiety and depression. If you’re interested in trying nootropics to better manage your anxiety disorder, try the Best Nootropics for Anxiety.

Why is this blog about somatic symptoms of anxiety important?

It is important to be aware and able to recognize the symptoms of anxiety since most people don’t know they are manifesting them, leading to significant interference with their normal functioning.

Also, knowing about them can help you identify them in yourself or others and seek professional help. 

In addition, they can become a real problem when they tend to control your thoughts, your behavior, and subsequently your life.

When you focus on the symptoms instead of the potential cause it can lead to keeping a vicious and never-ending anxiety cycle. 

Please feel free to comment in the comments section below.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

What we recommend for curbing Anxiety

Below are some of the services and products we recommend for anxiety

Online Therapy

• Online therapy is another thing we should all try. We highly recommend Online therapy with a provider who not only provides therapy but a complete mental health toolbox to help your wellness.

Anxiety Weighted Blankets

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Light Therapy

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Frequently Asked Questions (FAQs) about somatic symptoms of anxiety

Recommended reading

• Treating Somatic Symptoms in Children and Adolescents (Guilford Child and Adolescent Practitioner) (Guilford Child and Adolescent Practitioner Series)
• Somatization Disorder Explained: Somatic symptoms, nausea, diarrhea, bloated stomach, palpitations, chest pain, breathlessness, somatic pain, somatization disorder treatment, all covered
• Neuropsychological Evaluation of Somatoform and Other Functional Somatic Conditions: Assessment Primer (American Academy of Clinical … Continuing Education Series)
• When the Body Says No: The Cost of Hidden Stress
• Stress and Somatic Symptoms: Biopsychosociospiritual Perspectives