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Author Topic: Somatization or Somatoform disorder  (Read 762 times)

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Offline Pokey449

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Somatization or Somatoform disorder
« on: July 11, 2013, 05:58:52 PM »
Was wondering if this topic is discussed here any where. I have had health anxiety for years worrying about one disease or another, making the rounds to doctors, getting lots of tests. All of which have been negative for the most part. I do have documented GERD and mitral valve prolapse with regurgitation. However, I have been complaining for some time about debilitating fatigue and malaise. I try and eat right, exercise, deep breath, I see a therapist. I went to an internist who did about every blood test known to man, nothing, but the fatigue and malaise continues and I would say is getting more entrenched and chronic, and worse. I go to bed tired and wake up tired. I go from feeling Ok to feeling awful several times a day sometimes. Its taking all the joy out of my life.  None of the doctors can figure it out. My GERD has really been acting up and I have an upper endoscopy tomorrow, of course I am worried all this fatigue and malaise is due to stomach or esophageal cancer. I will likely be proved wrong again.

I have started reading about somatization/somatoform disorder. That a person can be so convinced they have a disease they can generate their own symptoms whether that be pain, fatigue, irritable bowel, etc. I have a hard time believing I am capapble of making myself so tired and feeling awful, that there has to be an organic cause and that if I think there is an organic cuase long enough there eventually will be. I feel like a dog chasing its own tail. Anyway, was wondering if this topic is dicussed anywhere in this forum?

Paul
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Offline Cuchculan

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Re: Somatization or Somatoform disorder
« Reply #1 on: July 12, 2013, 09:54:12 AM »
You may as well be the first with a topic on the subject. I am sure we may have had one or two in the past. Use the site search box on the subject and see if you can find any more threads similar. It is up the top of the forum. May find them in the sleep section.

But with anxiety, when a person is convinced they have something, they will go through the symptoms of what they believe they have. Even if they don't really have it. Hard to believe. But true. They will feel pain. They will feel whatever the illness tells them they are meant to feel. Because they normally google the illness. Check out the symptoms. Get them inside their minds. Then their minds begin to work. That is the key downfall. It is not like they imagine they have something and just begin to feel real symptoms of the illness. They check the illness out first online. Read up on it. Learn how it should effect them. Then go through the symptoms. The mind is a curious weapon for people with anxiety. But just as it you can use it to make you feel worse, you can learn to use it, to make you feel better too. All just takes a bit of training. Hope things pick up for you.
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Offline Pokey449

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Re: Somatization or Somatoform disorder
« Reply #2 on: July 12, 2013, 12:57:36 PM »
Many thanks. I noted several posts at the bottom about the subject. I think its a real issue for me as it seems to be the only explanation for my constant fatigue and malaise that no one can figure out. I am facing a big transition in my life. I am retiring from my job, that I have no love for, but its a big change and we are moving from Alaska to Oregon. I did not really want to leave Alaska, its a very special place to me, but my wife said she had had it with the winters and was leaving, I could come if I wanted or stay if I wanted. we have sold our house, which is hard for me to give up. Its on 2 acres in the woods, my Alaska dream if you will and now I have to let it go and dont want to. Perhaps all of this is causing alot of angst and making my symptoms worse. I get anxious over many things, tend to worry alot, but lately it has gotten really bad and I have been feeling awful. I have had health anxiety ever since I was a little boy. I recall telling my mom I was worried I had one disease or another, and paying visits to our small town doctor doing the same only to be reassured by a very patient man that I was OK. I seem to have developed this bizarre way of dealing with my stress. I am aware of this, and believe it all possible, but I keep finding myself with each new set of symptoms wondering "how do I really know its only anxiety this time, it really could be cancer"...Knowing all this I have not really found anyone who has offered good strategies for dealing with it. My psych doc says I am a hypochondriac and we have talked about somatization, but offered no solutions. May be time to find another psych doc????

Paul
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Offline Cuchculan

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Re: Somatization or Somatoform disorder
« Reply #3 on: July 12, 2013, 01:37:32 PM »
Around here you will more often than not hear the term HA used for hypochondriac. Simply means health anxiety. Plus it is shorter to write.  :laugh3: 

What I always tell people who suffer from HA to do, is make a list, over a period of about two to three months. On this list they are got to put everything they assume they have. Might be the heart one day. The brain the next day. Cancer the next day. Keep track of them on your list. Come the end of two months, tick off anything you really had. Leave blank the one that were the mind playing tricks on you. Chances are you will tick nothing off at all. Although you may feel certain symptoms, it won't really be a heart attack. It will pass. So we can leave it blank on the list. Now we look down our list and see exactly the power of the mind. This is were we try to change how we think. The next time you feel like you have anything wrong with you, go back to your list. See if it is on the list from before. If it is, we tell ourselves ' I have had this before and it was only my mind playing tricks on me '.

I know it won't be easy to begin with. As the symptoms can feel so real. But what people tend to do is feed the symptoms. By fear alone. This makes them much stronger. So by trying to change how we think we are learning not to feed the fear and the symptoms. If you can manage this things will lessen over time. This is the sort of thing you a need a good therapist to be working with you on. Exercises like this. Rather than just have you sit in a room and talk all day. So find one that is productive is this sort of way. You will get a lot better help from somebody like this.
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The Lovable Irish Rogue

Offline Pokey449

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Re: Somatization or Somatoform disorder
« Reply #4 on: July 14, 2013, 12:41:26 AM »
Had my upper endoscopy yesterday. My gut symptoms were not my mind playing tricks on me. Turns out I have esophagitis, 2 gastric erosions and 2 duodenal ulcers and have to go back on the nexium and take carafate to heal the ulcers. Likewise I dont think the fatigue and malaise is my mind playing tricks on me either. Its been chronic for over 3 years and getting worse. I eat well, exercise, take plenty of vitamins and other supplements, deep breath and try and get plenty of rest. I go to bed tired and wake up tired. I drag through the day, some days feeling exhausted and sick. While it might all be somatization the symptoms are all real and neither I nor any of my doctors know what the hell to do about it. I had a long conversation with my GP and he thought going to Mayos to get checked out would be a good idea, hopefully to find out if its organic in origin or I have a somatoform disorder. I have done psychotherapy on this until I am blue in the face and it has solved nothing. I know what hypochondriasis is and this goes a step or two beyond worrying that a pain is something bad.
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Offline Pokey449

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Re: Somatization or Somatoform disorder
« Reply #5 on: July 14, 2013, 12:54:08 AM »
one more thought. I cannot associate this fatigue and malaise with any specific disease, beleive I have googled about everything I can think of and I cannot associate the symptoms I am having with anything. For example, the things I looked at include thyroid, diabetes, chronic fatigue syndrome, fibromyalgia, gilberts syndrome, leukemia, anemia, colon cancer, just about everything I could think of that would cause me to feel this way and all the tests have proved all of them and many others I can't remember all wrong.......I have no idea what is causing me to feel so tired and crappy. My psych doc thinks its worry and depression and I tel him I am depressed because I am so damn tired all the time. I think we both are about to give up on each other as neither of us know of no other rocks to turn over to look under. So I am not sure what to do with all this. My last option I think is to go to Mayos and if they find nothing I guess I just have to live with it until it either goes away or I wear out and die.
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Offline Cheesus

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Re: Somatization or Somatoform disorder
« Reply #6 on: July 14, 2013, 06:05:22 AM »
I believe HA and somatoform to be closely related. If you look at the HA forum you will see people are more or less convinced that they have a certain illness. Some are even surprised that their symptoms get worse when their anxiety increases... as if the two aren't directly related.

Regarding your fatigue, I suffer from Chronic Fatigue Syndrome. It is essentially just a worse form of the fatigue you experience. It has a name, but it's not in the least bit understood. I am currently doing a programme for recovery called Gupta Amygdala Retraining. In this programme we essentially learn to confront all of the negativities and anxieties in our lives, both surrounding the illness and also in general.

You would be amazed at the physiological results people get from essentially psychological methods. People with fibromyalgia who have been in chronic pain for years return to normal. People with multiple chemical sensitivities once again become immune to the odour of cigarettes and carpets. I just read an account of someone who had CFS for 25 years - most of which was spent in bed - who the other day ran a 10km run. This is all due to correcting the adrenal cycle and the sensitisation of the sympathetic nervous system (the fight or flight response), which has a domino effect on our immune systems, our nervous system, and our GI tract (very important to wellbeing).

I get you that it is so difficult to see that psychological issues can cause such dire physiological symptoms. I really do understand that. However, our mentality is so deeply tied to our physiology that it is impossible for you to live with worry and not have serious effects. Let me give you a few examples of how the mind can effect the body (and vice versa).

1. In a recent study they found that certain social or psychological triggers can activate an immune response. This could be a certain perceived contamination, for instance, that has cause an immune response in the past, actively retriggering an immune response in leu of any actual pathogen. (e.g. I got ill when I ate this last time, thus my immune system is triggering this time as well).

2. The placebo effect - the act of administering a fake treatment for a real illness with positive results - is widely dismissed as 'oh, it was just the placebo effect'. However, the placebo effect is capable of actually causing obvious physiological changes. For instance, if you take two groups of people with any given treatable virus. The first group is given a placebo, and the second is told just to get bed rest or whatever. Studies have shown that the first group will clear the virus quicker, with immune markers such as inflammatory cytokines reducing to normal levels faster than the non-placebo group. There is nothing occurring here other than a belief in getting better, though it has very, very real and measurable impacts.

3. Studies of cancer patients who had a positive outlook showed they had betters chances of survival.

4. Stress causes a degradation of the intestinal lining leading to a number of illnesses. Moreover, it can cause ulcers (as you know very well).

5. Chronic stress obscures the immune system from a balanced Th1/Th2 response to a predominantly Th2 response. As a result you are less able to fight infection, however you are more prone to allergies than someone with a balanced Th1/Th2 response.

6. Looking at it from the other direction, the administration of regular probiotics has been shown in rats to significantly reduce levels of anxiety. This is because the GI tract is part of something called the enteric nervous system that is attached to the brain via the vagus nerve.

So, as I hope you will agree, this very short list of all the possible impacts of psychological elements on our physiology demonstrates the very real possibility that if no physical illness can be found it is very, very likely that your continued state of sympathetic nervous system arousal is leading to a degradation of your physiology and is likely causing you fatigue.
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Offline Pokey449

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Re: Somatization or Somatoform disorder
« Reply #7 on: July 14, 2013, 02:55:24 PM »
Cheesus- thanks very much for a very informative response. I don't understand why none of my doctors seem to have a deeper understanding of my anxiety/fatigue. They either have no idea of whats causing my fatigue or assume its all in my head and either want to ignore it  and assume I will just have to live with it, or take pills to mask it. A clue that my fatigue is based on an overactive sympathetic nervous system which has my system running on fumes can be born out by the fact that when I have occasionally taken valium in the past the symptoms dissipate and I feel well and rested, like a normal human being, that is until the valium wears off. Of course I can't take valium 24/7. I did take xanax for 25 years, but it was causing more harm than good. I am going to look into the amygdala retraining and see what my psych doc has to say about it. My only concern is I get wary of someone selling the latest and greatest on the internet if it is not a treatment with sound scientific basis. I am not necessarily saying this is the case here, I just need to research it more to convince myself its bonafide.

Pokey
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Offline Cheesus

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Re: Somatization or Somatoform disorder
« Reply #8 on: July 15, 2013, 04:01:43 AM »
Cheesus- thanks very much for a very informative response. I don't understand why none of my doctors seem to have a deeper understanding of my anxiety/fatigue. They either have no idea of whats causing my fatigue or assume its all in my head and either want to ignore it  and assume I will just have to live with it, or take pills to mask it. A clue that my fatigue is based on an overactive sympathetic nervous system which has my system running on fumes can be born out by the fact that when I have occasionally taken valium in the past the symptoms dissipate and I feel well and rested, like a normal human being, that is until the valium wears off. Of course I can't take valium 24/7. I did take xanax for 25 years, but it was causing more harm than good. I am going to look into the amygdala retraining and see what my psych doc has to say about it. My only concern is I get wary of someone selling the latest and greatest on the internet if it is not a treatment with sound scientific basis. I am not necessarily saying this is the case here, I just need to research it more to convince myself its bonafide.

Pokey

Oh absolutely. There is a cost involved and I would never ask someone to part with their hard earned cash or spend their precious time on something from the word of a stranger on the internet. Try to seek out impartial reviews and do a bit of digging around before you even consider committing to anything.

Honestly I think the idea of the overactive sympathetic nervous system is a bit lost on doctors too. They are aware of it in a round about sort of way, but to make it this explicit is perhaps something they are not used to. I don't think we can blame them for that... GPs are general practitioners, and the specialists specialise in something else :)

Even if your fatigue isn't as a result of sympathetic nervous system stimulation (though I am convinced that in part at least it probably is), I think nearly everyone in contemporary society could benefit from nurturing their ability to rest and repair :) this is especially true of the chronically sick. However you choose to do that is entirely up to you, whether it be a structured programme or independently.
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You can't calm the waves, but you can learn to surf!

Basis of Recovery
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