Category: Somatic Symptom and Related Disorders

Categories
Addiction Neurocognitive Disorders Neurodegenerative Disorders Somatic Symptom and Related Disorders

A General Introduction to Medication-Induced Movement Disorders

For every time we turn on the television, we often land on a commercial involving joyous people while promoting a certain medication and its side effects. In addition, we’re always notified about the side effects such as heart failure, seizures, or death that might potentially happen. As bothersome and even morbid as it may be to hear or think about, side effects like this can happen when you’re on prescribed medications. This is known as medication-induced movement disorders.

According to the DSM-5, the definition of medication-induced movement disorders is included because “the management by medication of mental disorders or other medical conditions and the differential diagnosis of mental disorders (e.g., anxiety disorder versus neuroleptic-induced akathisia; malignant catatonia versus neuroleptic malignant syndrome)” (American Psychiatric Association, 2013 p. 709) According to a study conducted by scholars Stephen R Duma, John Morris, and Victor SC Fung, one of the most common culprits that causes movement disorders is antipsychotics and antiemetics (Duma, Fung, & Morris, 2019). Therapeutic and illicit drugs can potentially cause neurological adverse effects and movement disorders. However, if there is early intervention, there is a probability that these effects can be reversed or prevented.

The DSM-5 has divided the definition of medication-induced movement disorders into multiple sections as it has a myriad of effects on an individual. Furthermore, it is important to emphasize that the following disorders are not mental disorders, but instead are disorders that impact the individual physically.  The following disorders include medication-induced acute dystonia, medication-induced acute akathisia, tardive disorders including dyskinesia, dystonia, and akathisia. While there are a few notable differences in each movement disorder, generally symptoms include irritability, restlessness, excessive and sporadic movements, and the inability to sit or stand still (American Psychiatric Association, 2013 p. 711).

Acute drug-induced movement disorders are one of the common medication-induced movement disorders. It is described to “occur within minutes to days of drug ingestion. They include akathisia, tremor, neuroleptic malignant syndrome, serotonin syndrome, parkinsonism-hyperpyrexia disorder and acute dystonic reactions” (Duma, Fung, & Morris, 2019). According to the DSM-5, medication-induced acute dystonia causes “Abnormal and prolonged contraction of the muscles of the eyes (oculogyric crisis), head, neck (torticollis or retrocollis), limbs, or trunk developing within a few days of starting or raising the dosage of a medication (such as a neuroleptic) or after reducing the dosage of a medication used to treat extrapyramidal symptoms” (American Psychiatric Association, 2013). 

Akathisia is actually a common yet an identifiably difficult medication-induced movement disorder that is the result of experiencing side effects from prescribed antipsychotic or antidepressant medication.When it comes to acute akathisia, an individual would display what the DSM-5 describes as “complaints of restlessness, often accompanied by observed excessive move­ments (e.g., fidgety movements of the legs, rocking from foot to foot, pacing, inability to sit or stand still), developing within a few weeks of starting or raising the dosage of a medi­cation (such as a neuroleptic) or after reducing the dosage of a medication used to treat ex­trapyramidal symptoms” (American Psychiatric Association, 2013). 

Tardive dyskinesia disorder blocks the brain chemical known as dopamine and can cause visible side effects in your limbs. This includes involuntary thrusting, kicking, waving your arms, and tapping your foot. Studies have also shown that a person who is on antipsychotic medication is more likely to experience these symptoms if they are middle aged. The DSM-5 explains that tardive dystonia and akathisia disorders “are distinguished by their late emergence in the course of treatment and their potential persistence for months to years, even in the face of neuroleptic discontinu­ation or dosage reduction” (American Psychiatric Association, 2013). 

Having perpetual tremors would seem exhausting and would get in the way of everyday tasks naturally. As far as treating any of the following disorders would go, it would involve withdrawal from the drugs and adjusting the dosage or being weaned off of it completely. However, there isn’t a specific treatment that exists for movement disorders that were a result from illicit drug use.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Duma, S., & Fung, V. (2019, April). Drug-induced movement disorders. Retrieved March 09, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478951/

Categories
Schizophrenia Somatic Symptom and Related Disorders Uncategorized

What is Anosognosia?

In a day and age where information is readily available to anyone with Internet access, a scenario that often pops up when you’re feeling ill is to look up your symptoms. This has led many people to self-diagnose themselves with various types of illnesses and falsely believe they have symptoms of a particular condition. While the Internet is helpful as a preliminary step before going to a doctor, what do you do when you show symptoms but don’t realize it? The people who struggle with recognizing and accepting their symptoms are said to have anosognosia. This impairment can affect the timing and quality of treatment they receive for an illness. Specifically, one illness that is quite readily affected by such an impairment is schizophrenia. 

Before one can understand how anosognosia affects people with schizophrenia, it is important to know what exactly it is. Anosognosia is described as “a lack of ability to perceive the realities of one’s own condition” (Jewell, 2018). This means that someone refutes the reality that they have a condition despite showing all of the symptoms or having been diagnosed. One large misconception surrounding this impairment is that someone with anosognosia’s inability to accept that they have a condition is a conscious choice that they are making. This is incorrect because people with this condition truly cannot perceive that they have a certain symptom or condition. Making this distinction is important to truly grasping what anosognosia is because it is not the same as being in denial. For example, one might experience delusions but have no true understanding that they are delusions. Rather those delusions are what define their reality, so they feel that their grasp on what’s “real” is no different than someone without anosognosia. A situation like this takes an emotional toll on someone with anosognosia and can cause them to disregard any other symptoms that they really did experience (Jewell, 2018). 

As alluded to previously, many people with schizophrenia are also diagnosed with some form of anosognosia. Around 57 to 98 percent of people with schizophrenia are reported to have “poor insight” where different aspects of their awareness can be affected. “Poor insight” in these cases relate to the lack of awareness and ability to recognize one’s own illness. Medical professionals believe that this “poor insight” is connected to any other mental health conditions that person may have. Specifically, in the case of people with schizophrenia, alterations to the prefrontal cortex and insular cortex are correlated with having “poor insight” (Lehrer & Lorenz, 2014). These parts of the brain are important players in the never-ending process of reshaping one’s self-image and any alterations can cause someone to lose the ability to ingest new information and update the perception of one’s health (Jewell, 2018). That is why doctors’ feel that a patient’s insight is a good predictor of a few things: will they react negatively to a certain treatment, will they relapse, and will their symptoms come back (Lehrer & Lorenz, 2014).

While people with schizophrenia often also have anosognosia, it should be noted that the aspects of their awareness that are affected, due to schizophrenia/anosognosia, are different and seemingly do not overlap. What this means is that just because someone lacks awareness in one domain does not mean they are completely unaware of how the other domains are affected. In one study, a group of people with schizophrenia were shown to have an understanding that their day-to-day functioning was impaired to a certain degree while underestimating their memory functioning. However, as a group, a majority of the participants were shown to be unaware that they were mentally ill (Gilleen et al., 2010). 

Someone refuting that they have a mental illness should not be characterized as stubborn or in denial. There are physiological and psychological reasons for their rebuttal and it cannot just be categorized as being hard-headed. Creating an environment where people with mental illnesses and anosognosia can have an open discussion about how they feel without the fear of being gaslighted or judged is crucial in ensuring that they can get the proper treatment in a timely manner. The main goal should be helping everyone who has a mental illness and not letting anyone slip through the cracks just because “they didn’t want to get helped.” 

 

References

Jewell, T. (2018, October). What Is Anosognosia? Healthline; Healthline Media. https://www.healthline.com/health/anosognosia 

Lehrer, D. S., & Lorenz, J. (2014). Anosognosia in schizophrenia: hidden in plain sight. Innovations in Clinical Neuroscience, 11(5–6), 10–17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140620/ 

Gilleen, J., Greenwood, K., & David, A. S. (2010). Domains of Awareness in Schizophrenia. Schizophrenia Bulletin, 37(1), 61–72. https://doi.org/10.1093/schbul/sbq100

Categories
Sleep-Wake Disorders Somatic Symptom and Related Disorders

The Fallacy of Narcolepsy

“Hi, I’m Carol…” (Bernandi et al., 1999) she says as she lags off the ending of her name, closing her eyes and dropping to the ground in sleep as her escort waits in the doorframe stunned. “I have narcolepsy, a sleeping disorder. It isn’t the worst thing you could ever have. I’m just not allowed to fly an airplane, or drive a car, or work in a gun range” (Bernandi et al., 1999) she giggles. This character, Carol, would continue to have these “narcoleptic attacks” throughout the film Deuce Bigalow: Male Gigolo where she would perform random activities (for instance, bowling) and then suddenly drop to the ground asleep. This depiction of narcolepsy is common in media, and follows the trope of a person randomly nodding off and falling into a deep sleep while doing various activities until they suddenly jolt awake. Movies and TV shows like the one previously mentioned typically depict the condition in a comedic context. However, this promotes detrimental misconceptions about this serious disorder.  

Narcolepsy is a chronic sleep disorder that affects the sleep-wake cycle of an individual (National Institute of Neurological Disorders and Stroke, n.d.). The disorder is categorized into two types: Type 1 Narcolepsy (formerly classified as narcolepsy with cataplexy) and Type 2 Narcolepsy (formerly classified as narcolepsy without cataplexy). In Type 1 Narcolepsy, low levels of the hormone hypocretin causes rapid eye movement (REM) sleep to occur at the wrong time (Lee, 2020). Individuals may experience excessive daytime sleepiness and cataplexy – sudden muscle weakness (or loss of control of muscles) that may last several seconds to several minutes and may cause head bobbing/nodding, knee buckling, and jaw dropping, etc. (Lee, 2020). The low levels of the hypocretin hormone in some cases may be due to an autoimmune disease where the immune system attacks the body’s own brain cells. However in many cases the cause of the low levels is unknown (National Institute of Neurological Disorders and Stroke, n.d.).  In Type 2 Narcolepsy, individuals also experience excessive daytime sleepiness, though they do not experience cataplexy and have normal levels of hypocretin (Lee, 2020). Unlike Type 1 Narcolepsy, the specific cause of Type 2 Narcolepsy is unknown, but individuals with family history of either Type 1 or Type 2 Narcolepsy have an increased probability of having Type 1 or Type 2 Narcolepsy (National Organization for Rare Disorder, n.d.). In addition to the common symptom of excessive daytime sleepiness, both individuals with Type 1 and Type 2 Narcolepsy may experience sleep paralysis, fragmented sleep (frequently waking up during sleep at night), or hallucinations when they are either waking up or falling asleep (Narcolepsy Network, n.d.). Though roughly 1 in 2000 people have narcolepsy (approximately 200,000 people in America per year and 3 million people worldwide), only 25% of people with narcolepsy are estimated to have an official diagnosis (Narcolepsy Network, n.d.). Important contributing factors to this are the common and widespread misconceptions on the disorder, many of which are perpetrated by movies and TV shows. 

As mentioned earlier, one common distorted portrayal of narcolepsy on television and in cinema is the sudden sleep spells that cause a collapse. Unfortunately, many people believe this to actually be a feature of narcolepsy. According to one study, conducted by Toluna Analytics, “43% of those who were aware of narcolepsy believed that patients with narcolepsy often fall down because they lose consciousness while walking or standing” (Mattina, 2019). While cataplexy does cause muscle weakness and may cause individuals affected to fall or lose balance, they are completely awake and conscious instead of asleep (Lee, 2020). It is also more common for the cataplexy to affect certain areas of the body rather than cause a collapse (Mattina, 2019). This aligns with the fact that many of these individuals learned of the disorder through television and movies. The study discovered that “of those who reported they had heard of narcolepsy, 35% said they had heard about it from television shows and 24% from movies.” (Mattina, 2019).

Another distorted portrayal of narcolepsy that leads to misconception is the stark lack of portrayal of children and young adults with narcolepsy. Of the characters with narcolepsy in movies and TV shows, the large majority of them are adults (IMDB, n.d.).  In reality, about 1 in every 100,000 children has narcolepsy, and symptoms can manifest as early as age five or six (Cleveland Clinic, n.d.). Unfortunately, official diagnosis is delayed and does not occur until years later, at an average of “15 years after the onset of symptoms” (Narcolepsy Network, n.d.). In addition, because of the fact that symptoms of narcolepsy present differently in children (sudden weight gain, early onset puberty, automatic behavior such as several seconds of falling asleep before continuing regular tasks with no memory of the occurrence), children with narcolepsy are also often misdiagnosed with other conditions like attention-deficit/hyperactivity disorder (ADHD), epilepsy, and depression (Spear, 2018). The child may also be seen as lazy and clumsy (Spear, 2018). 

Narcolepsy is a largely misunderstood disorder. Part of this is due to media representation, and one study found that “84 percent of physicians and 74 percent of people living with narcolepsy” agree (Thorpy, n.d.). Symptoms often go ignored and continue to affect daily activities. Narcolepsy goes beyond someone taking a lot of naps or someone collapsing into sleep in the middle of a conversation. Misrepresentation in the media could lead to the delay in recognition and subsequent treatment for people living with narcolepsy, further perpetuating myths. Despite this, with increased education and correct representation there can be a future where people with narcolepsy can receive diagnosis and treatment better than ever before. 

 

References

Bernandi , B., Ganis, S. (Producers), & Mitchell, M., V .(Director) . (1999). Deuce Bigalow: Male Gigolo [Film]. Retrieved from https://www.amazon.com

Cleveland Clinic. Narcolepsy in Children (n.d.). Retrieved September 26,  2020, from https://my.clevelandclinic.org/health/diseases/14307-narcolepsy-in-children 

IMDB. Most Popular Narcolepsy Movies and TV Shows (n.d.). Retrieved September 26,  2020, from https://www.imdb.com/search/keyword/?keywords=narcolepsy 

Lee, K. (2020, August 12). What is cataplexy? Symptoms, causes, diagnosis, treatment, and prevention. Everyday Health. https://www.everydayhealth.com/cataplexy/guide/

Mattina, C. (2019, August 12). Pediatric narcolepsy symptoms differ from those of adults, review finds. AJMC. https://www.ajmc.com/view/pediatric-narcolepsy-symptoms-differ-from-those-of-adults-review-finds 

Mattina, C. (2019, September 19). Survey finds widespread misconceptions about sleep disorders. AJMC. https://www.ajmc.com/view/survey-finds-widespread-misconceptions-about-sleep-disorders

Narcolepsy Network. Narcolepsy Fast Facts(n.d.). Retrieved September 26,  2020, from https://narcolepsynetwork.org/about-narcolepsy/narcolepsy-fast-facts/ 

National Institute of Neurological Disorders and Stroke. Narcolepsy Fact Sheet (n.d.). Retrieved September 24,  2020, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet

National Organization for Rare Disorders. Narcolepsy (n.d.). Retrieved September 26,  2020, from https://rarediseases.org/rare-diseases/narcolepsy/

Spear, L. (2018, December 10). Narcolepsy Can Look Different in Kids Than It Does in Adults. Sleep Review Magazine. https://www.sleepreviewmag.com/sleep-disorders/hypersomnias/narcolepsy/narcolepsy-kids/

Thorpy, M. New survey sheds light on the impact of narcolepsy (n.d.). STAT. Retrieved September 27,  2020, from https://www.statnews.com/sponsor/2018/11/26/new-survey-sheds-light-on-the-impact-of-narcolepsy/

Categories
Somatic Symptom and Related Disorders

Factitious Disorder: Is it a Game?

Elizabeth was a single mother that worked on construction sites throughout her native city of Memphis, until she badly sprained her ankle in a working accident. Being on paid leave while her ankle healed was a blessing. She had more time to get things done around the house and spend more time with her daughter, without worrying about her work. At her doctor’s appointment on Friday, she was cleared to work the following Monday, if she did not overdo it. Elizabeth started to think. “Having time off has really been great. I get to spend more time with my daughter and not having to work is just so much easier! You know what, I’m not ready to go back to work.”

Thinking back to her physician’s words, she created a plan. She exclaimed, “The doctor said I would not be able to work if I put unnecessary stress on it, so I’ll make my ankle even worse!” The next day, while driving her daughter to school, Elizabeth slipped on a pair of her highest heels. She was sure they would do the trick to worsen her sprained ankle. She did not plan on taking them off, until they did further damage to her injury. After dropping off her daughter and walking back to her car, Elizabeth noticed her ankle became swollen and red, and it hurt much worse than before. Even after this, she continued to walk on.

Elizabeth is experiencing factitious disorder. Factitious disorder is when an individual produces or fakes physical or mental illness, while intentionally worsening a minor illness or injury. A person with factitious disorder may also transfer a false illness or injury to another person. In some cases, this individual may benefit from the situation they create, such as getting out of school or work (American Psychiatric Association, 2017). This disorder can range in intensity from mild to severe. Symptoms can range from slight exaggerations, to tampering with medical tests, to convincing others that treatment such as serious surgery is needed. That being said, it is important to distinguish that factitious disorder is not equivalent to conjuring up medical problems for the sole purpose of personal benefit. Though this disorder may present itself as such, these individuals might not understand the “reasons for their behaviors”, or even recognize they are having a problem (Mayo Clinic, 2018).

In Elizabeth’s case, she purposefully worsened her ankle injury by intentionally wearing heels too soon. This is considered mild on the spectrum of symptoms of factitious disorder. She knew it would strain her injured ankle and as a result, she would not have to return to work. She wanted her injury to appear much worse than it actually was, leading her family and coworkers to believe her injury was serious. When questioned about her recovery, Elizabeth was able to respond swiftly and intelligently, having done her research to ensure she would have extended time off. All of Elizabeth’s actions fall under the umbrella that should be recognized as factitious disorder (Mayo Clinic, 2018). This disorder does not seem that pressing of a problem at first and is difficult, both to identify and treat. However, psychiatric and medical support is vital for “preventing serious injury and even death caused by the self-harm typical of this disorder” (Mayo Clinic, 2018).

Treatment is carried out by both psychiatrists and medical physicians. There are no standard therapies, due to the patient not wanting to recover. Therefore, it is best to take a gentle and nonjudgmental approach so the person will even slightly consider receiving help. Treatment usually starts with the primary care doctor. The physician will try medical treatment with the individual, and if that does not encourage recovery, then together they can explore possible psychological causes for the illnesses or symptoms. The most common psychological treatments are talk therapy and behavioral therapy. During these sessions, a trusted psychiatrist can help to develop coping skills and control stress (Mayo Clinic, 2018). Though not an easy road, treatment of factitious disorder is possible, and a better quality of life is achievable.

References:

 

American Psychiatric Association. Factitious Disorder. Retrieved 1 November, 2019, from, https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

Mayo Clinic. Factitious Disorder. Retrieved 1 November, 2019, from, https://www.mayoclinic.org/diseases-conditions/factitious-disorder/symptoms-causes/syc-20356028

(n.d) pixabay. https://pixabay.com/photos/battle-chess-checkmate-blur-1846807/

Categories
Somatic Symptom and Related Disorders

Conversion Disorder: Can You See It?

Barrelling down a seemingly empty Pennsylvania highway, Ayanna anxiously starts biting her thumbnail, and begins whispering under her breath, “I’m gonna be late to my last stop! Why am I always late?!” It’s almost dawn and she is straining to see the road and signs ahead. Ayanna rubs her eyes wondering why everything seems so blurry. She had only been driving for an hour, so her eyes should not be this tired. Yet, even the speedometer on the dashboard seemed fuzzy. Brushing this concern aside, she continues to stress over her deadline. “What will my supervisor say if I miss a shipment again? I can’t handle all this stress, but I can not afford to lose another job due to my anxiety.” As Ayanna is approaching her last station for pick up, her eyesight gets progressively worse. It becomes so bad that right after her shift finishes, she calls a taxi that rushes her to the nearest hospital. As she is brought to the Emergency Room, a nurse comforts her and asks how she can help. Unable to hide the panic in her voice Ayanna replies to the nurse in a distressed whisper, “I can’t see!”

The anxiety that results from Ayanna’s worrying thoughts is an example of conversion disorder. This is a type of functional neurological disorder. Though there is no evidence of a physical cause, this condition has symptoms that can affect a person’s perceptions, sensation, or movement(s) and can be a product of high-stress levels. “Typically these disorders affect your movement or your senses, such as the ability to walk, swallow, see or hear” (Mayo Clinic, 2019). As in Ayanna’s case, she could not see the road completely because her traumatizing thoughts left her with a loss of sensation in her eyes, resulting in a prolonged period of blindness. This condition is known to co-occur or be a product of depression and anxiety disorders. Therefore, conversion disorder can be experienced with, or can be a result of, somatic symptoms disorder and illness anxiety disorder, due to similarities in each disorder’s anxiety levels. The commonality of this disorder in no way undermines the difficulty in experiencing it. In addition, the fact that treatment is both achievable and successful can bring a sense of hope to many. successful (American Psychiatric Association, 2013).

Treatment for conversion disorder is much like somatic symptoms disorder because there are overlapping symptoms experienced, such as excessive pain and changes in perception. This disorder is dissimilar to illness anxiety disorder in that there is usually little to no symptoms exhibited at all (Cleveland Clinic, 2015). Conversion disorder differs from the two in that “symptoms tend to come on suddenly and may last for a while or may go away quickly” (American Psychiatric Association, 2013). Conversion disorder also finds its individuality in its treatment process. The disorder needs to be addressed with different medical perspectives, besides having primary care check-ups and trusted therapist appointments. Treatment for this type of neurological disorder normally requires a team of multiple professionals from different specialties. This health professional team includes a neurologist, a psychiatrist or other mental health professionals, and speech, physical and occupational therapists. Regardless of the specialty, all have the same goal for one’s success in individualized treatment (Mayo Clinic, 2019).

It is important to remember that though this experience is extremely difficult and overwhelming, it is more than reasonable to hope for change because “many, even most, conversion symptoms fade quickly and spontaneously” (Harvard Health Publishing, 2014). Therefore anyone who finds themselves in a situation such as Ayanna’s, can achieve a better quality of life with the help of specialized professionals and a few trusted individuals.

References:

American Psychiatric Association. Illness Anxiety Disorder. Retrieved October 20, 2019, from,

https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

Cleveland Clinic. Illness Anxiety Disorder. Retrieved October 20, 2019, from,

https://my.clevelandclinic.org/health/diseases/9886-illness-anxiety-disorder-beyond-hypochondriasis

Harvard Health Publishing. Conversion Disorder. Retrieved October 27, 2019, from, https://www.health.harvard.edu/newsletter_article/Conversion_disorder

Mayo Clinic. Conversion Disorder. Retrieved October 20, 2019, from, https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197

(n.d.). Retrieved from, https://pixabay.com/photos/blindfolded-blind-hair-girl-woman-1732539/

Categories
Anxiety and Anxiety Disorders Somatic Symptom and Related Disorders

Illness Anxiety Disorder: What If?

You are sitting down in your art history class and everything is as it always is. The professor is greeting the class and all the students, including you, look bored as usual. Staring down at the desk, you see an ant crawling across it. As you swipe your hand to brush it off the desk,, the ant bites you. Throughout the lecture, you cannot get the idea of the ant still crawling on you off of your mind. The mere thought of the ant still being alive and able to bite you again is bothering you in such a way that you cannot focus on the professor anymore. Knowing the bite is not poisonous, you redouble your efforts to focus and listen to the lecture. You look around on the top and bottom of the desks, as well as the seats next to you. You don’t see the ant, but you are afraid now that the damage has already been done. You feel the bite might be getting worse and wonder if the ant was poisonous. What if it starts to swell? What if it becomes infected? What if the infection spreads and you lose your hand?! Not able to take the intruding thoughts anymore, you rush to the bathroom to check and see exactly how your finger is after the bite.

This student is experiencing Illness Anxiety Disorder. Another, more commonly known name for this disorder, is Hypochondriasis (Mayo Clinic, 2018). This disorder, though it’s own entity, is heightened if you are experiencing or have had Somatic Symptoms Disorder (SSD), or disorders similar to SSD. “Illness Anxiety Disorder is when a person becomes preoccupied with having an illness or getting an illness, constantly thinking about their health.” They may continuously check for signs of illness and take extreme measures of precaution in order to prevent further risk(s). Hypochondriasis primarily distinguishes itself from SSD when the person is not experiencing symptoms such as excessive pain (American Psychiatric Association, 2013). “Physical symptoms are not present or if present, only mild. If another illness is present, or there is a high risk for developing an illness, the person’s concern is out of proportion” (Cleveland Clinic, 2015). Although IAD and SSD are two separate disorders, they are similar in their treatment processes. The similarity of these treatment plans is extremely convenient, because if you are treating one, then you are also partially treating the other, which is significant when one individual has both disorders. Additionally, understanding the steps necessary to find a solution for one disorder can make resolving the other disorder less intimidating. Having a basis from which to start can make all the difference and lead to a quicker return to one’s norm. 

Treatment of Illness Anxiety Disorder is very similar to SSD and can be comorbid with SSD. This is common between co-occurring disorders. Making an appointment with one’s primary care doctor is a great way to start. Go to regular check-ups, and for further assistance, find a trustworthy counselor to confide in. A reliable counselor will not only validate one’s feelings, but also disprove any worries at the same time. Resolving these constant and extreme fear of threats drastically improves an individual’s functionality and betters their quality of life. (American Psychiatric Association, 2013).

 

References

 

American Psychiatric Association. Illness Anxiety Disorder. Retrieved October 6, 2019, from, 

https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder 

 

Cleveland Clinic. Illness Anxiety Disorder. Retrieved October 10, 2019, from,

https://my.clevelandclinic.org/health/diseases/9886-illness-anxiety-disorder-beyond-hypochondriasis 

Mayo Clinic. Hypochondriasis. Retrieved October 6, 2019, from,

https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782 

(n.d.). Retrieved from https://pixabay.com/photos/depression-anxiety-stress-depressed-3912748/

Categories
Somatic Symptom and Related Disorders

Is it All in Your Head?

Looking up from tightening the straps of his ankle boot, Shea says to her husband, “Oh, Micheal. I don’t know why the doctor can’t figure out what’s wrong?! I hope this second opinion he’s requesting is helpful.” Leaning on his crutches, Micheal stands with a grimace and gives her a shrug. “I don’t know Shea, all I can tell you is that the pain just seems to be getting worse and worse,” as she helps him out the office doors and into the car. Shea wonders how soon they’ll be back. This is their third time going to the doctor since Micheal’s ankle was injured. But it did not make sense! Her husband had healed from a bad sprain almost three months ago and at first appeared to be recovering when everything escalated. Shea woke up one night to her husband sitting up in bed clutching his ankle saying something was wrong and the pain was much worse. Even after pain medication and rest, he was not able to go to work for the remainder of the week and the week after, saying there was no way he could walk around the construction site all day in this condition. Glancing over to the passenger side of the car, she sighed in confusion, hoping this would all be resolved soon, for Micheal’s sake.

Micheal is experiencing what is called somatic symptom(s) disorder. This disorder usually involves having a significant focus on physical symptoms, such as pain, weakness, or shortness of breath. The person experiences excessive feeling (such as extreme pain), and exhibits behavior related to the physical symptom(s), which prevents them from functioning normally. That being said, this diagnosis is not made solely because a physician cannot find a medical cause for these physical symptoms. Excessive thoughts, feelings, and behavior must also coincide with the illness. It is important to recognize that the individual believes they are feeling real pain and experiencing these symptoms. Thankfully, there are treatment options for individuals with this disorder. Treatment is designed to help with symptoms and control the pain. The goal is to get the affected individual back to their normal lifestyle as soon as possible, by providing reassurance and support, while monitoring symptoms, and eliminating unnecessary testing. In addition, psychotherapy is recommended. This way the individual can learn ways to cope with their pain or other symptoms, deal with stress, and improve functioning (American Psychiatric Association, 2018). 

The American Psychiatric Association tells the story of a man named Martin, who is 31 years old. Similar to Micheal, Martin began seeing his primary care doctor when he started experiencing pain. This pain became increasingly unbearable, which led Martin to reconsider his diet, thinking that might be the cause of his problem. Changing his diet did not resolve the pain, and as the pain progressed, Martin had to cancel pre-existing plans. He went back to his primary care doctor, who thoroughly examined him and ran a battery of tests, but they all came back normal. “As a result of these symptoms, Martin had lost the ability to find happiness and began to suffer from severe depression.” Trying to find a solution, Martin and his doctor decided to schedule frequent check-ups, as well as talks with a therapist to try and get Martin back to his norm. After three months of making these adjustments, Martin’s mood had improved. “After several sessions of counseling and cognitive behavioral therapy specifically related to his pain Martin noticed that his pain was much less and more manageable” (American Psychiatric Association, 2018).

With this treatment, Martin was gradually able to find relief, as a professional validated the feeling(s) of pain he experienced. All in all, Martin sought out and received treatment, therefore improving his quality of life. Fortunately, individuals suffering from somatic symptom(s) disorder don’t have to live in pain; they can speak to their healthcare providers and find help. 

 

References

American Psychiatric Association. Somatic Symptoms Disorder. Retrieved September 20, 2019, from, https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder