Somatic Symptoms SSD

[Bermuda]

After writing a long text I decided to do some research on actual SSD. It was deeply unsettling, and I kind of want to vent. I feel guilty that I have been using this forum to vent so much lately. Sorry about that.

Here are some things that Wikipedia says about SSD:

"Manifestations of Somatic symptom disorder are variable and symptoms can be widespread, specific, and often fluctuate. Somatic symptom disorder corresponds to the way an individual views and reacts to symptoms as rather than the symptoms themselves. Somatic symptom disorder may develop in those who suffer from an existing chronic illness or medical condition."

"Additional signs of Somatic Symptom Disorder include interpreting normal sensations for medical ailments, avoiding physical activity, being disproportionately sensitive to medication side effects, and seeking medical care from several physicians for the same concerns."

"In studies evaluating different physical ailments, 41.5% of individuals with semantic dementia, 11.2% of subjects with Alzheimer's disease,[12] 25% of female patients suffering from non-HIV lipodystrophy,[13] and 18.5% of patients with congestive heart failure[14] fulfilled Somatic symptom disorder criteria. 25.6% of individuals with fibromyalgia fulfilled Somatic symptom disorder criteria, and they exhibited higher depression rates than those with fibromyalgia who didn't meet the criteria for Somatic symptom disorder.[11] In one study, 28.8% of those with Somatic Symptom Disorder had asthma, 23.1% had a heart condition, and 13.5% had gout, rheumatoid arthritis, or osteoarthritis."

This is from psychiatry.org:
"Somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning. "

"The physician can offer support and reassurance, monitor heath and symptoms and avoid unnecessary tests and treatments. Psychotherapy (talk therapy) can help the individual change their thinking and behavior, and learn ways to cope with pain or other symptoms, deal with stress and improve functioning."

---My non-professional opinion---
It sounds to me that SSD more often than not has very little to do with the patient but rather the medical doctor's inerpretation of the patient. If you have symptoms that they cannot immediately pinpoint, if your symptoms come and go, if you are distressed by the impact of those symptoms on your daily life, a doctor will tell you it's somatic. That fits the criteria. Now, of course you may be thinking it fits the criteria for several possibilities, but you are visibly upset. Clearly, it's psychological, which somehow also means "not real".

I love the example psychiatry.org uses when they say pain, weakness, and shortness of breathe stating it can coincide with recognised medical conditions, that a patient may avoid physical activity (I would too if I were in pain and couldn't breathe), or seek help from multiple professionals. (I would too if I were in pain and couldn't breathe and it affected my physical activity.) It just sounds like seeking help when you are legitimately suffering is the problem and that you can be taught to not seek help, by those who are supposed to help you. Then they can simply assume your functioning has improved, because how would they ever know that? They can avoid giving you tests and helping you find answers, or more embarassingly for themselves, have to tell you they don't know.

In my case it would have been figuring out I had severe undiagnosed hypothyroidism. Honestly, it really angers me. It is everything C-PTSD already does to you. When medical professionals treat you this way, it is exactly the internalised message you likely already received. In anycase, if you are reading this, and you are suffering, I'm sorry. I'm sorry that you have to live with that. Acknowledging your suffering, sharing that suffering, sharing how your suffering affects you, all of that is not wrong. You deserve to be heard, to be helped when possible, and to be treated fairly. You don't deserve pain, and the pain is not your fault.

[NarcKiddo]

I wonder if the opposite reaction to symptoms would also be regarded as SSD? I mention this because I ignore symptoms and would rather move through pain than take a painkiller. I avoid taking drugs if at all humanly possible (with some notable exceptions like birth control which is a whole other kettle of fish in my dysfunctional behaviours). When I started suffering shortness of breath I exercised harder, just to see if I would keel over or not!

A lot of what you have said resonates with me for opposite reasons but "you can be taught not to seek help by those who are supposed to help you" totally fits my situation. In this case, my mother. I did my absolute utmost not to seek help from her because it always caused issues. Co-incidentally, shortly before reading your post I saw the neighbour out with his young daughter. She had a new bike with stabiliser wheels but was still riding very, very cautiously. I commented to my husband who said "I bet you rode your bike very cautiously too." Yes. I did. Because I was forbidden to get hurt. I would get in trouble for that and may as well have done it on purpose for all the sympathy I got. Hence why I do everything so cautiously now.

By the time I was an adult the behaviour of not seeking help was already ingrained. It is a marvel that I ever actually discovered my shortness of breath was due to lung disease, because when I did seek medical help the doctors were not exactly encouraging. They did try medications and x-rays, which initially showed nothing, but it took about a year of me constantly going back before they sent me for spirometry. Which is a specific and easy test of lung function and they had the equipment in their surgery!

As for the lung issue, there is no medical explanation for it, bar trauma, which is not a subject the medical consultant ever touched on. I think part of keeping myself small and invisible was breathing as shallowly as possible, always. So the small airways were never properly used and just atrophied.

I would rather just deal with pain and hope it goes away. Rather like an animal that will do its utmost to hide any physical weakness.

I suppose medics would not have much access to people who hide their symptoms, since by definition such people avoid medics.

Just throwing that into the mix.

And I don't think you should apologise for venting in the forum. You are coming up with very interesting and thought-provoking topics.

[Bermuda]

I absolutely agree with your assessment. I think it would likely follow the criteria of SSD because it would present the same way. The diagnostic criteria are not rigid and they are highly enterpretable. Maybe it's because I am used to reading law text, but it seems wrong. Especially so given that outcomes would inherently be unmeasureable. You can't tell someone they lack management skills, then train that person to manage themself, and then ask them to assess their managerial skills and expect and honest answer. That is not real life.

I am really happy for you, that you were able to get the answer, although it was likely not one you wanted. I can imagine how difficult that process must have been for you. Everyone should be able to feel safe, especially when they are most vulnerable.