Somatic and Dissociative Disorders

Somatic and Dissociative Disorders

At the core of somatic disorders are somatic symptoms and/or illness anxiety. Somatic disorders are much more common than you would think! Around 16 percent of people develop somatic symptom disorder (SSD) at some point. But, how do these people get this disorder? What causes it? Well, there's no one correct answer, but there are a lot of factors that can contribute to developing the disorder.

Some Theories

A few theories are floating around as to what specifically causes somatic disorders. There is growing evidence of a genetic basis for how sensitive you are to pain. Being hypersensitive to pain is sometimes genetic. Increased sensitivity to pain and chronic pain are both common in people with somatic symptom disorders.

The way you were raised can also impact whether or not you develop some form of SSD. If a child's parents have some sort of SSD, the child is more likely to be anxious about health problems and diseases. Around half of the people who experience SSD also experienced childhood trauma from their parents or primary caretakers. Undergoing traumatic events of any kind drastically increases a person's likelihood of developing somatic symptoms.

Multiple risk factors can increase the likelihood of developing SSD:

• Anxiety or depression

• Having a family history of high blood pressure or other health concerns

• Stressful or traumatic life events

• Achieving lower levels of education

• Lower socioeconomic status

• Having a preexisting medical condition

• Being in recovery from another illness

Dissociative disorders involve a disconnect or problem in consciousness, memory, identity, or behaviour. These types of disorders can disrupt almost every area of psychological functioning and can have huge impacts on daily life. Dissociative disorders are similar to trauma and stressor-related disorders such as posttraumatic stress disorder since both can include dissociative symptoms.

The most significant risk factor for dissociative disorders is experiencing long-term physical, sexual, or emotional abuse during childhood. However, both children and adults who experience traumatic events can develop these conditions. Trauma can take many forms, but certain traumatic events are common for those with dissociative disorders:

• War

• Repeated sexual assault

• Natural disasters

• Kidnapping and abductions

• Torture

• Significant medical procedures

Types of Somatic and Dissociative Disorders

Somatic disorders come in a variety of forms. Let's explore the five main types of somatic disorders!

Somatic Symptom Disorder

SSD involves one or more physical symptoms that are highly distressing for the individual. The physical complaints may or may not have explainable causes, and they may or may not be severe. The key feature of SSD is the unusual level of distress that the person experiences due to somatic complaints. Individuals with SSD are far more likely to present in a doctor's office than in a mental health clinic.

Illness Anxiety Disorder

Illness anxiety disorder (IAD) involves excessive, irrational concern over your health or the risk of contracting an illness. Those with IAD often believe or worry that they have developed a severe illness, even if there's no reason to suspect that. They may frequently visit the doctor's office or the ER for minor complaints due to how anxious they are about their health.

Functional Neurological Symptom Disorder (Conversion Disorder)

Conversion disorder is similar to SSD, but the symptoms are generally more pronounced or severe; there is no medical explanation for them. Someone with conversion disorder may experience weakness or paralysis of part of the body without an identifiable cause. Conversion disorder involves a continuous, significant change in motor or sensory functions.

Psychological Factors Affecting Other Medical Conditions

This one is a mouthful. PFAOMC is diagnosed when significant psychological or behavioral factors negatively impact someone's medical condition. These factors can be anything from harmful coping styles to denial of symptoms.

Factitious Disorder

This disorder is diagnosed when a person fakes having an illness or fakes someone else's illness without any apparent gain or reason.

Factitious disorder imposed on another, which used to be known as a factitious disorder by proxy, is when someone fakes an illness in someone else. A parent may convince doctors that their child has an illness and go to great lengths to make the illness appear genuine. In this example, the parent (NOT the child) is diagnosed with a factitious disorder imposed on another.

Doctor's visit, pexels.com

Now, let's take a look at dissociative disorders. There are four distinct types of dissociative disorders, each with its symptoms.

Dissociative Amnesia

People with dissociative amnesia forget information about themselves or key events in their life. They can forget anything from specific traumatic events to entire years of their life. Dissociative amnesia can cause a lack of self-knowledge, varying from forgetting personal information to forgetting their identity completely.

Dissociative Fugue

Dissociate fugue is an uncommon form of dissociative amnesia and one of the rarest forms of dissociative disorders.

It can be hard to tell when someone is in a dissociative fugue. However, they will often get confused or upset when asked about their personal history.

Dissociative Identity Disorder (DID)

DID is the new name for multiple personality disorder and is characterized by having two or more explicit and unique personality states, often called alters. Memory gaps are common due to alters switching in and out of consciousness. These alters tend to have their personal histories, likes and dislikes, and personality traits. The memory loss that may accompany dissociative identity disorder, the number of alters, and other symptoms vary widely from person to person.

Multiple personalities, pexels.com

Depersonalization/Derealization Disorder

Depersonalization and derealization disorder causes a disconnect between yourself and your daily life. Many people will experience some level of dissociation during their life, and that's okay. However, individuals with this disorder experience detachment from their thoughts and body and/or a disconnect between their environment and self that significantly impacts their daily life. One or both of these types of dissociation can be present.

Somatic and Dissociative Disorder Symptoms

What are some of the common symptoms of somatic and dissociative disorders?

Somatic Symptom Disorder

SSD comes in many forms, and the list of reported symptoms varies wildly. The most common complaints include headaches, dizziness, chest pain, abdominal pain, and limb pain.

Illness Anxiety Disorder

The overwhelming anxiety surrounding one's health is the main symptom of illness anxiety disorder. IAD can be categorized into two types: care-seeking and care-avoiding.

• Care-seeking: frequently go to the doctor, requests tests, undergo procedures, etc.

• Care-avoiding: rarely go to the doctor or seek medical care.

Depersonalization/Derealization Disorder

Depersonalization is when one experiences a sense of unreality or detachment from their thoughts, feelings, actions, or body. Their sense of time might be distorted, and they may feel physically or emotionally numb. They know that they are a real person in a real place, but they become disconnected psychologically from their experience of self.

Derealization is a similar sense of detachment, except with your surroundings or environment instead of yourself. People experiencing derealization might feel like they are in a dreamlike or foggy state, with their vision distorted. They still know that they are a real person in a real place, but they are also aware that what they are sensing is not normal or real.

Difference Between Somatic and Dissociative Disorders

Unlike somatic symptom disorders, dissociative disorders generally have more apparent potential causes. In most cases, dissociative disorders develop as a method to cope with trauma, and they typically start during childhood.

People with somatic disorders may have experienced stressful adverse life events that contribute to the disorder. This can be anything from lousy family dynamics to losing a job. With dissociative disorders, past traumatic experiences are the typical stressors that cause the onset of the disorder.

Examples of Dissociative Disorders in Psychology

If you have never experienced dissociation yourself, it can be hard to understand these disorders. Some famous examples of individuals who have experienced dissociation may help you better understand this diagnosis category.

Football Superstar

Herschel Walker was a professional football player, an Olympic athlete, and an Olympic torchbearer. He even won the Heisman Trophy in 1982 for his excellent work as a running back. He is often regarded as one of the best college football players of all time. Most people would recognize him for his athletic prowess without realizing that he had a dissociative disorder.

In 2008, Walker published a memoir about his life and struggles with a dissociative identity disorder. He wrote that he had around 12 alters, some of which helped him train harder and be a better person. However, some of his other alters were much more extreme and violent. One dangerously competitive alter would play Russian roulette when it dominated his consciousness.

He is now retired from sports and has devoted himself to DID advocacy and awareness. He is also a spokesperson for a mental health treatment program for veterans.

A Mystery Author's Personal Mystery

Agatha Christie is one of the most well-known mystery authors of the twentieth century, having written 66 detective novels and 14 short story collections. However, she lived a mystery of her own in 1926. Her husband asked Agatha for a divorce, having fallen in love with another woman. He went to spend the weekend with some friends, and while he was gone Agatha disappeared, leaving her car and suitcase behind.

Newspapers went crazy over the author's disappearance, following the huge search for her for over ten days. She had checked into a health spa 184 miles away from her home, using the name Tressa Neele. During this time, she claimed to know nothing about her past. People at the spa even said she looked like Agatha Christie, which she thought was a funny coincidence.

No one is sure if this was a dissociative fugue, an act of revenge against her cheating husband, or an attempt to garner attention from the press. However, doctors from her time and ours support the idea that this was an instance of dissociative fugue.

Unreal Rock 'n Roll

Adam Duritz is one of the most well-known rock songwriters. As frontman for the band Counting Crows, he performs cinematic songs, which helped earn the group two Grammy Awards nominations. Since his early 20s, Duritz experienced frequent dissociation, making his world seem unreal. He describes perceiving the world like a movie screen, feeling fully separated from his body. These experiences inspired some of Adam Duritz's more abstract lyrics.