Somatic symptom disorder and other disorders

we know that medical conditions often result in physical symptoms we also realize that mental disorders disorders affecting the mind such as depression schizophrenia anxiety disorders they can result in psychological symptoms we should also realize that medical conditions can in fact also manifest in psychological symptoms whether we look at autoimmune conditions or we look at cardiovascular disease or diabetes people with those conditions can get symptoms of depression symptoms of anxiety and even full-blown psychiatric / and mental disorders so we should also bear that in mind by the very same token mental disorders can also manifest in physical symptoms part of that could be for example depression can manifest in disturbances of sleep but I want you to really concentrate on this because for some mental disorders this becomes a really big deal and manifest in a really big way as physical symptoms either directly leading to physical symptoms or exacerbating physical symptoms that may already be occurring from medical conditions that may already be present so I'm going to talk about a couple of those now the first one I want to talk about is something called somatic symptom disorder and I actually want to compare that to another disorder called conversion disorder now when I say somatic what I'm actually referring to is physical symptoms so if we go back to our boxes up here and I said physical symptoms when we talk about how mental disorders manifest this is just another word for somatic and somatic is another word for physical so physically you can think of this as an physical symptom disorder in some ways so the first thing I want to do is to talk about what kind of symptoms can arise and a somatic symptom disorder we can have any symptom it could be something very very specific like wrist pain or it could be something much more generalized like a general feeling of fatigue it could be any symptom one whatsoever now contrast this to what we have in conversion disorder because in conversion disorder we're actually looking for something that's very neurological so think about it as a problem with speech with swallowing with seizures or even with paralysis anything whatsoever that could be a neurological symptom that looks like I should say a neurological center now the second point I want to say and when we think about somatic symptom disorder we may or may not be able to explain what we see these symptoms with medical tests and what this means is that they may or may not be related to a medical condition conversion disorder on the other hand is very very different the neurological symptoms that we see are incompatible with any known neurological or medical condition we simply cannot explain them based on our tests or clinical exam so what makes somatic symptom disorder a mental disorder well when we say disorder we're looking at some functional impairment so this this condition stops people from doing things that they like to do it stops them from say going to school enjoying life and and how does it do that it does that in a variety of ways these individuals when they have these symptoms really gets stressed out they really get worried and they get worried very very excessively they can have really extreme levels of anxiety and they can spend a lot of time and energy worrying and thinking about their symptoms and all of these things are - and totally excessive level excess totally excessive level and is really empowering for them the level of worry anxiety and the amount of time and resources they spend worrying about these stressing about these symptoms now when we look at conversion disorder we have these neurological symptoms that cannot be explained by our understanding of medicine or neurology but something that we sometimes can see not always but sometimes can see when we when we talk to these individuals and we try and understand them is that they sometimes have a level of psychological stress or traumatic event that's happened to them and the stress or trauma can actually be resulting in this manifestation of these neurologic symptoms finally there's another condition I want to touch base on and that condition is called factitious disorder now in this disorder the patient wants to be sick and they will falsify or deceive their physical signs and symptoms in order to get a diagnosis and treatment they may injure themselves they may falsify tests you may have heard of this as Munchausen's or even Munchausen's by proxy Munchausen's by proxy 's factitious disorder of another individual so one person is actually trying to make another person look ill so that there's medical attention investigation treatment provided for another individual what's notable about practitioners disorder is that people aren't doing this for money and people are doing this very specifically to be in this sick role