A common misconception is that a psychosomatic disorder is imaginary or “all in the head.” In reality, psychosomatic symptoms are real and require treatment, just as any other illness. Unfortunately, the pervasive social stigma of psychosomatic illness prevents some people from seeking treatment. Stigma is also present in research and medical communities, partly because of health professionals’ own experiences.
Psychosomatic Symptoms
Learning about how mental and emotional stress manifests physically can be helpful in reducing the effects of stress on your health. Common physical signs of stress include:
Digestive issues Dizziness or shaking Headaches Muscle aches and pain Racing heart Elevated blood pressure
Sex-Based Psychosomatic Symptoms
Bodily signs of stress can vary between the sexes. For example, when stressed, people who are biologically female often report symptoms such as fatigue (despite getting enough sleep) and irritability, as well as signs such as abdominal bloating and menstrual changes. Signs and symptoms of stress in males, however, are more likely to include chest pain, increased blood pressure, and changes in sex drive.
Age-Based Psychosomatic Symptoms
Signs and symptoms of stress also vary by age. Children often experience stress in a physical way because they haven’t yet developed the language to communicate how they feel. For example, a child who is having a hard time at school may have frequent stomachaches or headaches. Stress in the teen years can be especially intense, particularly during periods of major social adjustment and hormonal shifts. Frequently, adults attribute signs of stress to typical “teen angst” rather than adolescent depression. Older adults are also prone to depression as they contend with isolation, loss and grief, and health problems. If you are caring for an aging loved one, it’s important to know the signs of depression in older adults.
Causes of Psychosomatic Illness
The exact mechanisms of stress are not completely understood, but researchers know that stress and depression can manifest as physical pain and illness. It’s a complex process, but here’s an analogy that might help.
Psychogenic pain results from psychological disorders or issues such as mental or emotional stress. In other words, psychological problems are the main genesis of the pain. Psychosomatic pain has a known physical source, but psychological issues such as anxiety play a role in how the pain progresses—for example, depression exacerbating an endocrine disorder.
Compare your body to a pressure cooker. If it’s allowed to vent its steam, it works efficiently. If it can’t release steam, the pressure continues to build until the lid blows off. Now, imagine that the cooker is under pressure already and you apply more pressure to keep the lid on. When the container can no longer hold in all the pressure, it will break at its weakest point. Someone who is under stress and does not or is unable to vent their emotions will eventually reach an emotional breaking point. This may result in physical symptoms or trigger an episode of major depression. In retrospect, you may recognize some warning signs that a break was coming. For example, if you tend to strain your neck, you might experience increased neck pain when you’re stressed. Back pain, stomach trouble, and headaches are other common ways for stress to take up residence in your body. Stress can also compromise your immunity. For example, some people tend to catch colds, the flu, or other illnesses and infections when under pressure and may take longer to get better. Part of the body’s fight-or-flight response to stress is the release of certain chemicals, such as adrenaline, that can be very useful in a life-or-death situation. However, if the body has high amounts of these chemicals or they are released continuously over an extended period (such as with chronic stress), they may do more harm than good.
Psychosomatic Illness Diagnosis
When you see a healthcare provider for physical symptoms, they look first for physical causes. If none is obvious, coming up with a diagnosis and treatment plan can be tricky. If you have a psychosomatic disorder, you might feel as if your provider is not taking your symptoms seriously, thinks you’re making them up, or believes they’re “all in your head.” When unable to find a clear physical cause for your pain (such as an injury or infection), an astute healthcare provider may ask you how you feel emotionally. The hope is that, if a source of stress can be identified, it can be treated—just as with an obvious physical injury or illness. When a clinician asks about stress in your life, for example, they’re not implying that your pain is not real. Physical symptoms caused by stress are very real, but they’re caused by a different mechanism than, say, a bone break.
Treatment for Psychosomatic Illness
You may be referred to a mental health professional, but that doesn’t mean your physical symptoms require only psychological treatment. Learning how to effectively manage stress is important, but it can take time. In the meantime, your clinician may treat your physical pain and other symptoms with medication, mindfulness therapy, or cognitive therapy. Returning to the example of neck pain: If it tends to worsen with stress, learning to deal with stressful triggers can certainly help—but the pain is real. Although the stress might start in your brain, it can cause the release of chemicals (such as cortisol) that produce inflammation in your neck muscles. This causes you very real physical pain that your healthcare provider can address. Another way to think of psychosomatic illness is as a river that floods after a dam breaks. The most effective way to prevent more flooding is to fix the dam. However, the flooding that’s already happened must be dealt with while the dam is being repaired.
Coping With Stress
There are different kinds of stress. Positive stress, also known as eustress, keeps life invigorating and interesting. It’s the feeling that makes you want to get up in the morning and keeps you motivated. If you’ve ever enjoyed the thrill of a roller coaster ride or felt a sense of excitement and fulfillment when completing a project, you’ve experienced “good” stress. On the other hand, if you’ve experienced a major loss, a big life change, or other negative stressors, you know what “bad” stress feels like. Just as with positive stress, you can feel negative stress in your mind and body. When you can identify your main sources of stress, you can learn coping mechanisms. One of the first and most important is to avoid holding in your feelings. Another is to avoid unhealthy strategies, such as overusing alcohol. Healthy coping methods abound; it’s just a matter of finding what works best for you. Here are a few ideas to get you started.
Be honest with others and yourself. Confide in a friend. Do something kind for someone else. (Be sure to do nice things for yourself, too.) Eat a balanced diet, get regular exercise, and create a calming sleep ritual and space. Explore fun outlets for stress, such as a dance class. Join a support group. Learn relaxation techniques. Let go of grudges, patterns of thinking, or relationships that are unhealthy or negative for you. Make time for leisure activities you enjoy. Take a break if you’re in a stressful situation.
Remember that everyone handles stress in their own way. Two people in the same stressful situation can react very differently. Once you understand the unique way stress affects you both emotionally and physically, you can work on developing healthy and effective ways to manage it.
A Word From Verywell
In dealing with psychosomatic illness and the physical effects of stress, learn to let go of what isn’t serving you. First, accept that you are human, and allow yourself some grace. Then, do the difficult but necessary emotional work, such as allowing yourself to feel emotions that are hard to confront. Also let go of expectations and old guilt—the “shoulds” that have been guiding your behavior. You might benefit from giving up control in some areas of your life or easing off your tendency to strive for perfection. Remind yourself that it’s OK to fall short of your goals as long as you are trying and doing your best. As you are identifying stress in your life, you may realize a big source is the pressure you put on yourself—and therefore, it’s within your control to release.
