Quick Guide to Somatic Symptom Disorder

Somatic symptom disorder is a mental health disorder that can affect children. Children who have somatic symptom disorder worry a lot about physical feelings that are pretty normal — like headaches, stomachaches, or being tired. These small issues make them think they have a serious sickness. For example, they might think a stomachache means they have cancer. Kids with somatic symptom disorder worry so much that it causes them a lot of stress and anxiety that get in the way of normal activities like school.  

More girls than boys have somatic symptom disorder. Somatic symptom disorder is not the same as illness anxiety disorder. In illness anxiety disorder, the child worries about being seriously ill, but they don’t have any symptoms at all. 

Kids who do have an illness can also be diagnosed with somatic symptom disorder if they have unusually extreme worries about the illness. 

Signs that a child might have somatic symptom disorder include: 

• Thinking normal bodily feelings mean they are very sick. For example, the child might be sure that a headache means they have a brain tumor. 
• Spending a lot of time worrying about a specific pain or a more general feeling like being tired. 
• Having a lot of stomachaches or headaches or feeling tired a lot. 
• Being afraid of physical activities like sports because they think they will hurt themselves. 
• Spending a lot of time reading about illnesses. 

Some kids with somatic symptom disorder will refuse to go to the doctor. That might be because they’re afraid of a bad diagnosis or because they think they are already too sick to help. Others might go to the doctor or nurse’s office a lot and even demand that the doctor diagnose the illness they believe they have. 

Kids with somatic symptom disorder have extreme worries about their symptoms and are convinced they have a serious condition. This gets in the way of normal life, including school and friendships. They aren’t faking their fear. 

First, a doctor will examine the child to make sure they are not actually physically ill. Then, to get a diagnosis of somatic symptom disorder, the child must: 

• Show severe worry that they have a serious physical sickness 
• Think that everyday aches and pains like headaches and stomachaches mean that they have a serious sickness 
• Be so anxious and worried about these feelings that it gets in the way of school and social activities 

Somatic symptom disorder is usually treated with cognitive behavioral therapy (CBT). In CBT, kids learn that their worries are just thoughts and not real things to be afraid of. They also learn how to recognize scary thoughts as they happen and ways to make them less scary. 

Once a child has made progress with CBT, the therapist may have the child and their parents do another treatment that is called exposure and response prevention therapy. In this treatment, the therapist will ask the child to take small steps toward changing their reactions to their physical feelings. For example, the child and therapist may set a goal that the child will not go to the nurse for one whole day. Parents can also learn how to react to the child’s worries in a more helpful way. 

Sometimes, medication is used along with therapy if the child is very anxious. The most common medications for somatic symptom disorder are antidepressants, such as SSRIs.