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I am always depressed or if i can say i am always under pressure due to work
16 نوفمبر 2014
If these two conditions are ruled out, and in the context of stress or depression, we entertain the possibility of somatization disorder, which is a psychiatric condition marked by multiple medically unexplained physical, or somatic, symptoms. In order for a patient to qualify for the diagnosis of somatization disorder, somatic complaints must be serious enough to interfere significantly with his or her important daily activities, such as work, school or family and social responsibilities, or lead the person experiencing the symptoms to seek medical treatment.
Individuals with somatization disorder suffer from a number of vague physical symptoms, involving at least four different physical functions or parts of the body. Somatization disorder is characterized by a group of physical symptoms that cannot be explained by medical conditions or use of drugs, and individuals with somatization disorder often undergo numerous medical tests (with negative results) before the psychological cause of their distress is identified. They often describe their symptoms as burning sensations, pains that move from place to place, strange tastes on the tongue, tingling, or tremors. It is true that the physical symptoms of somatization disorder frequently lack medical explanations, but they are not intentionally fabricated. The typical person with somatization disorder has suffered from physical pain, discomfort, and dysfunction for an extended period of time and consulted several doctors; they are hopeful that they one can be found who can identify the cause of their illness and provide relief.
Causes
Defense mechanism against stress: this is one of the oldest theories suggested in an attempt to explain the cause of somatization disorder. Rather than experiencing depression or anxiety, some individuals will develop physical symptoms. According to this model, somatization disorder is a defense against psychological pain that allows some people to avoid the stigma of a psychiatric diagnosis.
Hypersensitivity to physical pains stimuli: An alternative theory suggests that somatization disorder arises from a heightened sensitivity to internal sensations. People with somatization disorder may be keenly aware of the minor pains and discomforts that most people simply ignore.
Catastrophic thinking about physical sensations: According to this hypothesis, somatization disorder results from negative beliefs and exaggerated fears about the significance of physical sensations. Individuals with somatization disorder are thus more likely to believe that vague physical symptoms are indicators of serious disease and to seek treatment for them.
The diagnosis of somatization disorder is made based upon history of multiple physical complaints that began before age 30 and that continued for several years. These symptoms must cause significant impairment to social, occupational or other areas of functioning—or lead the patient to seek medical treatment.
Each of the following four criteria must be met.
• The individual must report a history of pain affecting at least four different parts or functions of the body. Examples include headaches, back, joint, chest or abdominal pain, or pain during menstruation or sexual intercourse.
• A history of at least two gastrointestinal symptoms, such as nausea, bloating, vomiting, diarrhea, or food intolerance must be reported.
• There must be a history of at least one sexual or reproductive symptom, such as lack of interest in sex, irregular menstrual periods, excessive menstrual bleeding.
• One symptom must mimic a neurological condition. Examples include weakness, paralysis, problems with balance or coordination, seizures, hallucinations , loss of sensations such as touch, seeing, hearing, tasting, smelling—or difficulty swallowing or speaking, or amnesia and loss of consciousness.
If a thorough medical evaluation reveals no evidence of an underlying medical- or drug- or medication-induced condition, the diagnosis of somatization disorder is likely.
Treatments
Cognitive behavior therapy
Cognitive-behavioral therapy (CBT) for somatization disorder focuses on changing negative patterns of thoughts, feelings, and behavior that contribute to somatic symptoms. The cognitive component of the treatment focuses on helping patients identify dysfunctional thinking about physical sensations. With practice, patients learn to recognize catastrophic thinking and develop more rational explanations for their feelings. The behavioral component aims to increase activity.
Medications
Antidepressant medications may help to alleviate symptoms of somatization disorder.
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