psychosomatic illness.docx

8/21/2019 psychosomatic illness.docx

1/11

MONIQUE MAVRONICOLAS – PSYCHOSOMATIC ILLNESS

The main objective of this paper is to evaluate the term psychosomatic illness by

understanding what is meant by the term and having an understanding on how it

could affect parts of the body. The aim will be to explore the different psychosomatic

illnesses (somatoform disorders) and the effects they have on body systems.

By definition psychosomatic broken up into simpler terms is mind (psyche) and body

(soma). The word ‘psyche refers to the individual!s emotional state or any mind

related aspects and somatic refers to the physical state" symptoms and signs.

#sychosomatic disorders are regarded as a disruption of the ordinary occurring

mechanisms of the individuals! body that includes one of the various systems

(nervous" physiological" endocrine and immune system). Therefore the illness entails

a definite and medically$measurable somatic illness that is intensified by

psychological causes.

%very individual!s background" environment" genes and coping mechanisms play a

role within their everyday life and how they will react or face situations. &owever for

individuals with psychosomatic disorders these variables play a particular role in their

lives as their disorder limits their ability to effectively deal with the everyday life

demands. The symptoms and management of these disorders will depend on the

disorder and in which category they are classified in. %ssentially one could divide

psychosomatic disorders up into ' broad categories

. *ndividuals that suffer from both medical and mental illness" where the

illnesses muddle the symptoms and management of each other +. *ndividuals with a medical condition that causes a mental illness'. ,omatoform disorders - these are disorders that are displayed through

physical complications. ,omatoform disorders are not part of

psychosomatic disorders (olen$&oeksema" +//0) and rather classed as

a group of mental disorders that the individual have idiosyncratic feelings

of an illness that is superficial and that there is no way to medically

untestable.


2/11


Phantom Limb Syndrome

*ndividuals that suffer from phantom limb pain are individuals that either have had a

limb or limbs amputated or have been paralysed. They often experience pain or

sensation in these areas. ,ome suggests that it is due to the nerve endings in the

amputated area that is growing or stimulated where as others suggest that the brain

was mapped out in such a way that even though the physical part of the body have

been removed" that part of the mapping of the brain hasn!t. The pain these

individuals experience has an enormous influence on their nervous system and is

often excruciating and almost impossible to treat.

1n article in the British 2ournal of 1nastasia suggested 3that a series of mechanisms

are involved in generating phantom pains and that these include elements in the

periphery" spinal cord and brain. *t is likely that the first events occur in the periphery"

which subse4uently generates a cascade of events that sweep more centrally and

also recruit cortical brain structures. The latter may be responsible for the complex

and vivid sensation that characteri5es certain phantom pain sensations. The

unraveling of neuroplastic changes in periphery" spinal cord" and brain are also

reflected in many of the features seen in phantom pain phenomena.6 (1naesth

+//).

#hantom limb pain is triggered and exacerbated by psychological factors. There are

studies that have shown that there is a significant relationship between stress" the

onset and the flare up of episodes of phantom$limb pain (&ill" 778). *ndividuals who

had received more support before the amputation reported less phantom limb pain

than those who received less support.

Chronic Fatigue Syndrome

9hronic fatigue syndrome (9:,) is a psychosomatic illness that affects the body by

causing extreme and constant tiredness. ;nfortunately the tiredness comes and

goes as it pleases (usually elevated through stressful situations) and although the

individual will sleep or rest" the tiredness does not subside. *n conjunction with the


3/11


tiredness the individual suffer from muscle pains. 1part from the fatigue" there are

various other symptoms that affect individuals with 9:,<

• =ue to the tiredness" the individuals short$term memory and concentration is

influenced" often struggling with constructing sentences• painful lymph nodes

• The digestive system is also subjective and individuals often suffer with

stomach pains" bloating and nausea" which may lead to sensitivity to certain

foods and alcohol.

• Being tried all the time has a huge influence in the individuals social and

family life that often leads to isolation and depression.

1s mentioned 9:, have severe influences on different body systems (digestive"

neurological and immune system).

The category of ,omatic ,ymptom =isorders and >ther ?elated =isorders according

to the =iagnostic and ,tatistical @anual for @ental =isorders" (=,@ $8" +/')"

represents a group of disorders characteri5ed by thoughts" feelings" or behaviours

related to somatic symptoms. This category represents psychiatric conditions

because the somatic symptoms are excessive for any medical disorder that may be

present.

,omatoform disorders include the following 8 types

Types 9haracteristics

9onversion disorder The individual has a feeling of loss of

the use of a body part but there are not

medical or physical reasons that could

explain this feeling

,omatisation disorder There are no organic reasons for a

history of complaints

#ain disorder 9omparable to somati5ation disorder

but is restricted only to the idiosyncratic

feeling of pain.

&ypochondriasis =isplayed through a persistent fear of

having a minor physical discomforts and

believes that it is a serious illness that


4/11


leads to repeatedly seeking medical

attention.

Body dysmorphic disorder 1n extreme obsession with a body part

in which the individual believes is

defective or not as it should be.

Hypochondriasis

1s mentioned in the table above" hypochondriasis is a disorder where the individual

fear that insignificant symptoms may be the result of a severe and often life

threatening disease. This disorder is similar to somatisation disorder" with the only

variance being that individuals with hypochondriasis may admit the indicators areminor but believe or fear they are caused by a severe or life threatening disease.

1ssurance from their doctor does not generally relieve their concerns" as these

individuals have a fear that the doctor might have not found the serious disease.

Conversion disorder

*ndividuals with conversion disorder" unconsciously converts mental stress intophysical symptoms. *ndividuals who are affected by the disorder are usually of age

between 0 and '/ years old. :or some it is a short term disorders but there are

individuals that experience conversion disorder over a long period of time. These

disorders suggest that the individual that suffers with it might suffer from a

neurological disease which could have the following symptoms

• @otor symptoms $ impaired coordination or balance" paralysis" lump in throat

• ,ensory ,ymptoms $ loss of touch or pain sensation" double vision" deafness"

hallucination

• ,ei5ures or convulsions

• >r a mixed presentation of the above

Body dysmorphic disorder

*ndividuals with body dysmorphic disorders constantly have concerns about their

appearance. They often have concerns about a feature they have that might not beanything other than uni4ue to them but that they consider to be a defect or out of


5/11


proportion. The individual with the disorder places an amount of pressure on the

individual that they are constantly aware of this feature" thinking that others see it.

They often camouflage it or considers cosmetic surgery.

*ndividuals who suffer from this disorder often obsess about the following features

• :ace $ nose" complexion" wrinkles" acne and other blemishes

• &air $ such as appearance" thinning and baldness

• ,kin and vein appearance

• Breast si5e

• @uscle si5e and tone

• Aenitalia

These obsessive flaws might become of such an extent that they start imagining

negative images about their body that is completely untrue and irrational. This could

lead to constant fussing and start dominating their lives to the extent that they start

missing work or merely leaving the house due to them feeling self$conscious about

the flaw. This could all lead to other mental and physical complications that could

include

• ;nnecessary cosmetic surgery

• ,ocial isolation

• ow self$esteem

• =epression or other mood disorders

• 1nxiety disorders

• ,ubstance abuse

Pain disorder

Chen an individual is in constant pain but at no stage could it be accredited to any

physical disorder it is clarified as pain disorder" this usually occurs in individuals that

had psychological stress or trauma. *ndividuals that suffer from pain disorder often

seek medical attention" but it is believed that psychological influences the sensitivity


6/11


and degree of the pain. Chen one believes that they are in pain all the time it creates

an environment that restricts social interaction and influence family and work life.

Somatisation disorder

This is also known as Bri4uets syndrome. *ndividuals who suffer from somatisation

disorder have indicated feeling sick or ill for a great part of their lives. They often

indicated numerous parts of the body that have different symptoms making them feel

sickly. *ndividuals are so convinced of their medical problems that dispite constant

reassurance and negative results they continue to seek medical attention or advice.

#atients with this type have a long history of medical problems that starts before the

age of '/.

,omati5ation disorder is a long$term (chronic) condition the pain and other

symptoms people with this disorder feel are real" and are not created or faked on

purpose.

The symptoms involve several different organs and body systems. The patient may

report a combination of

• pain

• neurologic problems

• gastrointestinal complaints

• sexual symptoms

@any people who have somati5ation disorder will also suffer with anxiety disorder.

Psychosomatic illness effects on the body systems

@ost psychosomatic illnesses have more than one symptom that affects different

body systems and that often leads to more symptoms with a knock on effect on other

body systems. ;nderstanding ones illness is the key to managing an illness and by

correct management an individual and curb certain knock on symptoms and effects.


7/11


The immune and digestive system is often disturbed or in distress due to

psychosomatic illnesses and symptoms due to these illnesses. The best way to

explain the effects of an illness on a body system would be to refer to a specific

illness and the system it affects.

:ibromyalgia is an illness that causes severe and chronic pain in one!s ligaments

and muscles and causes various symptoms including< anxiety" depression" fatigue

and *B, to name but a few. 1ll of which then in turn has an effect on the body

systems. @edical literature suggests that there is a definite like between

:ibromyalgia and digestive system issues and increases indifference in pain

receptors" thus food could cause severe bloating and cramping in fibromyalgia

patients. *n addition to food" conventional drugs D medicine causes side effects that

impacts the digestive system. *B, one of the symptoms associated with

:ibromyalgia" is a classic example of a functional gastro intestinal disorder often

associated by painful cramps" bloating" and constipation alternating with diarrhoea.

There are more nerve cells in the stomach and intestines combined than in the

spinal cord" these nerve cells continuously 3speak6 and relay messages between the

brain and the digestive system. ,,?*s (,elective ,erotonin ?euptake *nhibitors) are

believed to ease depression by enhancing levels of ,erotonin from the digestive

system to the brain. But 78E of the ,erotonin in the body is produced in the

digestive system" distracting these supplies from their ordinary receptors could

escalate anxiety and alter one!s sleep pattern" all knock on effects from the

symptoms such as depression" fatigue and *B, associated with :ibromyalgia. Cith

*B," the digestive system shut down as the nervous system shuts down the blood

flow resulting in decreasing secretions of hormones and en5ymes vital for digestion

and causing contractions of the digestive muscles" decreased nutrient absorption"

decreased oxygenation to the guts and decreased metabolism. This could then lead

to inflammation of the gastrointestinal system and make one more susceptible or

prone to infections which is often associated with stress. ,tress causes our bodies to

go into overdrive in order to allow our body systems to work overtime $ fight$or flight

response to be able to cope with the stress" this however causes a chain reaction

(:igure .) within the body systems


8/11


#sychosomatic illnesses! symptoms are often responsible for the havoc caused

within the immune system. =ue to the result of stress (whether physical or

emotional) as a result of psychosomatic disorders the immune system are often a

target for bacterial infections. ,tress associated with psychosomatic disorders are

more likely to advance infectious diseases due to the weakened immune systemability to fight off antigens within bacterial toxins or tissue cells. ,tress causes the


9/11


brain to release adrenaline" cortisol and other hormones that leads to suppressing

the immune system. ,tress could cause chronic inflammation $$ the immune

systems response to injury or irritation $$ may be involved in everything from heart

disease and diabetes to 1l5heimers disease and other dementia. ,o" indirectly" a

stress$related imbalance in the immune system may have a wider$ranging effect

other than just that of the immune and digestive system. 3 *n autoimmune disease"

for example" the immune system treats self$tissue as an invader" attacking it and

causing pathology such as multiple sclerosis" rheumatoid arthritis" 9rohn!s disease"

and lupus.6 (Bull" +//F).

#sychosomatic illnesses cause chronic stress< as seen earlier" stress (especially in

the digestive system) restricts the blood flow through the body and weakens the

immune system which can eventually cause physical dysfunction, leading to other

knock on effects such as tiredness" sore jointsDmuscles and many other.

?eferences

=efinition of #sychosomatic *llness available at

httpDDwww.medicinenet.comDscriptDmainDart.aspGarticlekeyH8+ accessed on +'

:ebruary +/8

http://www.medicinenet.com/script/main/art.asp?articlekey=5112http://www.medicinenet.com/script/main/art.asp?articlekey=5112


10/11


,omatisationD,omatoform =isorders available at

httpDDwww.patient.co.ukDhealthDsomatisationsomatoform$disorders accessed on

+' :ebruary +/8

#sychosomatic *llness available at

httpDDwww.healthgrades.comDconditionsDpsychosomatic$illness accessed on +'

:ebruary +/8

#sychosomatic disorder available at

httpDDwww.britannica.comD%BcheckedDtopicDF00'FDpsychosomatic$disorder

accessed on +' :ebruary +/8

#sychosomatic =isorders available at

httpDDcirrie.buffalo.eduDencyclopediaDenDarticleD'7DconsumerD accessed on +8

:ebruary +/8

olen$&oeksema" ,. (+//0). 1bnormal #sychology Fth %dition. @cAraw$&ill

9ollege.

:einstein ?%" deAruy :I. =ifficult patients personality disorders and

somatoform complaints. *n ?akel ?%" ed. Textbook of Family Medicine. 0th ed.

#hiladelphia" #a ,aunders %lsevier< +/chap FJ.

=iagnostic and ,tatistical @anual of @ental =isorders " Fth %dition

1merican #sychiatric 1ssociation. =iagnostic and statistical manual of mental

disorders. 8th ed. 1rlington" I1 1merican #sychiatric #ublishing< +/'.

#hantom imb #ain available at

httpDDwww.wellcome.ac.ukDenDpainDmicrositeDmedicine+.html accessed on + @arch

+/8

The perception of #hantom imbs available at

httpDDredwood.berkeley.eduDbrunoDpsc+7DhandoutsDrama+.pdf accessed on ' @arch

+/8

#hantom imb #ain available at httpDDbja.oxfordjournals.orgDcontentD0KDD/K.fullL

accessed on ' @arch +/8

http://www.patient.co.uk/health/somatisationsomatoform-disordershttp://www.patient.co.uk/health/somatisationsomatoform-disordershttp://www.healthgrades.com/conditions/psychosomatic-illnesshttp://www.britannica.com/EBchecked/topic/481834/psychosomatic-disorderhttp://cirrie.buffalo.edu/encyclopedia/en/article/139/consumer/http://www.wellcome.ac.uk/en/pain/microsite/medicine2.htmlhttp://redwood.berkeley.edu/bruno/psc129/handouts/rama2.pdfhttp://bja.oxfordjournals.org/content/87/1/107.fullhttp://www.patient.co.uk/health/somatisationsomatoform-disordershttp://www.healthgrades.com/conditions/psychosomatic-illnesshttp://www.britannica.com/EBchecked/topic/481834/psychosomatic-disorderhttp://cirrie.buffalo.edu/encyclopedia/en/article/139/consumer/http://www.wellcome.ac.uk/en/pain/microsite/medicine2.htmlhttp://redwood.berkeley.edu/bruno/psc129/handouts/rama2.pdfhttp://bja.oxfordjournals.org/content/87/1/107.full


11/11


&ill 1" iven 91" Mnussen 9. The role of coping in adjustment to phantom limb pain.

#ain" 778< J+K7-0J.

Aallagher #" 1llen =" @acachlan @. #hantom limbpain and residual limb pain

following lower limbamputation a descriptive analysis. =isabil ?ehab +//< +'8++-

'/

9hronic :atigue ,ymdrome available at httpDDwww.nhs.ukD9onditionsD9hronic$

fatigue$syndromeD#agesD*ntroduction.aspx accessed on F @arch +/8

#sychological ,tress and the &uman *mmune ,ystem available at

httpDDwww.ncbi.nlm.nih.govDpmcDarticlesD#@9'J+0KD accessed F @arch +/F

&ow does stress contribute to ill healthG 1vailable at httpDDwww.my$holistic$

healing.comDpsychosomatic$illness.html accessed on F @arch +/8
http://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Introduction.aspxhttp://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Introduction.aspxhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/http://www.my-holistic-healing.com/psychosomatic-illness.htmlhttp://www.my-holistic-healing.com/psychosomatic-illness.htmlhttp://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Introduction.aspxhttp://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Introduction.aspxhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/http://www.my-holistic-healing.com/psychosomatic-illness.htmlhttp://www.my-holistic-healing.com/psychosomatic-illness.html

Documents

psychosomatic illness.docx