It’s never fun to deal with a painful or frustrating symptom, only to have a doctor or loved one be skeptical. Most people hope for some kind of validation when they’re feeling unwell. For this reason, the word psychosomatic can sometimes rub people the wrong way. Is your doctor telling you that your symptoms are “all in your head?”
It’s no surprise that this word has caused some confusion. Historically, doctors sometimes sent patients to psychologists (or asylums) when they had symptoms that the doctor didn’t understand. However, psychosomatic does not necessarily mean that you are “imagining” or “making up” symptoms that aren’t there.
Let’s break it down: The prefix psycho- refers to the mind, and somatic refers to the body. Psychosomatic simply refers to symptoms caused by an interaction between your mind and body. These symptoms are very real, but they’re not caused by anything physically wrong with the body. Instead, it’s a physical response to mental distress.
You could label some very common phenomena as psychosomatic, such as:
Getting a high blood pressure reading because you’re so nervous at the doctor’s office (known as “white coat hypertension”)
Having nausea when public speaking
Feeling your heart rate speed up before a kiss with your crush
Getting a headache at the end of a stressful day of work
Having upset stomach before a job interview
Long story short, don’t be offended if your doctor calls your symptoms “psychosomatic.” They’re not accusing you of making it up!
There are some health conditions that have a psychosomatic nature. Irritable bowel syndrome (IBS) is a great example.
IBS causes very real symptoms, including stomach pain, diarrhea, constipation, gas, and bloating. However, doctors won’t find anything abnormally happening in the body. You're not experiencing inflammation like you would with Crohn’s disease. There’s no halted digestion like there is with gastroparesis. There’s no sign of infection like with a food-borne illness.
Instead, IBS appears to stem from a miscommunication between your brain and the nerves in your gut. One of the big triggers of IBS symptoms is—you guessed it—stress. Thus, IBS symptoms are psychosomatic: They’re very real, but they’re not caused by a physical problem in the body.
Psychosomatic symptoms can really impact quality of life. Headaches, stomach aches, back pain, and nausea can disrupt your work days, family time, and social outings.
Because there isn’t a physical problem to “fix” or “cure,” the main treatment often involves treating the underlying mental distress. For example, psychotherapy can help treat anxiety, which can relieve things like back pain and stomach aches. In some cases, medication like antidepressants can also help.
It can be frustrating to learn that your symptoms don’t have an obvious culprit, but that doesn’t mean your symptoms aren’t real. Talk to a doctor to learn more about the symptoms that affect your life so you can get answers and find a treatment.
Fava GA, Sonino N. Psychosomatic medicine. Int J Clin Pract. 2010 Jul;64(8):1155-61.