Psychosomatic illnesses

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This thread was created by spinning off posts from the "GERD [stomach issues]" topic. Please disregard any previous comments regarding off-topic remarks; those were made in the context of the old thread. Now that they have been moved here, they belong in this discussion.>

To start things off, here is a standard definition and a brief list of psychosomatic conditions:

"Psychosomatic illnesses can be defined as physical ailments within various organ systems where a psychogenic factor is believed to play a significant role.>

According to the American Psychiatric Association, psychosomatic diseases include:

1. Skin disorders: acne, hives, neurodermatitis (chronic skin changes involving intense itching), and angioedema (swelling of the eyelids, lips, tongue, etc.),
2. Digestive system disorders: spasms in the muscle between the esophagus and stomach, the stomach and duodenum, gastric and duodenal ulcers, chronic constipation, ulcerative colitis, and Crohn's disease,
3. Respiratory system disorders: bronchial asthma and tuberculosis,
4. Cardiovascular diseases: angina pectoris and myocardial infarction, high blood pressure, arrhythmias,
5. Endocrine disorders: diabetes, low blood sugar (hyperinsulinism and hypoglycemia), hyperthyroidism,
6. Rheumatic diseases: rheumatoid arthritis, chronic lower back pain,
7. Gynecological issues: painful menstruation, miscarriages,
8. Other: obesity, allergic reactions, migraines and other headaches, chronic itching, tumors.

Nowadays, cancer is even considered within the realm of psychosomatic illness. Determining exactly how and why a psychosomatic condition develops isn't simple or straightforward. Many researchers suggest that emotional turmoil can trigger disruptions in organic systems. However, not everyone facing emotional struggles will develop a psychosomatic illness. It depends on several variables, such as genetics, life stressors, social support networks, and cultural factors.

Excerpted from Psychosomatics, D. Romac, MD, psychiatrist, Healthy Living, a family health magazine, Issue 56/2008.

To provide some context for this discussion, I am including snippets from the original thread (which focused on GERD—gastroesophageal reflux disease). These specific comments sparked the ongoing debate:

hrvoje dr. said:GERD is largely a psychosomatic condition; it isn't incurable. ...

analogbison13 said:I don't quite get how my inflamed lining has been psychosomatic for two years... sure, the symptoms are much milder now, but who knows, maybe there's already permanent damage to my esophagus. 🙄

And what about children diagnosed with GERD and Barrett's esophagus? For them, I assume the cause isn't psychosomatic, but rather chemical or mechanical.

AnnaMollyHr said:...In other words, most of us—mostly the younger crowd who met through this forum or this specific thread—are hypersensitive. We're over-educated. We read too much, then we read even more, second-guessing every single symptom or minor ache until the ailment becomes psychosomatic.

Given the daily grind and the stress we deal with, it’s hardly surprising...

At the very least, one can try to fix their diet and lifestyle—just slow down, if nothing else. 🙂

dr. hrvoje said:...Asthma, ulcerative colitis, hypertension, hives, dermatitis, ulcers, etc.—these all fall under psychosomatics. I'm not sure why reflux would be considered an exception here.
We need to define what "children" actually means in this context—as in, age range.

My kid's been dealing with allergic asthma for years now, and honestly? I'm starting to suspect they developed some kind of 'psychosomatic illness' back when they were just two 😕

analogbison13 said:My kid's been dealing with allergic asthma for years now, and honestly? I'm starting to suspect they developed some kind of 'psychosomatic illness' back when they were just two 😕

I have no interest in getting dragged into that debate, nor will I be weighing in on the matter. Instead, consider this one example. [Link] Regarding that specific issue.

The American Psychiatric Association has officially categorized asthma under the umbrella of psychosomatic disorders.

Look, I’ve read all the theories and I know the drill, but where does the allergy actually fit into this equation? My kid isn't gasping for air because of some anxious parent; they're choking because of a cat. We have the lab results to prove the allergy is real.

ONT I get it, okay? It's crystal clear to me that my GERD is a direct result of the anxiety I've been battling for years. I'm not even questioning that part.

Look, I’m not a psychiatry expert—that’s not my field—so I can't say for certain why organizations like the American Psychiatric Association have categorized asthma as a psychosomatic condition. It reminds me of a debate I once heard where an allergist and immunologist went after a psychologist, or maybe a psychiatrist, basically asking, "Oh, so you think we should treat anaphylactic shock with psychotherapy too?!"

The logic likely boils down to how mental states influence physical symptoms. Things like anxiety, stress, or general discontent can act as triggers for an attack.

Don't get me wrong; I'm not one of those people who believes everything is purely psychological. I'm just pointing out that this isn't some fringe theory someone made up; it’s actually documented in medical literature and research papers, just as my colleague mentioned.

Nicholas Myers said:Look, I’m not a psychiatry expert—that’s not my field—so I can't say for certain why organizations like the American Psychiatric Association have categorized asthma as a psychosomatic condition. It reminds me of a debate I once heard where an allergist and immunologist went after a psychologist, or maybe a psychiatrist, basically asking, "Oh, so you think we should treat anaphylactic shock with psychotherapy too?!"

The logic likely boils down to how mental states influence physical symptoms. Things like anxiety, stress, or general discontent can act as triggers for an attack.

Don't get me wrong; I'm not one of those people who believes everything is purely psychological. I'm just pointing out that this isn't some fringe theory someone made up; it’s actually documented in medical literature and research papers, just as my colleague mentioned.

Nicholas Myers is familiar with those theories, and it's certainly not the first time I've heard them. But from my own experience—having been a mother to an asthmatic child for nine years—watching exactly how her attacks happen, from an allergen trigger to excess mucus production and finally the tightness in the lungs... I find it hard to buy into that theory. And if that were true, then sending a kid like that primarily to an allergist or a pulmonologist would be the wrong approach. 🤷

analogbison13 said:Nicholas Myers is familiar with those theories, and it's certainly not the first time I've heard them. But from my own experience—having been a mother to an asthmatic child for nine years—watching exactly how her attacks happen, from an allergen trigger to excess mucus production and finally the tightness in the lungs... I find it hard to buy into that theory. And if that were true, then sending a kid like that primarily to an allergist or a pulmonologist would be the wrong approach. 🤷

I already mentioned I don't entirely agree with that list, so I get where you're coming from.

The logic holds, though: if someone has a psychosomatic condition, they still need to see a specialist for the actual physical ailment. At the end of the day, a psychosomatic illness manifests in a specific organ, so you need a specialist to treat that organ. My point is simply that this should happen in tandem with a psychologist, psychotherapist, or psychiatrist.

I’m right there with you. I deal with plenty of stuff from that list myself, and honestly, it’s infuriating. After my colonoscopy, once they slapped an IBS diagnosis on me, nobody even thought to suggest seeing a psychiatrist. If they had, maybe I wouldn't be dealing with GERD today.
My family doctor used to tell me all the time that I was suffering from "Alexandrov illnesses." From what I understand, it refers to that so-called "seven" group of psychosomatic conditions.😉

analogbison13 said:I’m right there with you. I deal with plenty of stuff from that list myself, and honestly, it’s infuriating. After my colonoscopy, once they slapped an IBS diagnosis on me, nobody even thought to suggest seeing a psychiatrist. If they had, maybe I wouldn't be dealing with GERD today.
My family doctor used to tell me all the time that I was suffering from "Alexandrov illnesses." From what I understand, it refers to that so-called "seven" group of psychosomatic conditions.😉

That’s correct. According to Franz Alexander, there are seven distinct psychosomatic illnesses: gastric and duodenal ulcers, ulcerative colitis, bronchial asthma, essential hypertension, rheumatoid arthritis, hyperthyroidism, and psychocutaneous diseases. Seven Alexandrov diseases.

Just because something is classified as a psychosomatic condition doesn't mean an acute flare-up should be treated solely with psychotherapy. Of course, medication is necessary. And let’s be realistic: psychotherapy isn't necessarily going to "cure" the underlying disease overnight (for instance, if you start therapy while the illness is in remission, but then a flare-up hits, you're definitely reaching for the meds). However, by working through internal conflicts, therapy can lead to gradual improvement, stabilization, and—on average—a much better quality of life.

There was a period when the study of Psychosomatics was incredibly popular, but it eventually fell out of favor once we had a wave of breakthroughs on the physiological side—think things like MRI technology and the development of new pharmaceutical drugs.

Physical symptoms and psychosomatic factors don't cancel each other out; it isn't an "either-or" situation, but rather an "and" situation.

Psychotherapy isn't a magic wand, just as medication isn't. Neither one truly cures the root cause; they mostly just manage the acute episodes. This is because the fundamental trigger remains unaddressed. It is also important to distinguish between immediate triggers and the actual underlying causes.

We know the difference between what triggered World War I and what the actual cause was.
Of course, if a child has an allergy, the allergens are the immediate cause of the reaction. But if we think about it more deeply, an allergy is essentially a hypersensitivity. And someone can be hypersensitive not just to a substance, but to the events happening around them too.

A lot of people assume children can't suffer from psychosomatic illnesses because they think, "Well, kids aren't crazy." But we aren't talking about mental illness here; we're talking about hypersensitivity and emotions. After all, don't children have feelings?
Neurodermatitis is actually very common in young children precisely because they lack the vocabulary to express their emotions. They are too small to talk it out, so they manifest their frustration physically because they have no other outlet. We often use metaphors like having "thin skin" or being "thick-skinned"—that kind of symbolism is exactly what we see in Psychosomatics.

It’s common knowledge that our bodies react to our moods: our faces flush when we're excited, our pulse and blood pressure spike when we're angry, our stomachs or heads ache when we suppress resentment, and our hearts race when we're scared. We all see this happen, so it’s obvious that emotions impact the body. So, how could long-term negative emotions that we fail to express properly *not* eventually contribute to chronic illness?

It honestly saddens me to hear certain doctors dismiss the connection between the mind and the body entirely. Honestly, that connection should be obvious to anyone, even from a plane!

p.s. I personally live with asthma and MS. I've been in psychotherapy for quite some time now, and both conditions are currently in remission. My last major flare-up occurred following an intense period of stress involving the death of a family member (and there is significant scientific research supporting that link)!

Yeah, I get everything written above, believe me. That’s exactly my point—nobody ever suggested I go see a psychiatrist. I definitely wasn't under the impression that some shrink was going to cure my stomach ulcer without using an IPP 🤣.
Of course, this was ages ago, but even looking at IBS threads today, I don't see anyone mentioning they were referred to a psychiatrist.

And regarding allergies—if we're talking about mere hypersensitivity, then why on earth do they bother recording family medical history for them? If it's just "sensitivity," then heredity shouldn't even matter if my kid is allergic. But every single time I walk into a doctor's office, that's the first thing they ask me 🤷
.
Anyway, my kid is in puberty now and hasn't had an attack in two years. So, I want a real medical explanation: how does this supposed "most sensitive period" square with the fact that asthma symptoms usually taper off by this age for most people?

They told me there’s a good chance about 90% of my seizures are actually psychosomatic 🤷 So, I’ve "prepared" myself by seeing both a therapist and a neurologist, and now I'm just pushing through 👍 They also mentioned my psoriasis is likely rooted in psychosomatics too 🤷

analogbison13 said:Yeah, I get everything written above, believe me. That’s exactly my point—nobody ever suggested I go see a psychiatrist. I definitely wasn't under the impression that some shrink was going to cure my stomach ulcer without using an IPP 🤣.
Of course, this was ages ago, but even looking at IBS threads today, I don't see anyone mentioning they were referred to a psychiatrist.

And regarding allergies—if we're talking about mere hypersensitivity, then why on earth do they bother recording family medical history for them? If it's just "sensitivity," then heredity shouldn't even matter if my kid is allergic. But every single time I walk into a doctor's office, that's the first thing they ask me 🤷
.
Anyway, my kid is in puberty now and hasn't had an attack in two years. So, I want a real medical explanation: how does this supposed "most sensitive period" square with the fact that asthma symptoms usually taper off by this age for most people?

When I mentioned treating an acute episode with psychotherapy, I was referring back to one of the earlier posts where a doctor stated that Psychosomatics is nonsense, just to illustrate that point.

Also, in medicine, it's hard to view things in a purely linear way. Naturally, various factors are taken into account, and genetic predisposition is always considered.
Emotions and stress definitely impact the body. To put it simply, the weakest organ or system usually takes the hit—perhaps specifically the one where a genetic predisposition already exists. Genetics isn't just simple math like 2+2=4; someone might carry a gene for a specific condition, but for that illness to actually develop, a whole host of other factors have to align.

To ensure this doesn't sound like mere psychological rambling... there is actually a field called psychoneuroimmunology, which very precisely studies the interactions between the mind, the neurological system, and the immune system within the body.

http://en.wikipedia.org/wiki/Psychoneuroimmunology

Finally, nobody is going to refer you to a psychiatrist or a psychologist if you have a psychosomatic illness—aside from the fact that many people shy away from anything labeled "psycho." Even many medical professionals often look at this branch of medicine with skepticism (or even disdain!). Another major factor is that here in the States, there are only a handful of specialists in this field. So, at any given time during therapy, you might be dealing with a few hundred people, or even more if you include group therapy. Since not every psychiatrist is also a psychotherapist, they can't offer much help beyond prescribing medication—and in the case of psychosomatic illnesses, the actual conversation is what helps. There is actually more work being done in this area at the Psychological Medicine Clinic, where they are even planning a specialized psychosomatic department. Some of their doctors specialize in helping people dealing with cancer and similar conditions. Essentially, psychotherapy plays a supportive role here, helping patients learn how to cope with their illness.

And at the end of the day, psychotherapy isn't primarily a direct cure or emergency aid; it's a long-term process through which a person works through stress, gets to know themselves and their feelings, and resolves emotional conflicts... which ultimately results in an improvement in physical health.

Besides psychologists and psychotherapists (of whom there are, unfortunately, not enough), various relaxation methods, meditation, and mindfulness can also help.

For anyone interested in this field, I would highly recommend a great book called *Why People Get Ill*.

I’m currently in psychotherapy. I’m not on any medication because my therapist decided I don't need them, but let's be real—not everyone is "enlightened" enough to actually admit where their problems start.

GE actually recommended I go see a psychotherapist,
therefore, clearly, not everyone is a skeptic.

Aha, so there actually *were* recommendations after all (you mentioned earlier that nobody had suggested them to you). Are you feeling satisfied with how the therapy is going?
As for me, I started treatment right at the same time my diagnosis came in, and I was lucky enough to have some professional guidance from the start.

Regarding your question about children and Psychosomatics—it’s actually quite common for these types of illnesses to show up in younger kids. It makes sense, really; toddlers can't talk much, and even slightly older children haven't quite mastered the ability to express themselves verbally. If they can't put their emotions into words, those feelings tend to manifest physically where they can be seen. That's why little kids often deal with things like neurodermatitis—everything shows up right on the skin. Usually, these issues clear up after age three, which lines up perfectly with when verbal communication starts to develop.
(Standard psychotherapy is fundamentally built on verbalization, anyway; you have to find a way to give those feelings an outlet).

When dealing with psychosomatic (and other) ailments, it’s fascinating to look at the function of the organ involved and connect it to its symbolic meaning. For instance, asthma—suffocation. Symbolically, it might mean someone or something is suffocating you or making it hard to breathe. With allergies, it could be that something is irritating you; with vision problems, maybe there's something you simply don't want to see... and so on. I'm not entirely sure why asthma tends to subside during puberty—there's definitely a medical explanation involving hormones or something similar, most likely. Just thinking out loud here, but from a psychological standpoint, puberty marks the beginning of the separation process from parents, so perhaps we don't feel as "smothered" anymore? Just a theory! I also read somewhere that kids undergoing treatment at a summer camp or a seaside resort actually see better results if their parents DON'T go with them, LOL. I spent three summers being treated at a coastal facility, but only one parent was ever present; unfortunately, I was too young to remember if that actually made a difference.

I should also mention that there is so much misunderstanding surrounding the concept of psychosomatic illness. When I was diagnosed with asthma at six years old, my relatives interpreted the term "psychosomatic" to mean I was just a malingerer, a hypochondriac, or just acting out. It got so bad that my grandmother once waited so long to seek help (we were out on an island without a car or a phone) that she nearly pushed me to the brink of death—that's how serious it was. I ended up spending two weeks in the hospital on IV drips, hundreds of miles away from home.

They didn't suggest any connection to psychosomatics when I was first diagnosed with IBS, even though the fact that my colonoscopy came back perfectly clean basically screams that the cause is psychological. That recommendation only popped up years later, after I started insisting that my IPP wasn't fully handling the heartburn—then the gastroenterologist started suspecting there was something deeper going on with my mental state. 🤣 Therefore, several years have passed since my symptoms first started, and now I'm sitting here with two new diagnoses, this time involving actual organic "damage."

My kid is an animal lover just like me, but they have a massive allergic reaction to them—both in lab tests and in real life. If anything is going to "suffocate" us, it’s being denied the things that actually matter. But that's why we rescue, treat, and foster animals; maybe we wouldn't be doing all this if things were different... because sometimes, just not being able to do something is its own kind of reality.

I’m dealing with the exact same situation—it's both hair and dander. We had pets growing up, but honestly, it felt like we were just playing with fire. After my last flare-up a few years ago, my rabbit ended up moving in with my parents. Now, I can be around animals for a little while, but I just can't live in an apartment with a dog or a cat. Being with the rabbit was okay, but I couldn't even clean its cage without feeling like I was suffocating, and I couldn't pet him too much because the skin around my wrist would start turning bright red.
I "have" a dog, but he stays at my parents' place. He isn't allowed to lick me because it makes my skin flush, and even after just petting him, I have to wash my hands immediately.

It’s the exact same story over here—the skin rashes, the itching, the runny nose, and that suffocating feeling... knock on wood, but it hasn't hit me in a while.
(Maybe I'm just not choking anymore, or maybe she's finally stopped getting under my skin 🤣)