Somatic Symptom Disorder & Substance Abuse


When many of us experience unusual physical symptoms or ailments, we turn to Google to figure out why. Unfortunately, some websites are notorious for providing the worst-case scenarios when it comes to health diagnoses, so your everyday headache turns into an inoperable brain tumor.

While many of us understand that this leap is likely not the case, not everyone is able to brush aside these dramatic diagnoses so easily. If your physical health is constantly causing you mental distress, you may have a somatic symptom disorder.

What is Somatic Symptom Disorder?

Somatic symptom disorder, formerly known as somatoform disorder, is when someone obsesses over aspects of or symptoms related to their physical health leading to excessive psychological distress. There are several types of somatic symptom disorders that can manifest themselves slightly differently.

While the physical symptoms are not always tied to a diagnosed medical cause and may be unexplained, those that do have a legitimate medical origin are reacted to in a way that is disproportional to the diagnosis.

Some somatic symptom disorder symptoms may include:

  • Pain in various parts of the body that go undiagnosed
  • Going to the doctor regularly for various ailments
  • Intense anxiety about health and physical symptoms
  • Not getting better with medical treatment
  • Not being satisfied with diagnoses and seeking other opinions

The person’s thoughts, feelings, and behaviors surrounding their physical symptoms may become so intense that they struggle to function properly and may act irrationally in an attempt to ease their physical and mental pain. In some cases without help, somatic symptom disorder may lead to other conditions like substance abuse.

The Connection Between Somatoform & Substance Use Disorders

Living with a somatic symptom disorder can be challenging enough, but it is often tied to other behavioral health conditions as well. The comorbidity of somatoform and substance use disorders can range anywhere from 33% to 2.2% depending on the study.1 Although more research needs to be done on the relationship between the two and the results vary drastically, there do appear to be some specific connections between somatic symptom disorders and substance abuse.

One positive correlation of drug use and somatic symptom disorders may be with body dysmorphic disorder, a type of somatic symptom disorder where someone obsesses over an imagined or minor defect in their physical appearance. One study suggests that as much as 25% to 49% of people diagnosed with body dysmorphic disorder will also have a substance use disorder at some point in their life, but other studies show smaller results.1

There may be a few reasons for this connection. People with body dysmorphic disorder may use drugs like cocaine to help them lose weight.2 They often also struggle with low self-esteem, another factor that is strongly correlated with substance abuse as drugs and alcohol become an enticing way to cope with these negative feelings about themselves.

Other research has focused on somatic symptom disorder and painkiller addiction. The rate of prescription opioid addiction tends to be higher in someone with a history of somatization.3 As people with somatic symptom disorder perceive physical pain, they may turn to alcohol or drugs like painkillers for relief. These opioids may help with the physical pain as well as the psychological distress but can be habit-forming if misused. In fact, anywhere from 21% to 29% of patients taking prescription opioids for chronic pain will end up misusing these medications and some may need to go to drug rehab to stop.4

While the research on the extent of the relationship between somatic symptom disorder and substance abuse is unclear, if you believe to be struggling with these conditions, get help. Co-occurring disorder treatment can help you work through both substance abuse and somatization together so that you can find lasting success in recovery.

1. PSU - Somatoform and Substance Use Disorders

2. NCBI - Substance Use Disorders in Individuals With Body Dysmorphic Disorder

3. NCBI - The Use of Prescription Opioid Medication by Patients with Borderline Personality Disorder and Axis II Comparison Subjects: A 10-year Follow-up Study

4. NIH - Opioid Overdose Crisis

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