Psychosomatic disorders

Which diseases are psychosomatic?

To an extent, most diseases are psychosomatic - involving both mind and body.

• There is a mental aspect to every physical disease. How we react to and cope with disease varies greatly from person to person. For example, the rash of psoriasis may not bother some people very much. However, the rash covering the same parts of the body in someone else may make them feel depressed and more ill.
• There can be physical effects from mental illness. For example, with some mental illnesses you may not eat, or take care of yourself, very well which can cause physical problems.

However, the term psychosomatic disorder is mainly used to mean ... "a physical disease that is thought to be caused, or made worse, by mental factors".

Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety. For example, psoriasis, eczema, stomach ulcers, high blood pressure and heart disease. It is thought that the actual physical part of the illness (the extent of a rash, the level of the blood pressure, etc) can be affected by mental factors. This is difficult to prove. However, many people with these and other physical diseases say that their current mental state can affect how bad their physical disease is at any given time.

Some people also use the term psychosomatic disorder when mental factors cause physical symptoms but where there is no physical disease. For example, a chest pain may be caused by stress and no physical disease can be found. Physical symptoms that are caused by mental factors are discussed further in another leaflet called Somatisation/Somatoform Disorders 

How can the mind affect physical diseases?

It is well known that the mind can cause physical symptoms. For example, when we are afraid or anxious we may develop:

• A fast heart rate
• A thumping heart (palpitations)
• Feeling sick (nauseated)
• Shaking (tremor)
• Sweating
• Dry mouth
• Chest pain
• Headaches
• A knot in the stomach
• Fast breathing

These physical symptoms are due to increased activity of nervous impulses sent from the brain to various parts of the body and to the release of adrenaline (epinephrine) into the bloodstream when we are anxious.

However, the exact way that the mind can cause certain other symptoms is not clear. Also, how the mind can affect actual physical diseases (rashes, blood pressure, etc) is not clear. It may have something to do with nervous impulses going to the body, which we do not fully understand. There is also some evidence that the brain may be able to affect certain cells of the immune system, which is involved in various physical diseases.

What are the treatments for psychosomatic disorders?Each disease has its own treatment options. For physical diseases, physical treatments such as medication or operations are usually the most important. However, healthcare workers will usually try to treat a person as a whole and take into account mental and social factors which may be contributing to a disease. Therefore, treatments to ease stress, anxiety, depression, etc, may help if they are thought to be contributing to your physical disease.