Patient Basics: Somatic Symptom Disorder (Somatization Disorder)

Somatization disorder is an older name for what doctors now call somatic symptom disorder. It describes physical symptoms, such as pain or tiredness, that cause a great deal of worry and take over daily life. People with it truly feel these symptoms and aren’t faking or imagining them. Treatment focuses on easing distress and getting back to normal activities, and talk therapy helps many people.

Key points

• The symptoms may or may not have a clear medical cause. The diagnosis rests on how much the symptoms, and worry about them, disrupt your life.
• About 5 to 7 in 100 adults may have it, and it is more common in women.
• Regular visits with one trusted primary care doctor work better than many emergency visits, specialists and repeated tests.
• Cognitive behavioral therapy (CBT) has the strongest evidence. Some antidepressants also help, especially with pain.
• Having this condition doesn’t protect you from other illnesses, so new or different symptoms still need checking.

Somatization disorder and somatic symptom disorder

In 2013, the main US guide for mental health diagnoses replaced somatization disorder with somatic symptom disorder. The old label required many unexplained symptoms in different parts of the body, starting before age 30. The new one is broader. It applies when one or more physical symptoms come with too much worry, time or energy spent on them, usually for more than 6 months.

Two related conditions are often confused with it:

• Illness anxiety disorder. Strong fear of having a serious illness, with few or no symptoms.
• Functional neurological disorder. Symptoms such as weakness or seizures that come from a problem with how the nervous system works, without damage to it.

Symptoms

The physical symptoms vary. Common ones are:

• Pain in the back, joints, head, belly or chest
• Tiredness and low energy
• Dizziness or feeling faint
• Upset stomach, bloating, nausea or bowel changes
• Shortness of breath or a pounding heart

What sets the condition apart is how a person thinks, feels and acts about these symptoms:

• Constant worry that symptoms mean a serious disease, even after normal tests
• Spending a lot of time and energy on symptoms and health concerns
• Many doctor visits and tests, with reassurance that doesn’t last
• Avoiding activity for fear of making symptoms worse
• Trouble working, keeping up with family life or enjoying things

Depression and anxiety often occur at the same time.

What causes somatization disorder

There is no single cause. Several things seem to work together:

• How the brain handles body signals. Some people notice normal sensations more strongly, and the brain can turn up the volume on pain and discomfort, especially under stress.
• Stress and life events. Major stress, grief, and trauma or neglect in childhood raise the risk.
• Anxiety and depression, which make physical symptoms feel stronger and harder to ignore
• Past experiences with illness, such as a serious illness in yourself or growing up with a family member who was often sick
• Personality traits, such as a tendency to worry

It can also begin after a real medical illness, when symptoms and worry continue beyond what the illness explains.

How it’s diagnosed

Your doctor will ask about your symptoms, how long they’ve lasted and how they affect your life. They’ll do an exam and order tests that make sense for your symptoms, to look for medical conditions. The diagnosis rests on a clear pattern of distress and disruption. Normal test results alone don’t make the diagnosis. A psychologist or psychiatrist may also see you, and short questionnaires help track symptoms over time.

Being told “nothing is wrong” can feel dismissive. A good diagnosis explains that the symptoms are real and gives you a plan.

How somatization disorder is treated

• One main doctor. Regular, scheduled visits with a primary care doctor, even when you feel well, give steady care and cut down on emergency visits and unneeded tests.
• Cognitive behavioral therapy. CBT helps you notice worried thoughts about symptoms, test them, and slowly change habits such as checking and avoiding. It can be done in person or online.
• Mindfulness-based therapy teaches you to notice sensations without getting caught up in them.
• Physical activity. A gradual exercise plan, sometimes with a physical therapist, builds strength and confidence.
• Medicines. Antidepressants such as SSRIs (sertraline, escitalopram), duloxetine or a low dose of amitriptyline can ease pain, anxiety and low mood.

Opioid pain medicines and sedatives such as benzodiazepines usually aren’t helpful and can cause new problems. The aim of treatment is to help you do more and worry less, even if some symptoms remain.

Things that help at home

• Keep a steady daily routine with regular sleep, meals and activity.
• Pace yourself. Spread tasks out instead of doing too much on good days and resting all day after.
• Limit time spent searching symptoms online.
• Write down stress and symptoms for a few weeks to spot patterns.
• Try slow breathing, stretching or relaxation exercises.
• Stay in touch with friends and activities you enjoy.

When to get help

See your doctor for new symptoms, or symptoms that change in a clear way. Call 911 for emergencies such as sudden chest pain, trouble breathing, fainting or signs of a stroke. If you feel hopeless or are thinking about suicide, call or text the 988 Suicide & Crisis Lifeline.

Common questions about somatization disorder

Are people with somatic symptoms faking?

No. People with this condition really feel their symptoms. Faking symptoms on purpose is something else entirely and is uncommon. The same goes for conditions such as fibromyalgia, whose pain is real even when tests are normal. Trying to “catch” someone faking rarely helps anyone. Good care and support do.

Is fibromyalgia a somatic symptom disorder?

No, fibromyalgia is a separate diagnosis of widespread pain, tiredness and poor sleep. Some people with fibromyalgia also have somatic symptom disorder, when worry about their pain becomes overwhelming. Both respond to similar care, including exercise, CBT and some antidepressants.

Can somatic symptom disorder go away?

Yes, it can improve a lot. With CBT, steady care from one doctor and a gradual return to activities, many people worry less and do more. Symptoms may come back during stressful times, but the skills learned in therapy help people cope sooner.

Questions to ask your doctor

• Which tests do I really need, and which can we skip?
• Can we set up regular visits instead of waiting for problems?
• Would CBT help me, and where can I find it?
• Could a medicine ease my pain or worry?
• Which new symptoms should I call you about right away?

Learn more

• Somatic symptom disorder (MedlinePlus, U.S. National Library of Medicine)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.