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Writer's pictureDr. Penny Lane

Somatic Symptom Disorder: The New Hysteria

This may prove to be a rant post that I'll later delete, and I try really hard not to be overly reactive about the gross dysfunction in conventional medicine or jump to conclusions, but this article today really frustrated me. When people ask me what my specialty is, most aren't familiar whatsoever with functional medicine. It can be a bit complex to explain, but I've found myself more often saying, particularly in business circles, that my client is the one who doesn't feel heard.


Functional medicine clinicians are the ones who identify the underlying cause of the often lengthy list of symptoms that never made sense to the conventional medicine practitioner or they hadn't enough time to even consider. Apparently the Lancet has recently published an article stating that one-third of all symptoms lack somatic explanations, which means a physical problem (soma referring to body). This has ultimately led them to believe then that the issue is not at all in the body, but instead in the mind. Remember the days when women with all sorts of concerns were diagnosed with hysteria? Those days have never truly gone away, but this new somatic symptom disorder diagnosis is sure to light a fire under those embers.



This new finding is more a reflection of the failures of modern medicine. It's simply a new diagnosis that otherwise means, "I haven't the time to listen. I haven't the time to think this through, to truly investigate an underlying cause. If I don't see the clear cause in our six minute visit or it doesn't present itself on my diagnostic study, then it's all in your head and you are now labeled with Somatic Symptom Disorder."


Functional medicine practitioners circle up at events and talk about these cases all day long - cases in which their client was on medications for PCOS, thyroid disease, hypertension, depression, panic attacks, suicide ideation - multiple medications - and they also have essentially every known allergy, so have been advised to only eat beef and rice because that's all they seem to be able to tolerate. Then the functional provider draws a few additional labs, digs in a bit deeper, and low and behold identifies a parathyroid tumor and a resulting histamine intolerance, along with impending mental health crisis.


Another may share about their client diagnosed with anorexia, who actually has insufficient enzyme production and fat absorption, but of course her anorexia diagnoses led to a bipolar diagnosis or borderline, because that's just what we do when someone with anorexia struggles emotionally; it's all in their head, right? We could also talk about the thousands of women suffering with endometriosis who suffer on average, a full decade, before ever being diagnosed. What about our obese clients who are told they just need to push themselves away from the table more often, because again, these issues are just in their head.


According to this article, those who experience persistent pain, dizziness, cardiovascular complaints, digestive disorders, gait disturbances, exhaustion, and fatigue or even have multiple chemical sensitivities might simply be suffering from a psychological condition and further investigation into a physical illness is unnecessary. This triggers my inner advocate. It's deplorable to me. And it isn't that mental health disorders can't be the cause of our physical symptoms, but that this new diagnosis dismisses the reality that our mental health and our somatic experience is all interrelated and deeply connected. Our mental health and wellbeing has always been part of the expression of our symptoms, but this doesn't mean this has to be mutually exclusive.


What I am thinking with this list of symptoms for example, is the potential for POTS, food sensitivity, maybe even Celiac Disease, Ehler's Danlos Syndrome, nervous system imbalance, HPO-axis dysfunction, PTSD, or even epigenetics with variants that challenge detoxification. Allergies, asthma, eczema, even rage can be the manifestation of histamine intolerance. Chronic fatigue syndrome is often an underlying virus activation or irritable bowel syndrome a specific trigger; for me, it was beef. In fact, I was diagnosed with Crohn's by a gastroenterologist at the IU Med Center with Crohn's based on the severity of my symptoms, and then into my 40s, I did the MRT with LEAP therapy and identified the underlying cause was a single food so that never again did I suffer IBS symptoms. Obesity may simply be a diluter of toxins. Maybe it's a manifestation of long term stress that drove up cortisol levels which resulted in a large waist line and inability to sleep. We might now have cPTSD or even addiction and binge eating that results from undiagnosed and untreated ADHD. I could talk for weeks on the impact of unaddressed trauma, but dig deeper, take more time, listen.


Heal using both art and science.


I can't help but feel this article is about relieving ourselves of the burden of digging in and simply assigning the issue as one of "somatic syndrome disorder," so we no longer have to be bothered. Maybe this is my own trigger, and some time will actually demonstrate that this article is much more about learning that modern medicine has been very bottom up or body focused and too separated from head down correlation. Psychology, for example, has long focused in what we call an "all head down focus" that forgets to consider issues in the body as manifesting in behavior and thought, such as a parathyroid tumor. We now have somatic therapy and the polyvagal theory which is advancing this a bit in the field of psychology, even Dr. Ames teaching us about how psychologists have long treated an organ they never actually evaluated diagnostically. Maybe this is modern medicine opening its mind a bit to the mind-body connection, and if so, I am a huge fan! I am all about integrating somatic therapy into my functional medicine treatment plans, but I am hesitant when I hear, we may simply have a brain that wants to falsely assign fault in the body for felt experience in the body, but no worries, don't run any additional tests, it's just all in the head.


The article reads patronizing and dismissive. It seems to clock with the progression of women's health, that we are incapable of being our own advocate, that doctors can better assign or diagnose complaints in their own body than clients themselves. It triggers my eroding rights to agency. Please, allow this to be an awakening into the somatic experience, the mind-body connection, and not simply a ticket to ignore the dis-ease of women.



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