Now we’re going to get
into somatoform disorders.
This is a psychological disorder characterized
primarily by physical symptoms.
And the reason why we’re
making this differentiation is
this is quite common as
individuals come in and saying
you know, “I have this general
pain in my legs and my back,”
and the doctor might say,
“Well, okay, you have this pain
and that’s what you’re describing to me.
I’m going to try to treat that pain.”
So they might give you a treatment therapy
that typically works for low back pain,
but it’s not resolving
the situation for you.
The reason is because the main
driver behind why you’re expressing
that lower back pain is
not actually physical.
It’s not that you’ve pulled a muscle
or you have a certain virus that’s
causing an inflammation in your back,
it’s psychologically driven.
And so a medicine is not going to
treat your psychological disorders.
You need a medicine that’s specifically
psychologically oriented, right?
So this is why it’s difficult for a lot of
doctors trying to figure out and establish
is this truly a physical disorder or
are these really physical symptoms,
or is this a psychological disorder that’s
being expressed as physical symptoms.
Conversion disorder is
another one where you
experience change in your
sensory or motor function.
So we’re highlighting two specific types
of function now, sensory or motor,
with no apparent physiological cause and
it is affected by psychological factors.
Again, the name implies to you
converting psychological --
into a physical response
but more specifically to
sensory and motor function.
So you just treating that sensory or motor
function is not going to solve your problem
because you need to get down to the
underlying psychological factors.
Pain disorder is which is previously
known as chronic pain disorder
is where you suffer from clinically important
pain affected by psychological factors.
So this would be, I’m feeling
a lot of neuropathic pain
or just a general fibromyalgia
or pain in my legs and my arms.
And the pain is there,
it’s clinically important,
but what’s causing that pain?
It’s not because you were beaten by a
stick and that’s why your legs hurt.
It’s because you have a psychological
driver behind that pain.
So you’re seeing some commonalities here
where you’re seeing something physical,
but it’s actually psychologically driven,
and that would under the umbrella
of somatoform disorders.
Now, somatization disorder
is again in the same family
and you’re going to
experience physical symptoms
that are linked to psychological drivers,
but here we’re a little bit more
specific in some of the criteria.
So you need to have pain in at
least four areas of the body,
you need to have at least two GI
or gastrointestinal symptoms,
you need to have at least
one sexual symptom,
you need to at least have one
which is things like your
balance or double vision.
And so collectively, if
you’ve achieved all of those,
we can say that you’re a somaticizer or
you’re suffering from somatization disorder.
Body dysmorphic disorder,
so this is when you feel like a specific
attribute of your body is bothering you.
And I know we all have our likes and
dislikes of our physical appearance
so we might say, “Well, you know I’m not
bad but I hate the length of my arms,”
or “I hate my nose” or what have you,
and I think that’s fairly normal.
But with individuals with body
dysmorphic disorder, what’s happening is
they are so preoccupied with that
slight, we say slight physical anomaly
or an imagined defect where
really it’s essentially normal
and you’re saying, “What are you
talking about? Your nose is perfect.”
These individuals will hone
in on that and focus on
that to the point where they
can't actually function.
And a lot of times this is
focused on things like hair,
face, breasts, things like that.
And that’s all they see.
And they focus on it and
you’ll be talking to them
and you’re saying, “Are
you listening to me?”
and “Oh, sorry. I was just looking at my
hair. It’s driving me nuts. I hate my hair.”
And they go on that rant.
And we know while at work, all
they’re thinking about is,
“Oh my God. I maybe I should get it cut or
fixed. I can’t deal with this anymore.”
It really impacts their
ability to function.
Hypochondrias is another
quite commonly used catchall
where we say this individual is concerned,
overly concerned or preoccupied
with fears of having a serious
illness for at least six months.
So they don’t actually have an illness.
They have a fear that “I think I’m sick.”
So say for example you wake up in
the morning with a sore throat
and you have maybe a small
cough and you say to yourself,
“Oh no, I think I’m
getting a cold.”
But an individual who’s
hypochondriac might be like,
“-- oh God. Yeah. I’m pretty sure that I have
SARS. I’m going to die and I have SARS.”
And you know, you say, “Well, it’s
probably not SARS. Just take it easy.
Maybe take some cough syrup,” and
then a day later they’re fine
and you’re like, “How’s
that SARS coming along?”
"Oh, it wasn’t SARS actually. I think I’m
fine. But I’m still worried about it.”
And a couple of days later they might
get a small itch on their arm,
maybe they changed the
detergent that their using
and they look at them and say, “Yeah.
I’m pretty sure I got skin cancer,”
and they make that huge
leap and they get into it
and they’re so
concerned about that
and it has to last for kind of
an extended period of time.