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What are Somatic Symptoms of Anxiety?

Instructor: Elizabeth Nyang

Elizabeth teaches counseling classes at the university level, has a private mental health practice and a doctorate degree in counseling psychology.

Somatic symptoms are the physical symptoms related to an illness. When the somatic symptoms of anxiety interfere with the activities of someone's life, that individual is considered to have an illness called generalized anxiety disorder. This lesson will describe the somatic symptoms associated with anxiety, as well as ways to treat those symptoms.

What are the Somatic Symptoms of Anxiety?

His heart rate is up and he feels very anxious and scared. But he's not watching a horror movie on TV. This is how Michael feels at least 3 times a week and he doesn't know why. He often feels ill and uncomfortable at work. So Michael meets with a mental health counselor and is diagnosed with generalized anxiety disorder or GAD, a mental health disorder.

During his session with his counselor Michael describes his symptoms. They include:

  • tightening in the chest,
  • sweating,
  • jumping or feeling startled from noises or sounds,
  • diarrhea,
  • rapid heart rate,
  • shortness of breath,
  • problems concentrating,
  • problems falling asleep, and
  • very tense muscles.

Michael does not experience these symptoms all at once, but he does experience many of them simultaneously during an anxiety attack.

How Are Somatic Symptoms Diagnosed?

Elizabeth is a licensed mental health counselor trained to use the DSM V, or the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, to make a mental health diagnosis. The DSM is published by the American Psychiatric Association and is used in the United States and globally as a primary reference to find clinical criteria to diagnose mental health disorders. Michael lets Elizabeth know that he often feels like he is going to have a panic attack, a sudden feeling of acute and disabling anxiety. He wants to know if this is also part of his diagnosis. Elizabeth lets Michael know that since he's only had one panic attack over the last six month, panic is probably not a major somatic symptom of his illness.

Different Types of Anxiety Disorders

Elizabeth sends Michael to Dr. Nieves, a psychiatrist, for a medication evaluation.

It is often difficult for patients to discuss their symptoms with their doctor.
Anxious man with doctor

Dr. Nieves recommends that Michael first work with Elizabeth to learn tools to reduce stress before taking any medication. Dr. Nieves is also able to rule out any other anxiety disorders. For example, during his session with Michael he also determines that Michael does not have any other form of anxiety disorder, such as:

  • social anxiety,
  • obsessive compulsive disorder,
  • post-traumatic stress disorder, or
  • agoraphobia (or the fear of going outside).

Michael is glad to hear that panic is not a major part of his disorder. While he has only experienced a panic attack once, he shares that he has experienced the other symptoms of anxiety often over the last 6 months. However, Dr. Nieves verifies Elizabeth's diagnosis and rules out panic disorder.

Treatment

Sometimes people with anxiety disorders are prescribed medication to help relieve their symptoms. Dr. Nieves often prescribes Xanax, Ativan, and Klonopin for clients with anxiety disorders. However, he understands that these benzodiazepines are very addictive, so he uses caution when working with new clients.

Elizabeth has a good reputation for using mindfulness techniques to help clients reduce symptoms of anxiety. During their second session, Elizabeth teaches Michael how to do a short sitting meditation, a short walking meditation, and techniques used to change negative thoughts into positive thoughts. Michael also starts a new exercise program; he will walk daily and go to the gym to lift weights 4 times per week.

Lifting weights and exercising relieves the symptoms of anxiety.
Man lifting weights

The exercise will help him reduce stress and lower his anxiety level. When he returns from work or the gym, Michael will meditate for 2-5 minutes. Elizabeth has taught him how to do a sitting meditation by focusing on his breath. She's also explained how the default mode network (DMN) functions; it's a complex network of interactive regions within the cortex and parietal lobule of the brain that allows us to have multiple thoughts spinning around in our head when our bodies are quiet. For example, when we are strolling from the car to the house or sitting on the couch before we start watching TV, our minds are 'running'. The DMN creates thoughts that spin around in our heads and cause us to become anxious. But when we meditate, it helps to quiet this part of the brain. Michael has noticed that he is able to keep his mind free of thoughts when he is meditating.

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