Somatoform Disorder
Somatoform disorder is a syndrome of prolonged physical symptoms in the absence of an identifiable organic cause with associated functional impairment in the context of an identifiable stressor.
People with somatoform disorder have a number of different symptoms that typically last for several years.
Their symptoms can’t be traced to a specific physical cause. In people with somatoform disorder, medical test results are either normal or do not explain the person’s symptoms.
People who have somatoform disorder often become very worried about their health because they do not know what is causing their health problems.
The symptoms of somatoform disorder are similar to the symptoms of other illnesses.
People with this disorder may have several medical evaluations and tests to be sure that they do not have another illness.
The cause is not known. In some cases, there may be a problem with the nerve impulses that send signals of pain, pressure also other unpleasant sensations to the brain.
We do know that the pain also problems caused by somatoform disorder are real.
Like many medical problems, somatoform disorder often runs in families. It tends to come and go over time.
Types
Types of Somatoform Disorder
Somatoform disorders are a group of mental health conditions characterized by physical symptoms that suggest a medical condition, but no underlying physical illness can be found to explain the symptoms. These disorders involve a person experiencing significant distress due to physical symptoms that cannot be fully explained by medical tests or diagnoses. Below are the main types of somatoform disorders:
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Somatic Symptom Disorder (SSD)
In this condition, individuals experience persistent physical symptoms, such as pain or fatigue, that are distressing and disrupt daily life. The symptoms may or may not have a clear medical cause, but the person’s preoccupation with their health and the distress caused by these symptoms is disproportionate. There is an excessive focus on the symptoms, often leading to anxiety, frequent doctor visits, and testing. -
Illness Anxiety Disorder (IAD) (formerly known as Hypochondriasis)
People with illness anxiety disorder are excessively worried about having or developing a serious illness, despite having few or no physical symptoms. Their preoccupation with health leads to frequent checking of their bodies, avoiding situations that may involve health risks, or seeking reassurance from doctors. Their anxiety persists even when medical tests show no problems. -
Conversion Disorder (Functional Neurological Symptom Disorder)
Conversion disorder is characterized by neurological symptoms, such as paralysis, blindness, or seizures, that cannot be explained by medical or neurological conditions. These symptoms often mimic those of a neurological disorder, but no physical cause can be identified. The symptoms typically arise after a stressful or traumatic event and may not involve any intentional physical impairment. -
Psychological Factors Affecting Other Medical Conditions
In this type of somatoform disorder, psychological factors (such as stress or anxiety) contribute to the worsening of an existing medical condition. The psychological distress is believed to exacerbate or interfere with the course of the medical illness, making it harder to treat or manage effectively. -
Body Dysmorphic Disorder (BDD)
BDD is characterized by a preoccupation with perceived flaws or defects in physical appearance that others may not notice. These concerns are often unrealistic and lead individuals to seek excessive medical or cosmetic treatments. While it is not primarily a somatoform disorder, its focus on perceived physical abnormalities places it in a related category.
Sign and Symptoms
Signs and Symptoms of Somatoform Disorders
Somatoform disorders involve physical symptoms that are not fully explained by medical conditions, and the distress caused by these symptoms often impacts the person’s daily life. While the symptoms can vary depending on the specific type of somatoform disorder, common signs and symptoms include:
1. Somatic Symptom Disorder (SSD):
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Physical symptoms: Persistent pain, fatigue, gastrointestinal issues, or other bodily symptoms (such as dizziness or headaches) that are distressing.
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Excessive focus on symptoms: Individuals may become preoccupied with their physical symptoms and spend a significant amount of time thinking about them.
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Frequent medical visits: They often visit multiple healthcare providers or undergo unnecessary medical tests in search of an explanation for their symptoms.
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Disproportionate anxiety: There is an excessive level of worry about health and the physical symptoms experienced, even when tests show no major underlying illness.
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Impairment in daily life: The symptoms and preoccupation with them can cause significant disruption to work, social activities, or relationships.
2. Illness Anxiety Disorder (IAD) (formerly Hypochondriasis):
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Fear of serious illness: A person with IAD experiences a persistent fear of having a serious illness despite little or no physical symptoms.
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Excessive checking of the body: Frequent self-examinations or seeking reassurance from doctors, friends, or family about health status.
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Avoidance behaviors: Avoiding situations or activities they believe might cause illness (e.g., avoiding crowded places for fear of germs).
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Reassurance-seeking: Repeated visits to doctors for tests, even if previous exams show no problem, because they are not convinced by normal results.
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Preoccupation with health: A constant focus on bodily sensations, with a tendency to misinterpret normal bodily changes as signs of serious disease.
3. Conversion Disorder (Functional Neurological Symptom Disorder):
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Neurological symptoms: Symptoms that mimic neurological conditions, such as paralysis, blindness, tremors, or seizures, but with no underlying medical cause.
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Motor or sensory dysfunctions: Difficulty walking, loss of vision, or inability to move limbs, without any identifiable physical reason.
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Psychological trigger: Symptoms often develop after a stressful or traumatic event, such as an accident, loss, or emotional trauma.
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Absence of neurological findings: Medical tests, such as MRI or CT scans, show no signs of the neurological condition that the symptoms suggest.
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Inconsistent symptoms: The symptoms may change or fluctuate over time, often worsening in stressful situations or improving when the person is distracted or relaxed.
4. Psychological Factors Affecting Other Medical Conditions:
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Exacerbation of existing conditions: Psychological stress or anxiety makes an existing physical condition (e.g., asthma, diabetes) worse.
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Increased sensitivity to physical symptoms: Stress or anxiety may cause the person to become overly focused on physical symptoms, worsening their perception of illness.
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Complicates treatment: The person may not adhere to treatment plans due to psychological factors affecting the medical condition’s course.
5. Body Dysmorphic Disorder (BDD):
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Distorted body image: A person may have a preoccupation with perceived flaws or defects in their appearance, even though others may not notice them.
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Repetitive behaviors: Individuals with BDD may engage in behaviors like excessive mirror checking, skin picking, or trying to hide or fix the perceived flaws through makeup, clothing, or cosmetic procedures.
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Distress and impairment: These concerns lead to significant emotional distress and impair functioning, including avoiding social situations or developing low self-esteem.
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Preoccupation with appearance: The focus on appearance becomes overwhelming and consumes a large part of the person’s thoughts.
What to eat
1. Foods that Support Mental Health:
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Omega-3 fatty acids: These are beneficial for brain health and can help manage mood and anxiety. Foods rich in omega-3s include:
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Fatty fish (salmon, mackerel, sardines)
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Chia seeds, flaxseeds, walnuts
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Fortified eggs
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B Vitamins: Important for mental health and reducing stress. Sources include:
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Whole grains (brown rice, oats, quinoa)
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Leafy green vegetables (spinach, kale)
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Eggs, poultry, and dairy products
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Legumes (beans, lentils)
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Magnesium-rich foods: Magnesium helps to calm the nervous system and reduce anxiety. Foods high in magnesium include:
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Leafy greens (spinach, Swiss chard)
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Nuts and seeds (almonds, pumpkin seeds)
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Bananas, avocados
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Dark chocolate (in moderation)
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Probiotics: A healthy gut can influence mood and mental health. Foods with probiotics help support gut health, such as:
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Yogurt with live cultures
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Kefir
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Sauerkraut, kimchi, and other fermented foods
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2. Foods that Promote Energy and Reduce Fatigue:
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Complex carbohydrates: These help maintain stable blood sugar levels, providing sustained energy and reducing fatigue.
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Whole grains (brown rice, oats, quinoa, whole-wheat bread)
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Sweet potatoes
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Beans and legumes
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Lean proteins: Protein helps with energy and reduces feelings of fatigue.
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Chicken, turkey, lean beef
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Tofu, tempeh, lentils
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Eggs
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3. Hydration:
Staying hydrated is crucial for both physical and mental health. Dehydration can exacerbate physical symptoms and lead to headaches, fatigue, and confusion. Aim to drink plenty of water throughout the day. Herbal teas like chamomile, ginger, or peppermint can also promote relaxation and ease digestive symptoms.
4. Foods that Reduce Inflammation:
Chronic stress and inflammation can exacerbate somatoform disorder symptoms. Anti-inflammatory foods can help support overall health and potentially reduce symptoms of pain or discomfort.
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Fruits and vegetables: Especially those rich in antioxidants like berries (blueberries, strawberries), cherries, and leafy greens (spinach, kale).
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Spices like turmeric and ginger: These have anti-inflammatory properties and can be added to meals or teas.
5. Foods to Avoid:
While no foods can directly cause somatoform disorder, some foods may worsen symptoms related to stress, anxiety, or digestive issues:
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Caffeine: Excessive caffeine can exacerbate anxiety, disrupt sleep, and contribute to jitteriness. Limit coffee, energy drinks, and caffeinated sodas.
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Refined sugars and processed foods: These can lead to mood swings and energy crashes, potentially worsening anxiety and fatigue. Try to limit sugary snacks, pastries, and processed junk food.
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Alcohol: It can interfere with sleep and mood, and it may worsen symptoms of anxiety and depression.
6. Consider Mindful Eating:
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Mindfulness-based practices like mindful eating can help reduce stress and improve your connection to your body. Eating slowly, focusing on your food, and paying attention to how it makes you feel can reduce emotional eating and enhance your overall well-being.
Dietary Regimen for Somatoform Disorder
1. Eat a Balanced Diet:
A nutrient-rich diet supports overall health, energy levels, and mood regulation, which can help reduce symptoms like fatigue and anxiety that often accompany somatoform disorder.
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Breakfast:
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Oatmeal with chia seeds, flaxseeds, and berries for fiber and omega-3s.
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A green smoothie with spinach, banana, almond milk, and a tablespoon of ground flaxseeds or chia seeds.
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Whole-grain toast with avocado and a boiled egg for protein and healthy fats.
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Lunch:
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Salad with mixed greens, quinoa, grilled chicken or tofu, avocado, tomatoes, and a light olive oil-based dressing.
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A vegetable soup with lentils or beans for fiber, protein, and vitamins.
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Brown rice with grilled fish (like salmon) and a side of roasted vegetables (such as carrots, broccoli, and sweet potatoes).
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Snack:
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Nuts and seeds (e.g., almonds, walnuts, sunflower seeds) which are rich in magnesium, healthy fats, and protein.
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Greek yogurt with a small handful of mixed berries or flaxseeds for probiotics and fiber.
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Apple slices with almond butter for healthy fats and a boost of energy.
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Dinner:
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Baked salmon or another fatty fish for omega-3 fatty acids, along with steamed or roasted vegetables and a serving of quinoa or brown rice.
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Tofu stir-fry with bell peppers, broccoli, and spinach, served over brown rice or cauliflower rice.
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Chicken breast with a side of steamed vegetables like zucchini, Brussels sprouts, or spinach.
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Hydration:
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Drink plenty of water throughout the day to stay hydrated.
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Herbal teas like chamomile, ginger, or peppermint can help with relaxation and digestion.
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Avoid excessive caffeine and alcohol, as these can increase anxiety and disrupt sleep.
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2. Nutrients that Support Mental Health:
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Omega-3 fatty acids (found in fatty fish like salmon, mackerel, and sardines) support brain health and help reduce symptoms of anxiety.
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Magnesium-rich foods (such as spinach, almonds, and bananas) help reduce stress and promote relaxation.
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B Vitamins (from whole grains, leafy greens, eggs, and lean meats) support energy production and mood regulation.
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Probiotics (found in yogurt, kefir, and fermented foods) support gut health, which is linked to mental well-being.
3. Foods to Avoid:
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Processed foods and refined sugars: These can cause blood sugar spikes and crashes, leading to mood swings and energy dips.
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Excessive caffeine: Can increase anxiety and disrupt sleep, making it harder to manage stress.
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Alcohol: Can interfere with mental health and exacerbate anxiety or depression.
Daily Regimen for Somatoform Disorder
Along with a balanced diet, adopting a healthy lifestyle and daily routine can significantly impact symptom management. Here’s a regimen that incorporates physical activity, stress management, and psychological support.
1. Morning Routine:
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Start the day with mindfulness or meditation: Spend 5-10 minutes practicing deep breathing or guided meditation to reduce stress and improve emotional regulation. Apps like Headspace or Calm can be useful.
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Gentle stretching or yoga: Incorporating light stretching or yoga in the morning helps relieve tension and improve circulation, which may reduce symptoms like muscle pain or discomfort.
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Healthy breakfast: Follow the balanced breakfast suggestions above to give your body the nutrients it needs to begin the day with energy and clarity.
2. Physical Activity:
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Exercise: Regular physical activity is essential for reducing anxiety, depression, and stress, and for improving overall health.
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Aim for 30 minutes of moderate exercise (e.g., walking, swimming, cycling, or light jogging) at least 5 days a week.
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Yoga, Pilates, or tai chi are particularly good for promoting relaxation and body awareness.
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Strength training (2-3 times per week) helps build muscle and boost mood by releasing endorphins.
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3. Stress Management:
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Mindfulness or relaxation techniques: Dedicate time each day for relaxation, such as:
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Progressive muscle relaxation: A technique where you systematically tense and relax muscle groups in the body to relieve physical tension.
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Breathing exercises: Practice deep breathing (e.g., 4-7-8 breathing technique) to calm the nervous system and reduce anxiety.
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Journaling: Writing down thoughts, emotions, and physical symptoms can help process feelings and create distance from distressing thoughts. It’s also a great way to track potential triggers.
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Limit overstimulation: Reduce exposure to stressful situations and media that might trigger anxiety or emotional distress. Consider reducing screen time, especially before bedtime.
4. Social Support and Therapy:
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Therapy: Cognitive-behavioral therapy (CBT) is particularly effective in managing somatoform disorder. CBT helps individuals recognize and change negative thought patterns related to their symptoms and health anxiety.
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Support groups: Joining a support group, either in person or online, can provide social support and help people feel understood.
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Family and friends: Open communication with supportive family or friends can help reduce feelings of isolation and provide emotional comfort.
5. Evening Routine:
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Wind down: Avoid stimulating activities such as watching intense TV shows or engaging in stressful conversations before bed. Instead, try reading a book, doing a relaxing activity, or taking a warm bath.
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Sleep hygiene: Aim for 7-9 hours of quality sleep each night. Stick to a regular sleep schedule and create a relaxing bedtime routine (e.g., dimming the lights, avoiding screens, and using calming scents like lavender).
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Light dinner: Avoid heavy or rich foods that may cause discomfort or indigestion. A light, balanced meal will promote better sleep.
6. Consistency:
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Be consistent with your diet, exercise, and stress management practices. It’s important to create and maintain a routine, as this can help regulate your body’s physical and emotional responses over time.
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HOMEOPATHY MEDICINES FOR SOMATOFORM DISORDER:
Some useful homeopathic remedies are:
Ignatia:
Ignatia is the great homoeopathic remedy for lagrande nevrose. In its proving it is a hysterical remedy.
Briefly, its symptoms are great sensitiveness to external impressions. Patients laugh and cry alternatively, the face flushes on the slightest emotion, spasmodic laughter which oftentimes ends in screaming, the globus hystericus is present and so is the clavus hystericus which shows itself as a sharp pain, as if a nail were being driven into the top of the head.
In Ignatia there is an emission of profuse, pale urine and this oftentimes relieves the headache.
There are, in the Ignatia patient, flatulent conditions also contortion of the muscles. The globus hystericus found under a number of drugs, but Ignatia and Asafoetida have it the most prominent.
The convulsive symptoms of Ignatia are as varied as the moods of the drug; there may be only a slight convulsive movement about the throat in drinking, or there may be severe spasms with clenched hands also blue face greatly resembling those of Cuprum.
Other symptoms
The return to consciousness always accompanied by a sigh and a deep inspiration. Fear also grief are prominent symptoms of the hysteria of Ignatia; it is a long suffering grief and the patient aggravate by the constant nursing of it.
Another interesting and, one may say hysterical point about Ignatia the numerous _ contradictory items found in its pathogenesis. Thus we have headache relieved by stooping, soreness of the teeth better by eating, sore throat better from swallowing, fever without thirst and chilliness relieved especially by uncovering.
cough
The cough even contradictory, for the more the patient coughs the more he wants to cough, also it only stop by an effort of the will.
In fact, the Ignatia patient is very much like what Sir James Paget described hysteria to be, namely: It says ‘I cannot.’ ‘I will not;’ but it really is ‘I cannot will.’ Richet says, “all mediums chose among the grandes hysteriques.”
Asafoetida:
One of the characterizing features of hysteria is the globus hystericus, or the sensation of a ball in the throat. Asafoetida has this symptom very prominently.
It seems with this drug to be a sort of reversed. peristalsis and it is especially the remedy if the nervous symptoms· were in any way due to the checking of habitual discharges.
Another important symptom of Asafoetida is the accumulation of flatus in the abdomen; it passes upwards and causes oppressed breathing.
Owing to this the symptom found that this ball-like sensation above referred, starts from the stomach and rises to the throat, and it naturally made worse by overeating and by motion.
Other symptoms
It is a bursting feeling, as if everything would come out of the mouth. Hysterical colic is, therefore, well met by Asafoetida. With Asafoetida the patient swallows continually to keep the lump down, and this gulping adds to the difficulty in breathing.
There is a great deal of restlessness and anxiety with Asafoetida and a changeable mental condition. The muscles jerk and twitch. The entire system is over-sensitive.
Hysterical convulsions due to suppression of discharges will often indicate Asafoetida. Predominance of the throat symptoms should lead one to think always of Asafoetida.
Moschus:
Fainting is the great keynote of Moschus. When hysterical attacks are found with fainting, other drugs may be indicated. Asafoetida may be indicated, Cocculus, Ignatia or Nux moschata, but in most cases Moschus will be the simillimum.
It is especially the remedy for the paroxysm. The stimulation of tetanic spasms, the unconsciousness or frequent swooning will point to Moschus. Hughes says no remedy is as good as Moschus for this condition, and Dr J. Heber Smith termed it an indispensable remedy in hysteria.
Muscular twitchings are present and violent spasm or constriction of the chest. She may even turn blue in the face, foam at the mouth and be chilly.
What is Somatoform Disorder ?
Somatoform disorder is a syndrome of prolonged physical symptoms in the absence of an identifiable organic cause with associated functional impairment in the context of an identifiable stressor.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Somatoform Disorder ?
- Ignatia
- Asafoetida
- Moschus
- Tarentula
- Platinum
- Valereana
- Nux moschata
What is the main cause Somatoform Disorder ?
- Problem with the nerve impulses
- Herediatry
What are Somatoform symptoms?
- Frequent headaches
- Back pain
- Abdominal cramping
- Pelvic pain
- Pain in the joints, legs and arms, and chest
- Abdominal pain
Reference
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Psychiatry, Fourth Edition- Oxford Medical Publications – SRG- by Geddes, Jonathan Price, Rebecca McKnight / Ch 32.
- A Short Textbook of PSYCHIATRY 7th edition by Niraj Ahuja / Ch 8.
- Homeopathy in treatment of Psychological Disorders by Shilpa Harwani / Ch 9.
