Hello! Hello. Oh no, we're changing it up!
Welcome back to another episode of Diagnosing a Killer, The Mental Breakdown. I'm Kenna.
And I'm RifRef. Oh my gosh, she doesn't sound like that! From Rocky Horror Picture. Oh, I'm thinking of
The Rappers. It's amusing. I'm quelt. Special guest star today. Yeah. How's it going? Pretty good.
Just a very stressful day. I was telling Kenna it took me about two hours to run two errands today.
Traffic was insane and I immediately came home and decompressed. I don't know what's going on.
People might be trying to get everything ready for the holiday. Yeah, that's true.
We're running around. We are getting ready for a way better holiday, which is the True Crime and Paranormal
Podcast Festival. We're going in like 10 days. And when you hear this, it'll be 10 days from now.
And that is so exciting. Oh my gosh, I can't wait. And I think we're just as excited to find out where
it's going to be held next year. Boston. We're hoping for Boston. Boston. Boston. Boston. Your cousin from Boston.
Yeah, there you go. Well, I do have a mental breakdown today, but if you want to give everyone our handles before we start.
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Okay, you ready for this one? I am.
Today we are going to be talking about somatic symptom disorder.
Oh. There's no content warning. Okay.
Somatic symptom disorder is characterized by an extreme focus on physical symptoms such as pain and or fatigue.
This extreme focus can cause major emotional distress and other problems with typical functioning.
Is this like hypochondria?
So I'll get there. Okay.
Although some people do experience different types of physical pain due to true illness, people with a somatic symptom disorder will react to the symptoms in an abnormal way.
It's somatic?
Somatic. Okay.
Furthermore, someone with somatic symptom disorder will usually seek out medical care for things that would seem like no big deal to the average person.
Okay.
So their chest might be hurting a little bit, but it's not like chest pains and they'll go say, I don't know, have like a weird feeling and then the doctor will check them out and it'll be fine.
Okay.
And since somatic symptom disorder is kind of difficult to say a billion times, I'm going to shorten it to SSD.
Gotcha.
Individuals struggling with SSD may have multiple visits to the emergency room and or urgent care for minor to no physical injuries.
When these concerns about one's health take over the person's thoughts, it can become extremely debilitating and can trickle into other parts of their lives.
Additionally, people with SSD often do not realize that they are struggling with this disorder, as their physical pain, thoughts, and emotions are typically very true to the brain.
So it's like, I don't even think I have SSD. I don't even know what that is. I'm having a heart attack.
Yeah.
Yeah. It's a wholeheartedly believe it and we've definitely listened to, I'm sure listeners have also heard or seen true crime cases where people have had been manipulated in a certain way that they believe wholeheartedly that these are the things or acts that they may be committed out of a justification of some kind.
And again, just a small example of what you're saying, which is it is very real to the person.
Absolutely. And we said to hypochondria just a second ago. So that is actually a different type of disorder, which I'll explain and I'll also explain the difference because I thought somatic symptom disorder was the same thing as hypochondria.
Yeah.
But it's not.
So the overwhelming over flood to the brain that says no, I'm actually like something's going on along with the symptoms, the physical symptoms that someone does have can truly convince the person that they are seriously ill.
Does this also like flood into phantom pregnancy?
No, I didn't actually talk about that at all, which is interesting. I actually don't know much about that.
Yeah. Because with phantom pregnancy or you believing that you're pregnant in some cases actually give you pregnancy symptoms like morning sickness or, you know, the feeling of maybe like a bloated tummy or, you know, even physically taking on what some physical
symptoms of being pregnant are.
Yes. In that sense, yes, because I feel like a lot of these internal thoughts and emotions, like they can make that pain feel more than it is.
For example, like, you know better than anybody when you're driving home the other day and I had a huge panic attack and I literally grabbed your shoulder.
I said, oh my God, oh my God, oh my God. And you were like, what, what, what? And I was like, I don't know, something just happened. Like I was having such bad symptoms of anxiety that it made me like lose my vision and I got like a weird head rush.
Yeah.
Like it literally caused that to happen.
Scared the shit out of me.
Scared the shit out of me. It was going 80 miles down the road.
Yeah, I thought maybe you had seen like an accident ahead or something like your reaction was so strong.
Yeah.
That it was just like, yeah, I was like, oh no.
Not fun. So essentially my anxiety caused that physical symptom just like this. Like the feeling and thinking about, oh my God, I'm like something's really wrong could potentially make those feelings or sometimes stronger.
It's mind over matter.
Yeah, sometimes. Yeah.
But again, if you don't understand that you're suffering with this disease or disorder, excuse me, you wouldn't know how to override those feelings because you wouldn't even know that there was something abnormal about what was happening.
That's true.
You just, you just believe in your whole heart that you are suffering from an ailment or a pain.
So just going back a little bit of history about this disorder, the Egyptians and Sumerians were actually reported to have utilized the notions of melancholia and hysteria as early as the year 2600 BC.
Hell yeah.
We always hear hysteria.
Yeah.
During the 17th century, knowledge of the central nervous system grew and it became clear that numerous inexplainable illnesses could be linked to the brain rather than physical symptoms.
The 17th century.
They're like, oh, you might have something wrong with your brain, not your body.
I mean, this sounds so ignorant, but do you think that's why they removed the brain from the body when they would mummify you?
Yeah, probably.
Because that is something that has been known to rot in order to preserve the body, you would remove that.
Or to try to study it at the very least, you know.
That's true.
But also, yeah, if there's something wrong with your brain and it's not your body, take your brain out so that your soul can descend or ascend or whatever.
Yeah.
Descend and tell.
Maybe the brain is the limitation, you know?
That's what keeps you in your bodily, or your earthly being.
Yeah.
Your brain.
Remove it.
Get rid of it.
Dang, Egyptians are so cool.
So Thomas Willis, who is widely recognized as the father of neurology, recognized hysteria in women and hypochondria in men as brain disorders.
Because only women can be hysterical, right?
And only men can have hypochondria.
Yeah.
Thomas Sidenham, a different Thomas, would later contribute significantly to the belief that hysteria and hypochondria are mental rather than physical.
Valheim Speichel, a German psychoanalyst, was actually first to introduce the term somatization, and when Paul Brichette was the first to characterize what is now known as somatic symptom disorder.
I think it's, maybe it's Brichet.
I think Paul might have been French.
Yeah.
Brichet.
Paul would do research on subjects who had been unwell for most of their lives and complained of a variety of symptoms from various areas of the body.
Despite many tests, treatments, etc., the symptoms would continue.
Somatic symptom disorder was later dubbed Brichette syndrome in his honor because he was the one that decided, or not decided, but figured out like, oh, there's nothing physical wrong with you at all.
Yeah.
It's definitely a mental thing.
I think it is Broquet.
Broquet.
It's a B-R-I-Q-U-E-T.
Yeah, but the E-T in French is E.
E.
Cresson.
It's a Cresson.
Oh, yeah, it's a Cresson.
So that's a little bit about the history.
SSD is a somewhat common disorder occurring in about 5 to 7% of the adult population.
Women are actually 10 times more likely to develop SSD than men, and the onset of the disorder typically begins by age 30.
However, it can more rarely occur at any age.
And I say it like that because I'm like, I'm almost 30 and I'm like, this is me.
And she just has a little tiny journal in her room of like, okay, this is the onset for specific disorders.
And she's like, oh gosh, like 17.
I don't have to worry about whatever.
Actually, I was talking to one of my coworkers today if you're listening, hello.
And I was telling her about the case that I'm doing, or this episode that I'm doing, and I was talking to her about it.
She goes, I feel like I might have that.
And she said, I have this other blah, blah, blah, that's comorbid with that.
And I was like, yeah, but how old are you?
And she told me her age.
I was like, oh, you would have already gotten it.
You would have been fine.
Yeah, you're good.
I was like, oh, okay, cool.
It felt so cool.
So like I said, it typically begins by age 30, but it can actually occur at any age.
Of course, not every single individual is going to be the same.
Why do you think it's 10 times more likely in women?
I think because women have a lot more hormonal imbalances in their body,
like especially if they try to have kids or with their puberty that happens.
And I think that that could trigger the disorder, having all those new like symptoms of physical pain, not pain, but physical symptoms.
I just think that's my, yeah, that's my reasoning.
Do you think that maybe, I'm going to go societal here, societal standards of what gender is that women tend to feel,
or young girls tend to feel like their position is to be weaker or meager.
They're more, therefore more likely to be sick.
Yeah, that on top of the fact that men are supposed to not tell you if they're in pain or they're feeling a certain way.
Yeah.
So tidally speaking, like, oh, just rope some dirt in it, you know, or whatever.
Like, I feel like a lot of men, if they were experiencing these symptoms, may not speak out about it.
Yeah.
Yeah, interesting.
We're both interesting.
We are.
When someone is experiencing somatic symptom disorder, it can come with a number of different physical symptoms.
These include pain, which is the most commonly reported symptom, fatigue or overall weakness, shortness of breath, and many others.
Again, not one person's the same.
These physical symptoms may be mild to severe, and there may be one or more occurring at the same time, depending on the person.
While most people experiencing SSD will report these physical symptoms, the main signs of SSD are how people think, feel, and behave in response to the symptoms.
So it's like an overall, like, culmination of a few different variables in this disorder.
Yeah.
So, like, just having physical pain and, like, recognizing it is not SSD.
It's the way that someone reacts and then overreacts to it or believes, you know, how, what it is versus what it could be or whatever.
That's how they, like, analyze themselves, how they process that pain, what they choose to do with it, if anything.
Of course, yeah.
People struggling with SSD may feel concerned that mild physical symptoms are a sign of a more serious health condition, may feel extreme anxiety about their physical sensations,
they may feel that their healthcare provider, who they usually see frequently, is not taking their physical symptoms as seriously as they should.
Those are just three, you know, examples.
Yeah.
I think I've seen this Scrubs episode.
Yeah.
And Grey's Anatomy.
People with SSD may also be unusually sensitive to side effects of any medication they're prescribed, and they also may become dependent on others in terms of demanding emotional support for how they're feeling, or feeling upset or angry when they're not believed or their needs aren't met.
So, this is really, I would say, intricate.
Yeah, it really is.
It's not just, again, like, it's not just like, oh, you have this physical pain and you think it might be something more serious.
It's like, no, they have to go through all the stops, like, getting it checked out over and over, having recurring thoughts and, you know, obsessions about the symptoms.
Reading, yeah, exactly.
Reading the back of the label and seeing the side effects, like, oh, diarrhea, but it actually was the burrito you had for lunch.
Right.
Well, I'm not, I'm like, I pointed to me, like, off mic, you obviously don't, you all couldn't see that, but I say that because, like, you know, I have medication anxiety whenever I get prescribed a new medication.
I'm not even exaggerating.
All like, if I'm by myself, I'll text someone, like, okay, I'm taking the medication now, and I'll text them in 20 minutes and say I didn't have a reaction, like, because I'm so scared.
And that whole 20 minutes, I'm freaking the fuck out, like, something's gonna happen, something's gonna happen, like, I'm gonna have a reaction.
And then, of course, it never does, but I can definitely relate to this somewhat.
I don't think I have it, but I can relate.
I definitely feel like I've been difficult about medication.
I feel like I hardly ever take a Tylenol, unless I need to.
But, I'm afraid of it.
She's a tortured soul.
She doesn't believe in anything a doctor doesn't tell her.
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I would rather complain all day than take some fucking leave to get rid of my headache.
She won't take a dayquil if it's a day expired.
Oh yeah, no I definitely won't.
Which, you know the expiration date is only there to let you know how potent it is.
Yeah, I know. I'm well aware of the facts.
I'm also like, no not risking it. I like life.
I choose life. I appreciate it.
Yeah, you just be more frustrated about the fact that it didn't do shit.
Yeah, that's true.
As far as comorbid disorders go, about 30 to 60% of people with SSD will also have generalizing anxiety disorder, major depressive disorder, many phobias, or others.
Furthermore, SSD can be associated with true physical disorders such as IBS, fibromyalgia, and other chronic diseases, which can make it difficult because those do come with pain, and then that manifests into something else.
While the cause of SSD is unknown, symptoms of the disorder may come to the surface when a heightened awareness of a specific physical sensation occurs.
Personally, I believe that the onset of this disorder is at an older age because around 30 is when people start to truly become aware of themselves and how they would react in certain situations.
That's my opinion. I don't know.
Also because I'm close to 30, so I'm thinking from a personal perspective. Some people probably get that at different ages, but for me personally.
I just feel like I'm on my way out. My back hurts.
She eat ibuprofen every day.
Not ibuprofen.
Not me. I can't do that.
Neither.
Oh you can either?
No.
I'm not trying to get some swelling lips.
I know. Swelling lips and swelling things.
Swelling beans.
We have problems.
So many allergens that we've developed.
I'm allergic to Texas.
Yeah.
I figured it out.
I'm allergic to California. Kind of scared to go.
Yeah.
Anytime that I used to work at a grocery store and every time we would get their floral stuff in from California, I just hated it.
I just would avoid half of the store for an entire day.
Interesting.
It was really bad.
Well we don't need to go.
It's the sulfates.
I won't drink wine from there either.
Neither.
Okay well we're getting back to the story.
Not the story. Back to the information.
When it comes to people with SSD, it is common that they will be more likely to abuse drugs or alcohol as this may be a way to help them forget or numb the pain they're feeling and or mask the emotions that arise from the pain.
Oh that's rough.
So it's like, I don't like this pain. I'm going to try to get rid of it by drinking or smoking or doing whatever.
Self medicating.
Or I don't like how I'm reacting to the pain so I'm going to numb it with alcohol.
That's awful.
It's just, it's awful that someone has to resort to self medicating like that.
Right.
It's just, I mean, but it's a fact. It's a fact of life.
And personally, I think this is one of those like icky disorders. Not in like the disorder kind of way, but I mean like it's harsh because it tricks the person into not even recognizing that they might need help.
Yeah.
Like other disorders like depression and stuff like that. I feel like it's kind of like, okay, maybe I need to get a little help or it's really recognizable in a friend or a family member.
Yeah.
This one I feel like it's kind of sneaky.
It sounds like there's like a pretty, like there's tall tail signs like you're saying essentially about things like depression or schizophrenia.
But you're right. Something like this. There's one part of your life, two parts of your life, three parts of your life and you don't realize they're connected.
Yeah, exactly.
That is scary.
And not for nothing, but like the average person that doesn't do what we do and doesn't listen to our podcast, like our listeners are great.
Like they wouldn't know this unless they researched it.
Yeah.
I mean, I didn't know this until I researched it, you know. Yeah, it's really, it's really a shitty.
Other complications of the disorder include problem with relationships, unemployment or trouble keeping a job due to absences or other reasons and financial stress.
Obviously, because if you're going to the doctor a lot to get unnecessary testing, you know, over and over, you're going to have to spend some money.
Right.
Some studies suggest that people who experience certain life traumas can be more likely to develop SSD in their adulthood.
These include early childhood trauma, insecure attachment, poor self-esteem and others.
Do you think, do you think, I don't know if our family members, second wife might have had this?
That's a good point. I think it may have started out like this, but it developed into Munchausen.
Yeah.
Because I think she definitely had Munchausen towards the end.
Yeah.
But that's a good point. It might have started out like this.
And that's a good reason to be aware of these things and get the treatment when you recognize symptoms before it can turn into something else, you know.
This person came into our life much later in her life.
So I'm wondering if it didn't start out in her 30s as something like this.
Because then by the time our family member met her, you know, she was much older, the disorder developed into Munchausen.
And you know she wasn't getting treatment if there was any diagnosis or anything.
Yeah.
Well, there probably wasn't even a diagnosis.
Well, she did enjoy the shopping, so I'm wondering if that was her vice, instead of the drinking for self-medication, maybe the shopping was.
That's a good point, yeah.
Just lastly, psychosocial factors such as unemployment or reduced job performance may also be the developing factor for SSD.
So that's a good, yeah, certain things can happen in your life and it's just like, well, now I'm going to worry about everything.
And then as I worry, you know, gets manifesting, gets bigger and bigger and it can turn into this.
Hmm.
Researchers also believe that there may be a genetic component when it comes to SSD as well.
One study found that genetic components contributed 7 to 21% of somatic symptoms, with the remainder being left to environmental factors.
So 21% is not that much as opposed to 80% environmental or 79% environmental.
So it seems like environmental is like the kicker here.
Yeah.
Those who experience negative psychological characteristics are also at higher risk for developing somatic symptoms and having them last for a longer time after appearance as well.
Hmm.
Furthermore, individuals raised in high risk environments where expressing emotion is considered a negative thing, maybe at increased risk for developing SSD.
That makes sense.
Because you weren't allowed to and now you have all the freedom to.
Yeah.
It's going to be overabundant.
If someone believes that themselves or a loved one are experiencing symptoms of SSD, it's important to seek health care advice.
A primary care physician can do a basic physical to rule out anything physical and will also take a health history in order to determine if anything else could be going on.
If the test suggests that there is nothing physical happening, the doctor will be able to provide a referral to a psychiatric professional who can determine further what the cause of symptoms is.
In order to be diagnosed with SSD, a person must have one or more symptoms that cause distress or disrupt daily life for at least six months.
They must also have excessive thoughts, feelings or behaviors in response to the symptoms that meet at least one of the following criterion.
Oh.
Overly excessive and long lasting thoughts about the seriousness of the physical symptoms, continuously high levels of anxiety about health or physical symptoms, an extreme amount of time and energy focused on physical symptoms and health concerns.
If someone is diagnosed with SSD, the goal of treatment will be to manage the physical symptoms in order to try to lessen the somatic response to them, which I thought was interesting.
Yeah, you would think that you wouldn't treat it because it's not as quote unquote, severe as you would think.
But we're not going to treat how you're reacting.
Yeah, we're going to get to the base.
Like maybe Kenesalinas takes some fucking leave every once in a while and you won't have those pains that will turn into anxieties about those pains.
Yeah, there's literally people that take Tylenol every day.
I know.
And it's fine.
It's fine.
On top of this, general psychotherapy is usually recommended for individuals with SSD, specifically cognitive behavioral therapy, which honestly, CBT is the fucking goat because it can treat so many disorders.
Yeah.
If you have SSD, CBT can be helpful in evaluating your feelings and beliefs about your physical symptoms and health in general, finding ways to reduce stress and anxiety about your symptoms, stopping the focus as much on your physical symptoms, recognizing what seems to make the physical symptoms worse, finding ways to stay active and social, and overall function better in your daily life, which finding, recognizing what seems to make the physical symptoms worse is like so true.
Yeah.
Because it's like, you're causing that, again, using myself as an example, when you drink the next day, you're probably going to be anxious.
You might have a headache because you drank the night before.
Yeah.
But now I'm like, I'm dying.
I know what the next morning is.
Why?
Why is this happening to me?
Why do I have a headache?
Oh no.
Silly.
If necessary, a psychiatrist can also prescribe it antidepressant, but this is not in all cases.
When SSD is left untreated, it can lead to negative episodes that can get worse.
These include limited daily function, unemployment or poor work performance, psychological disability, decreased quality of life, and again, alcohol and substance use disorders.
However, SSD is very treatable, and many people see extreme improvement after beginning treatment.
There are other types of disorders that are similar to SSD, but can also be the cause behind some of these symptoms.
The first is illness anxiety disorder, aka, hypochondria.
So it's a little different.
Illness anxiety disorder.
Yes.
This is a mental health condition in which a person is preoccupied and excessively worried about having an illness or getting an illness.
Unlike SSD, a person experiencing illness anxiety disorder typically does not experience physical symptoms.
So it's not called hypochondria anymore?
Well, it's kind of interchangeable.
Okay.
So, this is a mental anxiety disorder, aka, hypochondria.
They have all of the thoughts and feelings about getting sick or being sick, but they don't experience the pain that leads them to those thoughts.
They just have the thoughts.
The other one is called conversion disorder or functional neurological symptom disorder.
This is a condition involving the function of your nervous system with no evidence of physical or neurological causes.
This disorder can cause symptoms that affects one's perception, sensation, or mobility.
While people with conversion disorder frequently experience depression or anxiety, excessive worrying and distress are not part of the disorder.
So it's the opposite.
They have all the physical symptoms, but not the aftermath.
And lastly, if you find yourself with a diagnosis of SSD, taking the following steps may be beneficial in your treatment.
Developing a supportive relationship with your PCP or primary care provider.
Only keeping one primary care provider as having many can be confusing and can waste money with unnecessary procedures.
And seeing your health care and mental health care providers regularly.
That's all I have.
Interesting.
I said that I was going to keep going and that I didn't.
And that's it.
Yeah, so that's a manic symptom disorder with a little peppering in of hypochondria.
And yeah, so I thought that was really interesting because again, when I looked up the disorder, I was like, oh, hypochondria through and through.
I know the difference.
So yeah, it's not.
It's not.
Wow.
But like I said, you know, this disorder is seemingly pretty difficult to recognize, especially in yourself.
So if you notice any loved ones or yourself having, now that you have this knowledge, you know, having any of these symptoms, like the best thing you can do, reach out to your health care provider.
Get, I mean, do your own research.
We always suggest people to do their own research and get that second opinion because honestly, the first step to feeling better is knowing that there's nothing physically wrong with you.
Yeah.
If I had all of the resources and money in the world, I swear to God, I would get a full body exam and a brain scan.
I feel like I'm going to want to.
Because I literally have this disorder.
I feel like people all, I feel like every person would.
I've been saying all episode.
I definitely don't have this.
I definitely don't have this, but I wish I had a full body scan.
She says.
No, I don't mean to make light of it, but I'm serious.
Like I really do feel like I resonate with this.
I don't know if I meet like the full criteria for the disorder, but I hope I educated someone with this info.
I think I'd be interested to look into the cultural differences between different countries because at least like here in America, we don't have free health care.
So things like it's not just having anxiety about not feeling well.
It's having anxiety about the financial cost.
It's having the anxiety about which health care provider is this the right person.
Is this person enacting fraudulently?
Just things like that.
Who's going to accept my insurance?
Yeah, exactly.
How much is this going to cost me?
Co-pay or God forbid you don't have insurance.
A lot of people don't have insurance.
So I'm wanting to know and I want to look it up.
Look difference.
I know for a fact there's been studies done on the cultural effects of this disorder and like the differences.
However, I wasn't comfortable writing down what I read because I wasn't 100% sure it was accurate.
But there is stuff out there on there.
On that.
So yeah, we can definitely look more into that for sure.
Yeah, again, like just the anxiety of not again just having not just the disorder, but the concern and the money and all the time and patience that it takes to do all that.
Right.
Is alone, you know, can be an issue and a contributing factor to that anxiety.
Yeah, and like we said earlier, environmental is like 80% of the root cause of this disorder as they think.
So environmental obviously different cultures and different regions and areas are going to affect that.
Yeah.
Well, yeah, that's my mental breakdown.
Interesting.
Can you read it?
You think they made my point.
I think I made my point.
Anyway, we are so excited to see everyone at the true crime and parol on my back as possible.
Don't forget it's my birthday on Sunday.
You guys come and you mention us and be like, I know you already.
Yes.
Free Koozie just telling you.
Oh, fuck yes.
Free Koozie exclusive free self free free self free free.
We weren't going to charge anyway, but free.
We're not in a position to.
Yeah.
But yes, free Koozie.
I'm done with that.
Again, these are exclusive merch items that you can only get at TCEPF.
That's very true.
And also don't forget we're going to start to change our merch look like throughout the end of the year.
We're definitely going to have some new designs in the work and some just just different.
Like I think we're going to revamp our merch and just just get some new shit going because we're excited.
We're getting, oh my God, we're getting this.
We're getting this.
She's really excited.
Really excited.
Really excited for the merch.
Oh God, I'm going to cry.
Anyway, and I'm going to be old.
I think that's like my mind trying to trick me that I'm going to be old.
You're going to be 30.
I'm going to be 29.
You're going to be 29.
Yeah, you're fine.
Okay, I got a year.
Don't get me that look yet.
You got a year.
You're fine.
You find your birth certificate tomorrow and it's a year later.
That would mean I was 28.
You're already 30.
No.
No, you're earlier.
No, you're earlier would be.
If that was born a year earlier, I would be 30 this year.
That was born a year later.
All right, we got to go.
Love you.
Bye.
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