The Lovely DSM-5 & Somatoform Disorders

There have been some changes recently to the DSM-5 concerning Somatoform Disorders. I happen to have a Somatoform Disorder called Conversion Disorder. A very controversial diagnosis that no one Scientist or Psychiatrist can agree on. So I thought I would give some information on what is considered a Somatoform Disorder and as much info about the other disorders without putting you to sleep. Somehow I think there will be lots of snoring. But it’s important to me because I live with it.

Somatoform Disorders and Anxiety Disorders now fall under the category of Somatic Symptom and Related Disorders. Could they be any more vague? Somatic Symptoms can result from Anxiety, Depression, and Trauma.

All Somatic Symptom and Related Disorders have a common characteristic. There are bodily symptoms that cause stress and impairment BUT there is no Medical reason or Diagnosis for the symptoms. Individuals have legitimate health conditions but with no known explanation.

Illness Anxiety Disorder is a Somatoform Disorder where a person worries excessively about having a medical illness. This used to be called Hypochondria. Most people with this disorder will usually have it present in a medical setting and not a Mental Health one. They are more concerned with the meaning, cause, and course of their medical complaint. They may research their illness or concern obsessively.

My mother may have had a form of this. She kept a Medical Journal in her bedroom with every disease or ailment known to man in it. It also had anatomically correct drawings of the area of the body being discussed. She was often at the Doctors where they wouldn’t find anything really wrong with her. Some would get tired of her and say she had something small wrong with her or some would take advantage of her. I remember one Doctor put her in Traction in a Hospital Bed in the middle of our Living Room. She didn’t need it. As a family we grew used to her list of ailments and also our sympathy level decreased over the years. When she was 55 she was diagnosed with Lung Cancer. It had already gone to her lymph nodes. For someone who was always at the Doctors to have them miss this was unbelievable to us. They removed 1 lung and a small portion of the other. She lived for an amazing 7 years after that.

Conversion Disorder is an impairment in sensory or motor function that results from an unknown neurological origin.

When it’s Sensory the vision, hearing and skin sensation can be involved, also seizures and sometimes coma.

Motor Function is more complicated with symptoms involving tremors, speech difficulties, walking, fainting, trouble swallowing, overall weakness, and abnormal movements.

You have to meet a certain criteria to be diagnosed with Conversion Disorder.

1. One or multiple symptoms of altered voluntary motor or sensory function.
2. Testing by Doctors rule out a cause for symptoms.
3. Symptoms are not explained by another medical or mental disorder.
4. Symptoms cause significant stress in social, occupational, and other important areas of life.

Conversion Disorder is usually caused by a traumatic event that the brain does not want to remember. Instead it manifests itself in physical ways.

I have been diagnosed with Conversion Disorder by two Doctors. It is a difficult diagnosis to accept. I remember when the I was first told my hands felt numb and I could hear the blood rushing in my ears. I couldn’t comprehend what was being said. I wasn’t faking my hands shaking or my stutter. How could I? All these thoughts raced through my head that everyone would think I was a liar. Then I thought “Wait. What is so bad that I don’t want to remember? The stuff I do remember is bad enough.” It was then I started to cry and couldn’t stop. As most of you know this was when the Doctor wanted to videotape me and was very excited to have found me. It’s been several years and under stress, fear, or fatigue, I still stutter and tremor.

Most people recover when they are told that they have Conversion Disorder. It seems to make something in the brain click and make sense. But for those of us that go undiagnosed for a long time and have mostly Motor Functions affected it is harder to treat and sometimes never goes away.

This next one I disagree with being in this Category at all.

Factitious Disorder or what used to be known as Munchausen By Proxy. This usually involves falsifying an illness in someone else for the attention, usually children. People with this disorder have a clear intention to deceive and hurt themselves or others. They are conscious of their behavior. This is why I feel the DSM-5 fails here.

They still have a long way to go before they ever come close to getting a Diagnostic Manual correct. This isn’t a cookie cutter world and unfortunately some Doctors swear by this Manual. Which only causes more stigma and harm.