Somatic Symptom Disorder vs Illness Anxiety Disorder: What’s the Difference?
Both conditions involve intense health-related anxieties, but they have different symptoms and causes. In this article, we compare and contrast the two, and provide information on how to seek help for both.
Clinically Reviewed By: Don Gasparini Ph.D., M.A., CASAC
December 5, 2023
Table of Contents
Health-related concerns are increasingly common, fueled by the COVID-19 pandemic and the rise of online health information. However, if constant health concerns are interfering with your daily life, it may be a sign of an underlying mental health condition. Two such conditions are somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both conditions can impact daily functioning and involve excessive health concerns, but SSD involves distressing physical symptoms with no clear medical cause, while IAD is marked by excessive worry about developing a serious illness. Below, we delve into the difference between the two mental health conditions and evidence-based treatment options for both.
The similarities between somatic symptom disorder and illness anxiety disorder
Excessive health concerns
Health-related behaviors like frequent doctor’s visits
Significant impact on daily life
Chronic conditions that persist without treatment
Talk therapy is a treatment option for both conditions
Excessive health concerns
With both conditions, people are preoccupied with worries about their health, believing that any physical symptom could be a serious medical condition, often leading to heightened anxiety and distress.
People with SSD and IAD may both frequently go to doctor’s offices and ask for various tests. They may also both seek reassurance about their health from friends and medical providers.
Significant impact on daily life
Both conditions can greatly disrupt daily life and cause significant distress, impacting a person’s ability to engage in regular activities.
SSD and IAD are both chronic, meaning symptoms persist over time and are recurrent, especially without treatment.
Treatment for both conditions often involves psychotherapeutic interventions (talk therapy) with similar therapeutic approaches, such as cognitive behavioral therapy (more on this below).
The differences between somatic symptom disorder and illness anxiety disorder
SSD symptoms are related to tangible physical health symptoms (chronic pain, gastrointestinal distress, headaches, and more) whereas IAD manifests as intense health-related worries not always connected to a specific physical symptom.
Although both conditions must be diagnosed by a medical or mental health professional, the diagnostic criteria are different. SSD requires tangible physical symptoms that cause significant distress whereas IAD is diagnosed based on someone’s excessive health-related worries.
The cause of both conditions is not entirely certain, but the research that does exist suggests different causes. Studies have indicated that SSD might be associated with psychosocial stressors, childhood neglect, sexual abuse, a history of substance abuse, or even certain personality disorders. Also, for those with SSD, stress can trigger physical symptoms( like heart palpitations, upset stomach, muscle tension, and chronic pain) perpetuating a cycle of symptoms and worries. IAD, by contrast, is linked to factors like having a generalized anxiety disorder, growing up with a family member who had health anxiety, experiencing a serious illness in childhood, or spending a lot of time reading health-related material online.
SSD is more common than IAD, according to available data. Research suggests about 5% to 7% of the general population may have SSD, whereas, in medical outpatient settings, 0.1% or less of people are estimated to have IAD.
Gendered biases in healthcare
When discussing the gender prevalence of SSD and IAD, it’s important to consider gender biases and gaslighting in healthcare. Unfortunately, several studies have shown that compared with patients assigned male at birth, female-identifying clients who present with similar symptoms may not receive the same caliber of care. In key areas like heart health and pain management, this may lead to poorer outcomes, research shows.
Regardless of your gender, if you’re experiencing chronic physical health symptoms (like those in SSD and IAD) but being dismissed by medical professionals, you should consider whether to persist with advocacy or trust that you’re healthy and concentrate on your mental well-being. There’s no right answer for everyone, but taking the following steps may help you figure out how to proceed:
- Find a primary care physician that you trust. This does not mean someone who orders every test you suggest, but rather someone who really listens to your health concerns. Sometimes this might mean finding a physician who matches your gender.
- Ask your doctor to explain the results of tests and why this helps to rule out diseases.
- Have someone come with you to appointments and take notes.
- Keep in mind that seeking a second opinion is normal (but you may want to reconsider your approach before seeing a tenth option, for example).
Treatment options for somatic symptom disorder and illness anxiety disorder
Both SSD and IAD are treatable, and, as mentioned, involve similar treatment approaches, typically including a combination of psychotherapy and medication. Cognitive behavioral therapy (CBT), can help people with both conditions address and modify dysfunctional thought patterns related to physical symptoms, health-related anxieties, and help-seeking behaviors. In addition to therapy, medications such as selective serotonin reuptake inhibitors (SSRIs), which have FDA approval for depression, generalized anxiety, social anxiety disorder, panic disorder, and more, can help alleviate SSD and IAD symptoms in certain people.
How Charlie Health can help with somatic symptom disorder and illness anxiety disorder
If you feel fixated on the possibility of having a medical condition or can’t get through your day without health-related worries, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for young people dealing with complex mental health conditions, including health-related conditions, generalized anxiety disorder, and more. Our expert clinicians incorporate evidence-based therapy, like cognitive behavioral therapy, into individual counseling, family therapy, and group sessions. With treatment, managing SSD and IAD is possible. Fill out the form below or give us a call to start healing today.
D’Souza RS, Hooten WM. Somatic Symptom Disorder. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532253/
Kurlansik SL, Maffei MS. Somatic Symptom Disorder. Am Fam Physician. 2016 Jan 01;93(1):49-54.