I'm dealing with chronic pain and fatigue; after several specialists were unable to find the cause, I was referred to a pain clinic. I had an evaluation with a psychiatrist today, and at the end I asked him about his findings. Among other things, he said there was evidence of Somatization Disorder. But I don't think that is it; I think the pain has a physical cause. But if I do have Somatization Disorder, I would think that anyway. How do I determine if that is the problem or not, and if not, how do I make sure my doctors don't dwell on it.
posted by [insert clever name here] to Health & Fitness (11 answers total) 6 users marked this as a favorite
I've been dealing with issues of fatigue for a couple years, and about a year and half ago it started getting bad, and I would occasionally have pain associated with it. The pain started getting worse and more frequent starting summer of 2011, and was really bad and daily fall of 2011. I also have a ton of other symptoms, insomnia, restless leg syndrom, dry hair, daytime sleepiness, IBS, horrible, painful acne, brain fog etc . . . Many tests have been done, and no answer found. But they have found some things, like low potassium periodically, blood in my urine with no cause, low vitamin d, increased SED rate. But nothing that points to a specific problem. Anyway, I'm giving the short version. I've seen a lot of doctors and no one can say what the problem is. One doctor says fibromyalgia is a strong possibility.
Fast forward to now, referred to a pain clinic where I met with a psychiatrist for evaluation before treatment. After it was done, I asked about his results, and he said possible fibromyalgia with symptoms of fatigue, but there is also evidence of somatization disorder. Now, I can see how he got there, but I don't think somatization disorder is a correct assessment. But, of course I wouldn't think that's the problem, people with somatization disorder don't think that's the problem.
I understand how he came to that conclusion - my father was abusive, and right now, I get depressed easily, especially when think or talking about my illness, largely from frustration about not knowing the cause and being limited in my abilities. My life has been interrupted, I'm not working and I spend a lot of time just hurting. I've had medical issues going back years (though mostly migraine and allergies), and the doctors haven't found a physical problem of the pain and fatigue.
But here is why I doubt somatization disorder - The year leading up to this was a fucking fantastic year. I was having a great year, I was in a good mood, I recently had a promotion at work. I was getting job offers left and right, my hobby was going well and I was getting recognition as an expert in that community. My home life was good, I was feeling good, other than physical symptoms. The abuse from my childhood was the furthest thing on my mind.
. . . But I kept getting more and more tired and more pain.
It's likely I was overextended, but I certainly was enjoying myself. Not that everything was perfect, there were of course ups and downs, but overall it was pretty good and I was feeling pretty good.
Even when this first started, I was still doing okay mentally. I was frustrated at not finding a cause, and frustrated with being unable to do normal daily activities. But I thought I'd get better soon and so overall it started out feeling like it might be a nice little break then I'd get back to things. The pain caused/causes me to be irritable and depressed, but I think it's safe to say that's a pretty normal reaction. It was really only the last few months when it's become apparent that my doctors aren't finding a cause and I probably won't be getting better soon. This strikes me as a perfectly normal reaction.
I genuinely don't think I have a psychological reason that would cause my body to express pain. The abuse stuff is in the past and it doesn't bother me anymore, if anything I've gotten better about dealing with it and telling people in a matter of fact way rather than getting upset about it or hiding it. I also rarely actually think about it, having left that life behind. I only bring it up as my reading on somatization disorder suggests that many people with the disorder dealt with childhood about. And there really isn't anything else going on in my life that would cause psychological distress. Even now, feeling disabled and in pain, I still generally have a positive outlook; I keep in touch with friends, I am trying to work on a few projects as I have the energy. I'm even looking forward to treatment with the pain clinic so I can either learn to adjust to living with this or to get better.
But I would say that if I had somatization disorder, wouldn't I?
I feel it's a bit damned if I do, damned if I don't situation. If I don't have somatization disorder, I won't think I have it. But if I do suffer from somatization disorder I also won't think I have it. In short, if someone has somatization disorder, they'd do the same exact things as someone looking to treat a physical illness.
I guess my question is in short; how do I deal with this? I don't want the doctors treating me as if it's all in my head in lieu of finding a cause or relief and I don't want to be marginalized because it's "all in my head". But I also want to be able to come to terms with it if it is all in my head.