Psychosomatics

In the Psychosomatics it is a special sub-area of ​​human medicine. The school takes an approach according to which psychological properties can also directly or indirectly influence physical health.

There is thus an inseparable connection between psyche (spirit) and body. The therapy of psychosomatic illnesses requires a holistic treatment concept that is composed of psychotherapeutic, psychiatric and somatic parts.

What is psychosomatics?

The medical term psychosomatic comes from ancient Greek. It is composed of psyche for breath, soul or breath as well as soma, which means as much as life, body or body. The medical teaching of psychosomatics assumes that there is an inseparable connection between body and psyche, which is characterized by interactions.

The course of a purely physical illness (somatic illness or somatic disorder) can therefore be largely determined by the mental, i.e. H. the psychological or mental condition of the person affected can be influenced. Based on this connection, it is also possible that certain physical complaints have exclusively psychological reasons. These are called psychosomatosis in the professional world. It is not uncommon for them to be based on essential feelings such as depression, fear or guilt. Usually the intensity of the feelings experienced is above average.

In the literature it is partly assumed that basically purely somatic diseases such as gastroduodenal ulcer disease or bronchial asthma can be traced back to psychological causes. However, this view is not undisputed.

In addition to the term psychosomatosis, there is another important basic term in psychosomatics, somatoform disorders. Somatoform disorders are those mental disorders that lead to recurring physical symptoms. Those affected usually demand a physical examination with particular emphasis. And that although previous investigations were already inconclusive. Little or no faith is given to the results of the medical examination. Instead, sufferers insist on their avoidable symptoms and feel badly treated.

Treatments & therapies

The exact form of the indicated treatment depends on the underlying disease and thus on the cause of the psychosomatosis or the somatoform disorder.

It is known from clinical practice that, for example, punctual functional disorders of the body can occur as a side effect of certain conflicts or emotions. These then present themselves as an indirect or direct consequence of an often psychological trauma. These cases include adjustment and anxiety disorders as well as post-traumatic stress disorders (often also called PTSD or PTSD) or burnout.

However, conversion disorders or hypochondria, a special form of somatoform disorder, also belong to the field of psychosomatics. Often, psychosomatoses can also be traced back to mental disorders or personality disorders. This is especially true for abnormal sensations in the body such as sensory disturbances in certain parts of the body (e.g. hands, feet). But depression can also have physical effects that lead to a general deterioration in health and listlessness.

The spectrum of treatment in psychosomatic medicine is broad. Because psychosomatic therapies usually require holistic approaches. A treatment therefore consists of psychotherapeutic, physical and psychiatric elements. Outpatient treatment can be provided by specialists in psychosomatic medicine, psychiatrists or psychotherapists. There is also the option of being treated as an inpatient in psychosomatic acute hospitals. This guarantees more intensive care and recovery from everyday life. Rehabilitation is also possible under psychosomatic aspects. These special rehabilitation measures are mainly used after, during or for the treatment of anxiety disorders, burnout, depression or similar illnesses.

In addition to classic psychotherapeutic therapeutic approaches, drug treatment may also be necessary. Numerous neuroleptics and psychotropic drugs are available for this purpose. Serotonin or dopamine antagonists are often used because they have calming effects. It is also possible to use placebo effects.

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Diagnosis & examination methods

Due to the strong intertwining of physical and psychological causes, the diagnosis of psychosomatics is not easy. It is imperative to do extensive physical exams beforehand.

Obtaining independent second or third opinions is often advisable. A finding of a psychosomatic disorder is usually only possible at the end of a long chain of examinations. It is also common to carry out technical diagnostic procedures such as MRT, CT or the production of X-ray images. This means that only physical causes can be excluded.

The first examination and diagnostic procedures are usually carried out by the family doctor. Because the general practitioner is often the first point of contact for patients who have specific physical complaints. Depending on the severity of the physical symptoms, this will be referred to a specialist in somatic diseases. Orthopaedists, neurologists and dermatologists can be considered.The specialist will initiate more detailed examination and diagnostic procedures that are tailored to the respective complaints. If this rules out physical causes, a diagnosis of psychosomatic diseases can be considered confirmed.

The further treatment of the complaints is then carried out by psychotherapists, specialists in psychosomatics or psychiatrists. If both physical and psychological causes are identified, a comprehensive and holistic treatment concept is required. Patients are then treated by both somatic and psychological specialists. It is important here that both doctors are fully informed in order to coordinate their measures in a targeted manner.