22-year-old Radha was brought for psychiatric evaluation by her parents and husband. Her parents reported that she had been complaining of multiple pains and bodily symptoms for several years.
Her husband reported that ever since their marriage a year back, she frequently complained of various physical symptoms for which three separate medical evaluations and numerous medical tests had been done and everything had been found normal. The symptoms kept changing – one week it was back pain, next week it was breathlessness, more often there were multiple symptoms. These were a cause of intense worry for Radha who then became irritable and anxious and feared the worst when symptoms appeared. She rarely had a period of time free from symptoms.
Her most frequent complaints were headache, backache, chest pain and pain over the calves. She also reported throbbing pain in her abdomen. She was totally disinterested in sex. She sometimes felt numb and got a ‘pins and needles’ sensation all over. She also felt giddy and complained of shortness of breath and a trembling sensation. She denied feeling sad but was anxious about her physical problems. She felt handicapped by the pains and physical symptoms and was not able to her household chores.
Radha worried a lot about physical symptoms. For example, she frequently feared she had kidney stones (when her back ached), or cancer (when she had abdominal pain). Chest pain made her feel that it was an impending heart attack.
She also had a habit of reading about her symptoms and possible diagnoses on the Internet and this worsened her anxiety and insistence on seeing a ‘specialist’.
Radha felt that she has not yet received a proper medical evaluation and became adamant that her husband must take her for another opinion. She also said that she was not happy to see a psychiatrist but had come only at the insistence of her physician, husband and relatives.
There is no history of drug abuse, depression or any other medical or psychiatric illness. She was an average student, did not pursue higher studies after her graduation and was not interested in pursuing a career. She reported that her main hobby was watching TV and ‘browsing the Internet’.
Radha’s condition is common – often people have bodily complaints for which no physical cause can be found after extensive tests. In such cases, psychiatric disorders have to be ruled out. Several Psychiatric conditions present with somatic symptoms.
Radha was diagnosed by her psychiatrist as a case of ‘Somatic Symptom Disorder’ and was started on a course of psychiatric medication. He also referred her to a clinical psychologist for Cognitive Behavior Therapy.
As the medical treatment and therapy progressed, the patient made considerable progress and was able to get back to normal life – the pains and bodily complaints decreased; and even when they occurred, the patient was able to keep them aside and get on with her normal pursuits. She stopped frequent medical consultations and physical tests and avoided reading about medical conditions on the internet. She took up work as a volunteer in a school for handicapped children and found considerable satisfaction doing this work.
Please note that the information in this case study should not be considered as medical advice for an individual’s condition. If anyone shows or feel symptoms of a possible medical condition, we strongly encourage you to seek advice from your primary physician or a mental health professional for an evaluation as soon as possible.
The names been changed to protect the privacy of individuals.