Psychosomatose

Mental stress can manifest itself in physiological disorders, which subsequently represent an independent complaint and require correspondingly adapted therapeutic measures. Patients often experience a considerable amount of suffering, not least because the context between the mental health problems and their illness often goes unnoticed for a long time.

contents

definition
symptoms
causes
diagnosis
treatment
Naturopathy in psychosomatoses

definition

As psychosomatosis are physically referred to diseases that go back in their development on mental impairments. While in the field of psychosomatic also physical complaints that are caused by psychological stress but are purely functional in nature (somatoform disorders), the term "psychosomatosis" is narrower and refers exclusively to mentally-related organ diseases. They are also delineated by psychosomatic problems that can occur as a result of illness. A good overview of the psychosomatoses is provided by the psychoanalyst Franz Gabriel Alexander from the year 1950. The classic psychosomatic diseases known as "Holy Seven" form:

• bronchial asthma
• Hypertension (essential hypertension)
• Inflammatory bowel disease (Crohn's disease, for example)
• eczema
• Rheumatoid arthritis (Chronic polyarthritis)
• Hyperthyroidism (hyperthyroidism)
• Gastric Ulcers (Ulcus Ventriculi) and Duodenal Ulcers (Ulcer Duodeni)

In the case of hypertension, it is true that initially a purely functional complaint should be assumed, which would speak against a classification as psychosomatosis, but in the further course impairments of the vascular structures and other organs may be added. In addition to the "Holy Seven" there is a possible correlation with mental stress in many other physical illnesses, but in most cases this is significantly less marked than in the "Holy Seven". In the broadest sense, organic disorders due to eating disorders such as bulimia or anorexia nervosa are also to be understood as psychosomatoses. However, these are commonly defined as a mental disorder with physical consequences. The International Statistical Classification of Diseases and Related Health Problems speaks of "behavioral problems with physical disorders and factors".

The definition of "psychosomatosis" suggests a relatively simple causality of the physiological complaints. However, this is not consistent with the approaches of modern psychosomatics, which assume a complex interaction between physical and psychological factors. Although the symptoms mentioned above can generally be regarded as having a significant influence on the development and course of psychological stress, one-sided causality, as it is the basis of the psychosomatosis model, no longer corresponds to the current state of research.

symptoms

The symptoms of psychosomatoses can vary greatly according to their manifestation. They range from imperceptible increases in blood pressure, changes in the appearance of the skin in atopic dermatitis, respiratory ailments and coughing in asthma, abdominal pain, gastric pressure, diarrhea, nausea and vomiting in gastric ulcers and chronic bowel disease, to joint and limb pain in rheumatoid arthritis. Every form of psychosomatosis is characterized by its own specific clinical picture, which usually does not initially foreshadow the connection with mental stress. However, those affected may find that with increasing stress and suffering, the intensity of the symptoms increases. With the eating disturbances the starting situation is somewhat different, since here the connection between the appearing symptoms and the eating disturbances is usually clearly recognizable also for laymen.

Psychosomatoses are often associated with discomfort in the digestive tract, such as abdominal pain, gastric pressure, diarrhea or nausea and vomiting. Image: gpointstudio / fotolia.com

causes

The causes of psychosomatoses are, by definition, to be found in psychological stress. However, it can be differentiated here diagnosed mental disorders (for example, depression or anxiety disorders) and general mental health problems, such as prolonged stress or intense grief. The way in which the suffering of the soul causes the physical discomfort is in most cases still not fully understood. Also, some of the supposedly psychosomatic illnesses have been found to be far more important than originally thought. For example, it is known today that the majority of gastric ulcers and duodenal ulcers are caused by the bacterium Helicobacter pylori, and that mental stress plays only a minor role here. However, it can be surmised that stress and mental conflicts generally have a detrimental effect on the immune defense and therefore favor pathological propagation of the bacteria. Here the interaction between physical and mental causes of the illnesses becomes clear.

diagnosis

It is often relatively easy to diagnose the physical symptoms of the different forms of psychosomatosis. For example, every dermatologist will recognize atopic dermatitis. A gastric ulcer or duodenal ulcer can be detected by gastroscopy and, if necessary, the removal of a tissue sample (biopsy). A pulmonary function test is used to diagnose asthma and blood tests provide evidence of possibly existing hyperthyroidism, polyarthritis and inflammatory bowel disease. To diagnose the latter, an ultrasound examination of the abdomen is often performed. In addition, other imaging techniques such as contrast agent-based X-ray or magnetic resonance imaging in chronic inflammatory bowel disease can serve to secure the diagnosis. Furthermore, there is the possibility of a colonoscopy with removal of a tissue sample, also to exclude tumor disease in the intestinal tract.

Although the various clinical pictures of psychosomatoses can be reliably diagnosed, but this is usually not clear, is the connection with the mental health problems of those affected. Accordingly, considerable difficulties may arise in the course of therapy, since the actual cause of the complaints remains unrecognized.

treatment

In order to alleviate the physical symptoms, effective remedies are available for the various psychosomatic disorders, but they do not take into account the cause of the discomfort. For example, itchy rash, as it occurs in atopic dermatitis, can be relieved relatively reliably with anti-inflammatory and antiseptic ointments. However, the highly effective ointments based on glucocorticoids (colloquially "cortisone ointments") have a high risk of side effects, so that they can be used only over a limited period of time. After discontinuation of the preparations, however, the symptoms often recur. The situation is similar in most other psychosomatoses. Although there are various therapeutic - mostly drug-based - approaches to alleviate the symptoms, but after the end of therapy threatens a renewed outbreak.

In view of the influence of psychic factors on the development of psychosomatoses, it can be concluded that a cure can be achieved with the help of a psychotherapeutic treatment. However, although psychotherapy has been shown to have a positive effect on the disease in most cases, it is usually not possible to achieve complete healing with its help alone, since the physical manifestations of mental suffering also require physical treatment. The best results can therefore usually be achieved with the combination of medical and psychotherapeutic treatment. For example, acute forms of a non-bacterial gastric ulcer can be treated on the basis of so-called proton pump inhibitors, while those involved in accompanying psychotherapy also learn how to best cope with stress and other mental stress. For example, special relaxation techniques such as autogenic training, yoga or progressive muscle relaxation are quite helpful.

In psychosomatic asthma a relatively reliable relief of the acute symptoms by means of so-called inhalers is possible, with the help of psychotherapy, however, can rather influence the long-term disease course positively. In atopic dermatitis psychotherapy is also a good concomitant therapy, as stress has an adverse effect on the disease and the affected also learn in the context of psychotherapy to better deal with the constant itching. Finally, in all psychosomatoses psychotherapy offers at least a meaningful supplement to conventional therapy, in some cases it can even bring about a complete resolution of the symptoms in combination with conventional treatment.

Naturopathy in psychosomatoses

In addition to the already mentioned approaches of psychotherapy, naturopathy holds some further treatment options against the various forms of psychosomatoses ready, at this point in particular herbal supplements (valerian, hops, Bach flowers) and homeopathic remedies (especially Nux vomica) are worth noting for stress relief. Also, a change in diet or a nutritional therapy can certainly have a positive effect. This is especially true for the psychosomatic diseases in the digestive tract. Naturopathy is based on a complex interplay between mind and body in all symptoms, which must also be taken into account in the treatment. However, not only the effect of mental stress on the organism is to be considered here, but it is also in supposedly purely mental suffering for possible physical causes researched. For example, certain psychosomatoses may be accompanied by physical treatment in the form of acupuncture, massages or manual therapies. Which measures from the broad spectrum of naturopathy come to the application ultimately depends on the individual symptoms of the affected person. (Fp)