Psychosomatics is a special branch of human medicine. The school is based on a way of looking at things, according to which mental characteristics can also indirectly or directly influence physical health. There is thus an inseparable connection between psyche (mind) and body. The therapy of psychosomatic diseases requires a holistic treatment concept consisting of psychotherapeutic, psychiatric and somatic parts.
What is psychosomatic medicine?
The medical term psychosomatic comes from ancient Greek. It is composed of psyche for breath, soul or breath as well as soma, which means life, body or body. The human medical doctrine of psychosomatics assumes that there is an inseparable connection between body and psyche, characterized by interactions. The course of a purely physical disease (somatic disease or somatic disorder) can therefore be significantly influenced by the mental, i.e. psychological or spiritual condition of the person affected. Based on this connection, it is also possible that certain physical complaints have exclusively psychological causes. These are called psychosomatosis in the professional world. They are not infrequently based on essential feelings such as depression, anxiety or guilt. In most cases, the intensity of the experienced feelings is above average. In the literature it is partly assumed that basically purely somatic diseases such as gastroduodenal ulcer disease or bronchial asthma are due to psychological causes. However, this view is not uncontroversial. In addition to the concept of psychosomatosis, another important basic concept of psychosomatics exists in the form of somatoform disorders. Somatoform disorders are mental disorders that lead to recurring physical symptoms. Affected persons usually demand a physical examination with particular insistence. And this despite the fact that previous examinations have already been inconclusive. The results of the medical examination are either given little or no credence. Instead, those affected insist on their avoidable symptoms and feel badly treated.
Treatments and therapies
The exact form of treatment indicated in each case depends on the underlying disease and thus on the causative agent of the psychosomatosis or somatoform disorder. It is known from clinical experience that, for example, selective dysfunctions of the body can occur as a concomitant 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 disorder (often called PTSD or PTSD) or burnout. However, conversion disorders or hypochondria as a special form of somatoform disorder also belong to the field of psychsosomatics. Often psychosomatoses can also be traced back to mental disorders or personality disorders. This is especially true for insensations of the body, such as sensory disturbances in certain parts of the body (e.g., hands, feet). But depression can also have physical effects, leading to a general deterioration in health as well as listlessness. The treatment spectrum of psychosomatics is broad. This is because psychosomatic therapies usually require holistic approaches. Therefore, a treatment is composed of psychotherapeutic, physical and psychiatric elements. Outpatient treatment can be provided by specialists in psychosomatic medicine, psychiatrists or psychotherapists. In addition, there is also the possibility of inpatient treatment in psychosomatic acute hospitals. This ensures more intensive care and a recovery far away 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 classical psychotherapeutic therapy approaches, drug treatment may also be necessary. Numerous neuroleptics or psychotropic drugs are available for this purpose. Serotonin or dopamine antagonists are often used, as these have calming effects. In addition, it is also possible to rely on placebo effects.
Diagnosis and examination methods
Due to the strong interconnection of physical and psychological causes, the diagnosis of psychosomatics is not easy. It is imperative to perform comprehensive physical examinations in advance. Obtaining independent second or third opinions is also often indicated. The finding of a psychosomatic disorder is therefore regularly only possible at the end of a long chain of examinations. It is also common to carry out technical diagnostic procedures such as MRI, CT or the production of X-ray images. In this way, exclusively physical causes can be excluded. The first examination and diagnostic procedures are usually performed by the general practitioner. This is 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 complaints, he or she will refer the patient to a specialist in somatic diseases. Orthopedists, neurologists or dermatologists, for example, may be considered. The specialist will initiate more detailed examination and diagnostic procedures tailored to the particular complaints. If this rules out physical causes, a diagnosis of psychosomatics can be considered confirmed. 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. Here, it is important that both physicians are fully informed in order to coordinate their measures in a targeted manner.
