Stress and anxiety are increasingly common problems in today’s society.. According to the World Health Organization (WHO), some 260 million people around the globe suffer from some type of anxiety problem, whether temporary or generalized.
Generalized anxiety disorder (GAD) is a particularly worrying clinical entity, as it is estimated that up to 5% of the population in high-income countries suffer from it. The lifetime prevalence is up to 8%, meaning up to 8 in every 100 people will suffer from this long-term disorder at some point.
Transient stress is a positive thing, since it is a clear adaptive response. When we feel stressed, the cortisol released favors the synthesis of glucose from non-carbohydrate precursors (gluconeogenesis), suppresses the immune system and promotes the metabolism of fats, proteins and carbohydrates. In the same way, adrenaline increases heart rate, constricts blood vessels, dilates bronchi and many other things. The answer is clear: prepare the body for fight or flight.
In the short term, these hormones prepare us to be as active as possible in a dangerous situation and respond with maximum biological efficiency. The sharpness of the reflexes at these moments and the amount of energy obtained by the metabolism can literally save our lives. The problem occurs when this state of alert goes from being transitory to chronic, as it can take its toll on the entire body. Based on this premise, we tell you everything about stress and somatizations.
First of all, it is necessary to lay some foundations regarding these terms. Stress is the immediate physiological response that we have just described, of rapid onset and ephemeral nature.. Once the exogenous trigger disappears (a loud noise, a scare, a barking dog or realizing that you have lost your keys), the patient’s physiological situation stabilizes.
Unfortunately, anxiety persists once the immediate problem is not present. Furthermore, if the symptoms persist, Anxiety goes from being a slightly more prolonged physiological event to a pathology that must be treated: generalized anxiety disorder (GAD).. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA), GAD is characterized by the following events:
As you can see, the differential line between anxiety and GAD is fine, but above all it lies in the time scale in which the symptoms are recorded. It is normal to feel anxious a few days before receiving a response from a job interview, but not to spend half a year with the symptoms described above.
Relationships between stress, anxiety and somatization
We have already made it clear that stress is temporary and natural, anxiety usually stays for longer and GAD is chronic in nature and is considered a pathology. This was necessary, because in reality, somatization is much more related to GAD than to the rest of the variants.
The term “somatization”, in medical practice, refers to physical complaints that cause discomfort, in the absence of clinical findings that justify an organic cause. It is a very common reason for visiting primary care (up to 25% of cases) and, curiously, up to 70% of the pain that these people present remains unknown even after medical evaluation.
Here we enter another pathological group: somatic symptom disorder (SSD). As indicated in the medical article Somatic Syndrome Disorders, published on the StatPearls portal, this disorder is considered such when the patient presents the following clinical signs:
The study “The Relationship Between Symptoms of Anxiety and Somatic Symptoms in Health Professionals During the Coronavirus Disease 2019 Pandemic” investigated the correlation between anxiety and somatization in a group of health professionals (N=606) during the beginning of the virus pandemic. COVID-19. This sample group was chosen due to the intense concern that these workers suffered at almost all times in the hospital setting and because of the uniqueness of the situation.
This study showed that more than 20% of healthcare professionals with somatic symptoms also had anxiety or generalized anxietywhich establishes a non-negligible correlation between both events.
As if this were not enough, one of the clearest symptoms of GAD is stomach pain and gastrointestinal imbalances. Pains and punctures in the stomach are one of the first signs of anxiety, since peristaltic contractions and unnecessary muscle movements occur in response to the physiological imbalance. The patient does not have an ulcer or a tumor, but it is his own stress and anxiety that is causing the pain that worries him so much.
Is there a correlation?
For a somatic symptom disorder (STS) to occur, The patient must present repetitive thoughts regarding his or her pain and these may cause a certain degree of anxiety.. This criterion is necessary for the diagnosis of the pathology, so stress and anxiety are a requirement for TSS to take place.
On the other hand, not all people with stress and anxiety develop TTS, but as we have seen, there is at least minimal causality between the two: worry manifests itself physically and pain exacerbates worry. Beyond objective data, we want to close these lines with an idea: breaking this vicious circle is possible, but always with psychological help. If you feel persistent pain and all your analyzes and tests have come back fine, perhaps your answer lies in the psychiatric field.
