Worrying too much makes you weak

Dr. Thorsten Bracher is the chief physician at the Schlossparkklinik Dirmstein. The specialist in psychosomatic medicine, psychiatry and psychotherapy specializes in depression, psychosomatic illnesses and stress-related illnesses such as burnout syn
Psychosomatic complaints

When the psyche makes the body sick

Often the causes behind headaches and backaches, stomach problems, dizziness or other physical complaints are not organic, but emotional. Affected by this: a third of all adult Germans. How psychosomatic disorders arise and what helps against them is explained by Dr. Thorsten Bracher, chief physician at the Schlossparkklinik Dirmstein.
Headache and backache, gastrointestinal complaints, dizziness or skin rashes: Many physical complaints are psychological - or at least emotional factors play a major role in the development. Doctors assume that a third of all Germans are affected - and the trend is rising. Experts suspect the causes include increasing stress and high pressure to adapt and perform in our fast-moving times. Those affected often have years of suffering behind them before they can finally find the long-awaited help from experts in mental disorders (specialists in psychiatry or psychosomatic medicine, psychotherapists). "Usually organic causes are initially suspected and appropriate specialists are consulted," explains Dr. Thorsten Bracher, chief physician at the Schlossparkklinik Dirmstein. But neither ultrasound, computed tomography or MRI show the cause - and so a grueling walk from doctor to doctor often follows. “Many of those affected hesitate a long time before they turn to a psychiatrist or psychotherapist because they cannot understand that their physical complaints are supposed to be psychological,” the specialist in psychosomatic medicine, psychiatry and psychotherapy knows from years of practice.

This is how the therapist can help

Even if no organic causes can be determined, psychosomatic complaints are by no means “imagined” illnesses and the sick are not “simulators” either. As a rule, the complaints turn out to be at least as stressful, they have just one other cause: As the name suggests, the interplay between soul (Greek: psyche) and body (soma) is crucial. "As soon as those affected understand that their body is expressing something that their soul cannot express, therapeutic help can begin," emphasizes Dr. Bracher. The aim is "to recognize unconscious emotional conflicts hidden behind the physical symptoms or to identify special psychological stresses and to find solutions together." In this context, behavioral and depth psychological psychotherapy are predominantly used - methods whose effectiveness has been scientifically well investigated and is occupied. In addition to outpatient psychotherapeutic treatment, drug support with an antidepressant can also be useful in certain cases.

If the symptoms are very pronounced and do not respond adequately to outpatient treatment, the expert recommends treatment in a specialist clinic. The same applies if the symptoms are so severe that it is hardly possible to cope with everyday life. There the patients are treated with a therapy program composed of various components. In addition to psychotherapy, it usually also includes procedures such as art, occupational, music and movement therapy, physiotherapy and relaxation techniques (e.g. autogenic training, progressive muscle relaxation) - possibly combined with drug treatment.

This works against pain and dizziness

Very often have Pain psychosomatic reasons. The musculoskeletal system or the abdomen are often affected. If organic causes can be excluded, psychotherapeutic treatment can lead to a significant improvement. "In addition to reducing pain, it is often about changing the way people deal with it, since complete freedom from pain cannot always be achieved," explains Dr. Bracher. Because "the individual reaction pattern to feel physical pain when mentally stressed remains in principle."

Learning effective stress management strategies is also very helpful, as chronic stress is often a major cause of psychosomatic complaints (such as pain or gastrointestinal complaints). Keeping a pain diary can provide further clarity about the relationships between symptoms and triggers. Teaching relaxation techniques such as autogenic training, yoga and progressive muscle relaxation is also a valuable supportive measure here.

That Back pain Not necessarily only caused by sitting at a desk for hours or too little exercise, but rather can also have psychological causes, is not clear to many of those affected. "Of course, one also initially suspects malpositions, one-sided loads or weak back and abdominal muscles as the trigger," emphasizes Dr. Bracher. But “functional back pain”, as the corresponding diagnosis is, is very often the result of pressure to perform, conflicts and other psychological stresses. It comes to painful muscle hardening and tension, which troubles the back. In addition to psychotherapy, massages and relaxation exercises can help. "As with other psychosomatic complaints, it is important to ensure sufficient physical compensation," recommends Dr. Bracher. Every now and then in the office or at home a stretching exercise in between is an additional benefit for the back and joints.

Attacks of dizziness are often the result of mental problems. After a headache, dizziness is one of the most common symptoms of illness in this country that prompts patients to see a doctor. If physical causes such as disorders of the balance organ, circulatory problems, viral infections or nerve inflammation are excluded, then there is presumably a psychologically-related dizziness. This can be treated psychotherapeutically. The combination of behavior therapy and certain exercises has proven to be particularly effective.

How do psychosomatic complaints arise?

The possible triggers are as varied as the symptoms. Experts assume that biological, psychological and social factors usually work together. In addition to a genetic predisposition, stress, personal losses, traumatic experiences (especially in childhood) and unconscious conflicts also play a role. Not infrequently, in addition to physical complaints, depressive moods or fears are added. The symptoms often change too - and initial back pain turns into headaches or gastrointestinal problems, for example.

Learn to understand the inner workings better

Psychosomatic complaints are generally considered to be easily treatable. At the beginning of every treatment with a psychiatrist or psychotherapist, there is a detailed discussion in order to identify the previous course of the disease and its causes and to be able to create an individual treatment concept. Even if there is not always a complete freedom from symptoms, in the majority of all cases a clear improvement of the symptoms can be achieved. "In addition, the patient now knows how to perceive his" inner life "better and how to deal with his complaints much better," says Dr. Bracher.
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