Somatoform Autonomic Dysfunction

By | June 10, 2022

The feeling of being ill does not always have to have a physical cause, even if the symptoms can be determined diagnostically. It can also be a psychosomatic condition, as is the case with somatoform autonomic dysfunction.

What is Somatoform Autonomic Dysfunction?

A somatoform autonomic dysfunction is a mental illness that manifests itself in physical symptoms for which no organic causes can be found. A predisposition can play a role, but also stressful experiences. It is often a side effect of anxiety disorders or depression. For hms explanations, please visit

The most important complaints include complaints that suggest organic causes such as stomach, heart, circulatory and respiratory problems.


On the one hand, a hereditary predisposition comes into question, visible in family clusters.

On the other hand, biological conditions can cause the disorder to occur, e.g. B. changed breathing patterns, a different body perception z. B. after accidents, illnesses and a decrease in physical adaptability to environmental conditions.

Stressful experiences from childhood and adolescence such as experiences of violence or abuse can be just as much as witnessing chronic illnesses in the family, experiences of death or an accident of a loved one.

Symptoms, Ailments & Signs

The somatoform autonomic dysfunction can affect all organs that are controlled and controlled by the autonomic nervous system. The digestive system is often affected. Typical symptoms are stomach pain, feeling of fullness, hiccups, nausea and digestive problems such as flatulence, diarrhea or constipation.

In the area of ​​the cardiovascular system, chest pain, a feeling of tightness in the chest, palpitations and palpitations often occur, and breathing can be hampered by subjective shortness of breath. Increased inhalation ( hyperventilation ) can lead to drowsiness, tingling in the hands and muscle tremors. In the urogenital area, the somatoform autonomic dysfunction becomes noticeable through frequent urge to urinate and pain when urinating.

It is characteristic that no organic cause can be found for any of these complaints, even after a thorough examination. A general vegetative over-arousal is expressed through non-specific symptoms such as dry mouth, sweating and hot flashes. Those affected have the feeling of being constantly tense and tire quickly even with light exertion.

Exaggerated body awareness and the overestimation of harmless mood disorders are also typical: Even the slightest deviations from the norm are classified as threatening and trigger strong fears, which in turn can cause physical symptoms such as tachycardia or shortness of breath. Although the patient’s physical health is confirmed by the doctor, in many cases the symptoms severely affect their everyday life and can significantly reduce their quality of life.

Diagnosis & History

Typical symptoms are complaints of the autonomic nervous system such. B. Heart, stomach, circulatory, respiratory or bladder/kidney problems.

Two groups of symptoms are distinguished:

  • objectively detectable changes, e.g. B. tachycardia, hyperventilation
  • subjectively perceived complaints such as flowing pain, a feeling of being bloated, etc.

It is typical of the symptoms that those affected pay increased attention to minor physical discomfort and classify them as problematic, e.g. B. tachycardia as a harbinger of a heart attack.

These fears trigger fear reactions, which in turn are perceived as new complaints. A vicious circle develops in which those affected tend to constantly observe themselves and panic at the slightest sign of being seriously ill without being able to find a cause.

The first step in diagnosis is a physical exam to rule out organic causes. If an organic cause can be ruled out and the doctor suspects a somatoform autonomic dysfunction, a psychological anamnesis follows, for which there are numerous tests.

There are 3 diagnostic criteria required for the diagnosis:

  1. Existing complaints can be assigned to organs and are perceived by those affected as signs of illness.
  2. At least 2 of the following autonomic symptoms must be present:
  • functional heart problems such as tachycardia
  • sweats
  • dry mouth
  • Hot flashes / flushing
  • Pressure problems in the upper abdomen
  • Tingling or restlessness in the abdomen
  1. At least one of the following accompanying symptoms is present:
  • chest pain or pressure
  • shortness of breath / hyperventilation
  • rapid fatigue on exertion
  • Swallowing air, hiccups, burning in upper abdomen
  • frequent urge to urinate or defecate even with small amounts, voiding disorders, feeling of being bloated

Even if no physical causes are found, people suffering from diagnosed somatoform autonomic dysfunction often find it very difficult to assume that they do not have an organic disease.


In the case of somatoform autonomic dysfunction, a major challenge for the doctor and patient is to distinguish between psychosomatic and physical causes of the symptoms. Difficulties arise not only with the initial diagnosis. Various complications are possible if an additional physical illness is not recognized in time.

In addition, it is conceivable that an actual worsening of an existing physical dysfunction is misinterpreted as psychosomatic. Some people suffering from a somatoform autonomic dysfunction experience complaints that are related to a specific organ. An example of this is cardiac neurosis.

A patient with cardiac neurosis can not only develop actual heart problems, but also suffer from another organ disorder. Conversely, a person suffering from physical cardiac ailments may additionally struggle with a somatoform autonomic dysfunction related to the heart or other autonomic functions.

Thorough examinations are therefore necessary to rule out physical complications. For the treatment of the somatoform autonomic dysfunction, however, this means a dilemma: the medical examinations can (and must) rule out physical causes for the symptoms – but at the same time these examinations can increase the mental illness.

In addition, it is possible for medical examinations and treatments to cause direct harm or for the physically healthy patient to become infected with a pathogen via other patients. Possible complications of the somatoform autonomic dysfunction also include psychological complaints such as depression and anxiety.

When should you go to the doctor?

With this disease, the patient is usually always dependent on direct treatment by a doctor. Self-healing cannot occur in this case, as it is a serious psychological complaint that can only be cured with the help of a psychologist. If the disorder is not treated, it can lead to serious complications.

A doctor should be consulted for this disease if the patient suffers from severe stomach discomfort. There is severe pain, nausea and gas or even diarrhea. If these symptoms last for a longer period of time and do not go away on their own, a doctor must be consulted in any case. Pain when urinating or severe shortness of breath can also indicate this disorder.

In the case of this disorder, a general practitioner can be consulted. Further treatment is then carried out by a specialist and depends on the exact severity of the symptoms. It cannot generally be predicted whether the disease will lead to a reduced life expectancy.

Treatment & Therapy

Early treatment is advisable to prevent the disorder from persisting over a longer period of time. Those affected must recognize the connection between physical symptoms and mental processes. Relaxation methods such as autogenic training, progressive muscle relaxation and biofeedback have proven themselves for treatment. Here, however, it is important to choose the individually correct procedure. Not every procedure is suitable for everyone.

Operant behavior training can also be used, especially for people who have developed a pronounced protective behavior. With self-confidence training and systematic behavioral exercises, it should be possible to take part in everyday life again. Cognitive treatment approaches are also used.


There is no prevention of somatoform autonomic dysfunction. If symptoms appear, it is important to find out about them early on and to learn to understand that psychological causes can be the underlying cause. The sooner treatment begins, the less the disorder affects life.


Somatoform autonomic dysfunction is a disease in which there is no primary physical trigger. The cause is psychological and neurological, physical symptoms are caused by inner restlessness. They range from general malaise to heart problems and shortness of breath.

Since there is no actual organic evidence, the complaints are subjective in nature. The person concerned nevertheless perceives them as a burden. Follow-up is advisable to counteract a recurrence of the somatoform dysfunction. After an examination has ruled out physical causes, the general practitioner prescribes medication for the patient to treat the symptoms.

The somatoform dysfunction is an expression for psychological complaints. For this reason, the follow-up therapy takes place within a psychotherapeutic framework. It starts when the psychological reason for the physical phenomena could be determined. The goal is a symptom-free life for the person concerned and sustainable conflict resolution. Follow-up care depends on the psychological cause.

If the somatoform dysfunction was triggered by dissatisfaction at work, the psychotherapist accompanies the patient in his professional reorientation. Maintaining and restoring quality of life is a priority in follow-up care. With increasing satisfaction, the somatoform complaints decrease and heal in the long term. The follow-up care lasts up to this point, for prevention it can continue beyond that.

You can do that yourself

The causes of complaints and health impairments are not always found on the physical level. If several doctors have already been consulted and all medical tests carried out do not indicate any disorders of the organism, the person concerned should look at his emotional states. Unfulfilled desires, stress and strokes of fate can be so stressful that they lead to functional disorders in the body.

In the case of circling thoughts, heavy brooding, the loss of joie de vivre and dissatisfaction with oneself and with life, a reflection on the inner life is advisable. As part of self-help, every person affected can take a quiet hour to think about their life and the path they have taken. If there are discrepancies, it is advisable to work them up. Anger and injustice towards a medic are of little help in this process. In the case of states of anxiety, severe insecurity or a low zest for life, on the other hand, it is advisable to work with a therapist. This takes a neutral position and can provide food for thought.

Ultimately, however, the person concerned should ensure good mental hygiene himself and alleviate the symptoms through relaxation techniques or other restorative therapies. A balanced lifestyle, a healthy diet and avoiding alcohol and nicotine are also helpful in promoting your own health.

Somatoform Autonomic Dysfunction