# Psychosomatic symptoms: When the mind takes its toll on the body [View the interactive version](https://instahelp.me/en/magazine/mental-health/psychosomatic-symptoms-when-the-mind-takes-its-toll-on-the-body/) By Mag. Kerstin Schuller · Reviewed by Dr. Annette Wallisch-Tomasch, M.A. · 2026-10-23 · 12 min read Stomach ache before an important appointment, a racing heart in a tense situation, or a headache after a stressful day: psychological stress can manifest itself physically – something many people have experienced. Sometimes these symptoms disappear as soon as the tension eases. Sometimes they persist or return. In such cases, we often refer to them as **psychosomatic symptoms**. But what exactly does that mean? What physical symptoms can stress trigger – and what helps when the body keeps sending out warning signals? ## Key points at a glance: - Psychosomatic symptoms are genuine physical ailments in which psychological and social factors may play a role in their onset or persistence. - Psychological stress can, amongst other things, affect gastrointestinal symptoms, headaches, palpitations, breathing difficulties, dizziness, muscle tension or pain. - ‘Psychosomatic’ does not mean ‘imaginary’. The body and the mind influence one another and cannot be separated. - Physical symptoms should first be assessed by a doctor. Psychological factors and a physical illness may co-exist. - Psychological counselling or treatment can help you to recognise personal connections, reduce stress and develop new ways of coping with your symptoms. ## What are psychosomatic symptoms? Psychosomatic symptoms are physically perceptible complaints in which psychological and social factors may play a role in their onset, intensity or persistence (Löwe et al., 2024; World Health Organisation, 2024). These symptoms are real – even when no sufficient organic cause can be identified (American Psychiatric Association, 2022). The term ‘psychosomatic’ is derived from the Greek words ‘psyche’, meaning ‘soul’, and ‘soma’, meaning ‘body’. It is based on a realisation that is actually taken for granted today: **the body and the mind do not function independently of one another.** Psychosomatic complaints do **not**, by any means, imply that those affected are ‘merely imagining’ their symptoms. **Pain is still pain**. A racing heart is still noticeable. And even a stomach that reacts to chronic stress responds physically. ## Psychosomatic symptoms: What kinds of symptoms are there? Psychological stress can manifest itself in **a wide variety of places** in the body. This is hardly surprising: the stress response affects, amongst other things, the nervous system, the cardiovascular system, respiration, the muscles, digestion and the endocrine system. ### Possible physical symptoms caused by psychological stress include, for example: - Stomach ache, nausea, bloating, diarrhoea or constipation - Headaches and tension headaches - Dizziness or light-headedness, tingling or other unpleasant physical sensations - Heart palpitations or a racing heart - A feeling of pressure or tightness in the chest - Rapid or laboured breathing - Muscle tension and back pain - Exhaustion and tiredness, sleep problems Important: Such symptoms **may** be linked to stress and psychological strain, but they can have **numerous possible causes**. It is therefore not possible to determine whether a complaint is psychosomatic on the basis of a single symptom. ### Gastrointestinal complaints The idea that something ‘upsets our stomach’ is more than just a figure of speech. The brain and the digestive system are closely linked via what is known as the **gut-brain axis**. Among other things, stress can affect bowel movements and the perception of stimuli in the digestive system. This can lead, for example, to abdominal pain, bloating, nausea, diarrhoea or constipation, or it can exacerbate existing symptoms. ### Headaches and dizziness Headaches can also be **influenced**by **psychological stress**. [Stress](https://instahelp.me/en/magazine/stress/i-cant-take-it-anymore-what-should-i-do-5-tips-to-overcome-a-crisis.md), for example, is considered a common trigger for tension headaches and can also trigger or exacerbate **migraines**. **Dizziness or light-headedness** can also occur in stressful situations. As dizziness can have many different physical causes, any new or persistent dizziness in particular should be investigated by a doctor. ### Heart palpitations and breathing difficulties When under stress, the body prepares itself within a very short space of time **to react**to a **potential threat**. Heart rate and breathing may change, muscles tense up and the body mobilises **energy**. This is why, during periods of high stress, people may experience, for example, palpitations, a racing heart, a feeling of tightness or changes in breathing. However, symptoms in the chest area in particular should not be hastily attributed to psychological causes, but should be investigated **medically**. ### Tension and psychosomatic pain Stress often causes the **muscles** to tense up. In the short term, this is part of a normal **protective response**. However, if the tension persists, it can lead to, or exacerbate, pain in the neck, shoulders, jaw or back, for example (Löwe et al., 2024). ## How do psychosomatic symptoms develop? There is generally **no single cause** for psychosomatic symptoms. Rather, they often arise from an **interplay of** various factors. A major **review** of persistent physical symptoms describes, amongst other things, biological processes, stressful life experiences, depression, health-related anxiety, expectations, a strong focus of attention on bodily signals, learning processes and avoidance behaviour as possible influencing factors (Löwe et al., 2024). Further research by Kitselaar et al. (2023) shows that various psychological and social factors may be linked to the onset or persistence of persistent physical symptoms. **A simple example illustrates how this can develop into a vicious circle:** You suddenly notice your heart racing. The thought, ‘There’s something wrong with my heart,’ triggers anxiety. The stress response intensifies, your heart beats faster, and you pay even closer attention to your body. As a result, you perceive every subsequent flutter particularly intensely – and your anxiety rises once more. This does not mean that you are causing the symptom yourself. Rather, it shows how bodily sensations, evaluation, attention, emotion and the body’s stress response can reinforce one another (Smakowski et al., 2024). Sometimes, panic attacks are also triggered or exacerbated by this dynamic. Find out here what symptoms occur and what advice is available for dealing with panic attacks. ### What role does psychological stress play? Psychological stress can affect **numerous** physical systems. In an acute stressful situation, this response is beneficial: the body mobilises energy, the heart rate may rise, breathing changes and the muscles tense up. Things can become**more problematic** if stress persists over a longer period and there are no periods of recovery. Chronic stress can be linked, amongst other things, to digestive problems, headaches, muscle tension, sleep problems and changes in concentration and memory. Not everyone reacts in the same way, however. What one person feels first in their stomach may manifest itself in another as tension in the neck, a headache or inner restlessness. ## What is a psychosomatic disorder? The presence of individual psychosomatic symptoms does not automatically imply a **psychosomatic disorder or psychosomatic illness**. In everyday language, terms such as ‘psychosomatic symptoms’, ‘psychosomatic complaints’, ‘psychosomatic disorder’ and ‘psychosomatic illness’ are often used interchangeably. From a medical and psychological perspective, however, it is worth making a more precise distinction: Modern diagnostic systems are increasingly moving away from the notion that physical symptoms must be either ‘organic’ **or** ‘psychological’. The ICD-11 distinguishes between specific clinical presentations and places greater emphasis on the impact of, and coping with, physical symptoms when making a diagnosis (World Health Organisation, 2024). ## Psychosomatic or physical: how can I tell the difference? **You cannot reliably determine, based on your symptoms alone, whether they are psychosomatic or physically caused.** That is why any new, severe, unusual or persistent symptoms should **always** be investigated by a doctor. Even a temporal link to **stress** **does not in itself** prove a psychosomatic cause. At the same time, a medical examination **that reveals no abnormalities** can be an important starting point for taking a closer look at additional psychological and social factors. **Indications of this may include, for example, that symptoms…** - …regularly become **more severe** during stressful periods, - **…subside** during quieter periods, - …occur particularly frequently in **certain** situations, - …are **exacerbated** by anxiety and intense self-reflection, - **…persist** despite appropriate medical investigation, - …occur**alongside** sleep problems, tension, worries or exhaustion. However, it is also important to note here that **psychological and physical causes are not mutually exclusive.** A physical illness can be exacerbated by stress. Conversely, physical ailments themselves can place an enormous psychological strain on a person. ## What helps with psychosomatic symptoms? The appropriate psychosomatic treatment depends on **the nature of the** symptoms, their **severity** and the factors contributing to their **onset** or persistence. However, there are some steps that can generally be helpful: ### 1. Take symptoms seriously and have them assessed by a doctor Psychosomatic symptoms are no reason to ignore physical causes. A proper medical examination provides reassurance and forms the basis for further action. ### 2. Observing connections When do the symptoms get worse? What happened in the hours or days leading up to it? What thoughts, feelings or sources of stress occur at the same time? A **symptom diary** can help to reveal patterns. It is important not to constantly monitor every physical sensation, but rather to recognise the bigger picture. ### 3. Not just reducing stress, but understanding it “You need to reduce your stress levels” is rarely helpful advice. A more interesting question is: what causes long-term tension? Is it high demands? Conflicts? A lack of boundaries? Worries? Perfectionism? Being constantly on call? The better you understand your personal stress patterns, the more effectively you can make changes. ### 4. Allow the nervous system to rest regularly Relaxation doesn’t necessarily mean meditating for an hour. Exercise, conscious breathing breaks, time spent in nature, socialising, getting enough sleep or taking short breaks during the day can all help to balance periods of physical activity with rest. ### 5. Question avoidance with caution Anyone who develops a fear of certain physical sensations may begin to avoid exercise, social situations or other activities. In the short term, this may provide a sense of security. In the long term, however, avoidance can perpetuate anxiety and an excessive preoccupation with symptoms. Such behavioural patterns are also discussed in research as possible factors in the perpetuation of persistent physical symptoms (Smakowski et al., 2024). ### 6. Seek psychological support If symptoms keep recurring, are causing you significant distress or are increasingly taking over your life, psychological support may be helpful. A systematic review and meta-analysis by Swainston et al. (2023) shows that, amongst other things, psychological interventions can help to reduce somatic symptoms in cases of persistent physical symptoms. ## When should I seek medical or psychological help? ### When a medical assessment is important Any new, severe, unusual or persistent physical symptoms should **always** be investigated by a doctor. This is particularly important if symptoms appear suddenly, worsen significantly or change. In the event of acute or severe symptoms, such as pronounced chest pain, severe shortness of breath, impaired consciousness or sudden-onset neurological symptoms, medical assistance should be sought **immediately**. ### When psychological support may be helpful **Psychological counselling or treatment can be particularly helpful if:** - medical examinations do not provide a sufficient explanation for your symptoms, - your symptoms worsen significantly during periods of stress, - you spend a great deal of time thinking about possible illnesses, - you are constantly monitoring or checking your body, - your fear of certain symptoms is restricting your daily life, - you feel exhausted, helpless or increasingly burdened by your symptoms. You don’t have to wait until a psychosomatic disorder has been diagnosed. Even recurring physical stress reactions can be a good reason to take a closer look. ## How can psychological counselling help with psychosomatic symptoms? Psychological counselling does not start by asking whether your symptoms are ‘real **’. They are real.** Rather, it is about **understanding** which factors influence your symptoms and where change is possible. **Together with a psychologist,** you can, for example, find out: - which stresses your body reacts to particularly strongly, - which thoughts or fears intensify physical reactions, - how you cope with unpleasant physical sensations, - what role stress, conflicts or high expectations play, - which behaviours may be perpetuating your symptoms, - how you can regain a greater sense of confidence in how you relate to your body. Psychological counselling or treatment can therefore usefully complement – but**not replace –**medical care**.** ## Psychological counselling for psychosomatic symptoms Do you have physical symptoms that keep coming back or get worse during stressful periods? Perhaps you’ve already had medical examinations but still feel you don’t have a proper explanation for them. The [online psychologists](https://instahelp.me/en/online-psychologists.md) at Instahelp can help you better understand the possible links between physical symptoms, stress and mental strain, and develop a personalised approach to managing them. _Get started now_ ## Start your online psychological counselling session Find suitable psychologists to treat psychosomatic conditions [Find a psychologist](https://web.instahelp.me/#onboard) ## FAQs **What are psychosomatic symptoms?** Psychosomatic symptoms are physical complaints in which psychological and social factors may play a role in their onset, intensity or persistence. These complaints are real and not imagined. **What physical symptoms can psychological stress cause?** Psychological stress can, amongst other things, contribute to or exacerbate headaches, muscle tension, gastrointestinal complaints, palpitations, changes in breathing, sleep problems and exhaustion. As these symptoms may also have physical causes, it is important to seek medical advice. **What is a psychosomatic illness?** The term ‘psychosomatic disorder’ is used to describe clinical conditions in which physical, psychological and social factors interact. However, it is not a standard diagnostic term. **Can pain be caused by psychological factors?** Yes. Psychological factors can play a part in the development, perception and persistence of pain. Pain is therefore no less real. Biological, psychological and social factors often interact simultaneously. **How can I tell if my symptoms are psychosomatic?** It is not possible to diagnose this with certainty based on the symptoms alone. A recurring link to stress may be an indication, but it is no substitute for a medical examination. Following an appropriate physical assessment, it may be worthwhile to also consider psychological and social factors. **What helps with psychosomatic symptoms?** Depending on the individual cause, medical treatment, stress management, exercise, sufficient rest, overcoming avoidance behaviours, and psychological counselling or psychotherapy may be helpful. A biopsychosocial approach to treatment is often advisable. **When should I seek psychological help?** Psychological support may be helpful if physical symptoms recur during stressful periods, are a major source of concern for you, or are affecting your day-to-day life. You do not need to wait until you have been diagnosed with a psychosomatic disorder. ## Citations - [Löwe, B., Toussaint, A., Rosmalen, J. G. M., Huang, W.-L., Burton, C., Weigel, A., Levenson, J. L., & Henningsen, P. (2024). Persistent physical symptoms: Definition, genesis, and management. The Lancet, 403(10444), 2649–2662. ](https://doi.org/10.1016/S0140-6736(24)00623-8) - [Kitselaar, W. M., van der Vaart, R., Perschl, J., Numans, M. E., & Evers, A. W. M. (2023). Predictors of persistent somatic symptoms in the general population: A systematic review of cohort studies. Psychosomatic Medicine, 85, 71–83. ](https://doi.org/10.1097/PSY.0000000000001145) - [Smakowski, A., Hüsing, P., Völcker, S., Löwe, B., Rosmalen, J. G. M., Shedden-Mora, M., & Toussaint, A. (2024). Psychological risk factors for somatic symptom disorder: A systematic review and meta-analysis of cross-sectional and longitudinal studies. Journal of Psychosomatic Research, 181, 111608. ](https://doi.org/10.1016/j.jpsychores.2024.111608) - [Swainston, K., Thursby, S., Bell, B., Poulter, H., Dismore, L., & Copping, L. (2023). What psychological interventions are effective for the management of persistent physical symptoms (PPS)? A systematic review and meta-analysis. British Journal of Health Psychology, 28(1), 80–97.](https://doi.org/10.1111/bjhp.12613) - World Health Organisation. (2024). Clinical descriptions and diagnostic criteria for mental, behavioural and neurodevelopmental disorders in the ICD-11. World Health Organisation.