Somatic Symptom Disorder

Tovani does not treat this with ketamine

This page is here for honesty and completeness. Ketamine is not an appropriate treatment for Somatic Symptom Disorder, and in some cases it is contraindicated. Below is what the condition is and the treatments that genuinely help — and where, if at all, ketamine has any narrow role (usually only for a separate co-occurring depression). If you’re in crisis, call or text 988.

The short version

●Somatic symptom disorder (SSD) involves one or more distressing physical symptoms plus excessive thoughts, feelings, or behaviors about them — disproportionate worry, high health anxiety, or excessive time and energy devoted to symptoms.
●The symptoms are real and the distress is real; the diagnosis is about the disproportionate response, not about symptoms being "made up."
●Importantly, the symptoms may or may not have a clear medical explanation — SSD can coexist with medical illness.
●First-line treatment is psychological — especially CBT — plus a consistent, collaborative relationship with a single coordinating clinician and limiting unnecessary tests and procedures.¹ ²
●Antidepressants can help where depression or anxiety co-occur, but there is no specific drug that "treats" SSD.
●Ketamine is not a treatment for somatic symptom disorder; this page is here for completeness and direction.

Clinical definition

SSD is defined by one or more somatic symptoms that are distressing or disrupt daily life, together with excessive thoughts, feelings, or behaviors related to the symptoms or health concerns — manifested as disproportionate and persistent thoughts about the seriousness of symptoms, persistently high health anxiety, or excessive time and energy devoted to symptoms or health. Although any one symptom may not be continuously present, a symptomatic state persists (typically more than six months). DSM-5 deliberately shifted the focus from "medically unexplained" symptoms to the disproportionate psychological and behavioral response, recognizing that SSD can occur with or without a co-occurring medical condition.

How it differs from related conditions

vs. Health anxiety

There the focus is fear of having or getting a serious illness, often with few or no actual somatic symptoms; SSD centers on distressing symptoms themselves.

vs. Functional neurological disorder

FND specifically involves neurological symptoms with positive examination signs; SSD is broader and defined by the disproportionate response to symptoms.

vs. Major depressive disorder

Depression and anxiety frequently co-occur with and amplify SSD; treating them is part of care.

First-line treatments

Cognitive behavioral therapy

The best-supported treatment, addressing symptom-focused attention, catastrophic interpretations, and avoidance/checking behaviors.

A single coordinating clinician

Regular, scheduled visits with one trusted clinician reduce fragmented care and unnecessary testing.

Limiting unnecessary tests/procedures

Avoiding the cycle of investigations that reinforces illness worry, while not dismissing real symptoms.

Treating co-occurring depression/anxiety

Antidepressants where indicated for comorbid conditions.

When standard treatments fail

For persistent SSD, care strengthens the collaborative-care model — a consistent clinician, structured CBT (sometimes more intensive or specialized), graded activity, and treatment of co-occurring depression and anxiety. The emphasis stays on function and quality of life rather than eliminating every symptom. Ketamine has no established role in SSD.

Where ketamine fits

Ketamine is not a treatment for somatic symptom disorder. The evidence-based approach is psychological — CBT in particular — combined with a steady, collaborative relationship with one coordinating clinician and a careful approach to testing that neither dismisses symptoms nor reinforces illness worry.¹ ² There is no evidence base for ketamine in SSD, and it does not address the disorder's mechanisms. Because depression and anxiety frequently co-occur with SSD and amplify it, those can be treated on their own terms — but the somatic symptom disorder itself is best addressed through CBT and collaborative care, not ketamine.

Where this fits with Tovani

Tovani treats mood and anxiety conditions, which often co-occur with somatic symptom disorder and can worsen it — and treating them may help. But SSD itself is best managed with CBT and a consistent, collaborative clinical relationship, rather than with ketamine, which has no role here. If distressing physical symptoms and disproportionate worry about them are your main difficulty, this page is here to point you toward the psychological and collaborative care that helps.

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Frequently asked

Can ketamine treat somatic symptom disorder?

No — there is no evidence for it and it does not address the disorder's mechanisms. SSD is treated with psychological therapy (especially CBT) and collaborative care. Ketamine could only be relevant for a separate co-occurring depression, not for SSD itself.

Does somatic symptom disorder mean my symptoms aren't real?

No. The symptoms are real and so is the distress. The diagnosis is about a disproportionate response — excessive worry, anxiety, or time spent on the symptoms — and SSD can occur even alongside a genuine medical condition.

What actually treats SSD?

CBT is the best-supported treatment, along with having one coordinating clinician you see regularly and avoiding unnecessary repeat testing (which can reinforce worry). Treating co-occurring depression or anxiety helps too. The goal is better function and quality of life.

Does Tovani treat somatic symptom disorder?

Not the SSD itself — that is best handled with CBT and collaborative care. We can potentially help with co-occurring depression or anxiety, which often amplify SSD, but the somatic symptom disorder needs its own psychological treatment, and we would point you toward it.

References

Henningsen P 2018, Dialogues in Clinical Neuroscience — Management of somatic symptom disorder. (PMID 29946208)
van Dessel N et al. 2014, Cochrane Database of Systematic Reviews — Non-pharmacological interventions for somatoform disorders and medically unexplained symptoms. (PMID 25362239)

Last reviewed by Dr. Ben Soffer, DO on June 2, 2026. This page is educational and not a substitute for clinical evaluation. A physician determines whether ketamine therapy is appropriate for your specific situation.