F45.1, somatic symptom disorder.
F50.02, anorexia nervosa, binging and purging subtype.
i grieve for the fifteen-year-old version of me who didn’t have an understanding of what these diagnoses meant for me, how they would follow me. i didn’t understand why or how having a mental health diagnosis would make it harder for me to seek care for an undiagnosed invisible illness and disability – until it happened to me.
hospitalized for the treatment of my eating disorder in a medical psychiatric unit at a children’s hospital, one of my few luxuries was that i had access to professionals from other departments within the hospital. i met with a pediatrician every week while being treated, who would review my nutrition records and do a quick physical exam. my vitals showed consistent orthostasis (meaning, when i sat up or stood up, my heart rate would sky rocket and my blood pressure would drop significantly.) as i nutritionally rehabilitated, my blood pressure started to stabilize, but my heart rate – not so much. even as i was stable nutritionally for months, my heart rate continued to jump when i sat up or stood up. i was unsteady on my feet, experienced persistent nausea when i tried to stand for more then a few minutes at a time, and often could feel my heart beating in my chest – hard and fast. i also frequently told doctors that it felt like my joints were “slipping out of place” when i sneezed too hard, it felt like my ribs “dislocated”, and my body constantly physically ached.
at first, my pediatrician told me that it was my body trying to catch up to the amount of nutritional rehabilitation it had undergone over the past few months. then, as time went on, and my symptoms persisted, she and my therapist sat me down for a group meeting and told me that “psychological factors can have an influence on our mental health.” this made sense to me. i didn’t question it, and i had no further testing.
when i was discharged from the hospital, somatic symptom disorder was listed under my diagnoses. upon looking it up, i read in an article, “the person’s reaction to the symptoms is not normal”, and somatic symptom disorder is diagnosed when a person is “excessively focused on a physical symptom or complaint. the person’s symptoms may not be attributed to any medical issue, but the person genuinely believes they are sick.”
the diagnosis followed me through my adolescent years. whenever i mentioned my symptoms to subsequent pediatricians, i would get a response along the lines of,
“i see you have a diagnosis listed here of somatic symptom disorder and an eating disorder. is that true?”