Are psychosomatic illnesses "all in your head"?

No. Psychosomatic symptoms are real physical symptoms. The pain is real, the functional impairment is real. The difference is that the primary or significant cause is psychological, not structural. "Not real" is a category that is incorrectly applied to psychosomatics, causing harm to patients.

What diseases are considered psychosomatic?

Strictly psychosomatic conditions include: arterial hypertension, bronchial asthma, gastric ulcer, ulcerative colitis, rheumatoid arthritis, neurodermatitis, hyperthyroidism — Alexander's "Chicago Seven". More broadly: IBS, tension headaches, chronic back pain, some skin conditions. Psychological stress plays a role in the pathogenesis of many diseases.

Psychosomatic: What It Is and Why Stress Makes Us Physically Ill

Psychosomatics is not "all in your head." It refers to real physical symptoms with a psychological component. It's about how the mind causes bodily illnesses.

🌿psybot.app·June 19, 2026·2 min read

Before an important presentation, your stomach cramps. After a stressful period at work, psoriasis flares up. Chronic anxiety – and your back constantly aches without a visible reason. This is psychosomatics.

But "psychosomatics" is not a synonym for "made it up." It's a real physical process where the mind and body speak the same language.

1. What is Psychosomatics

Psychosomatics is a field of medicine and psychology that studies the connection between psychological factors (emotions, stress, personality traits) and physical health. Psychosomatic disorders are illnesses in whose pathogenesis psychological factors play a significant role.

2. Mechanisms: How Stress Becomes Illness

Autonomic Nervous System: sympathetic ("gas") and parasympathetic ("brake"). Chronic stress keeps the sympathetic system in a state of constant activation: increased blood pressure, accelerated heart rate, muscle tension, digestive issues.

HPA Axis (hypothalamic-pituitary-adrenal): chronic stress → chronic cortisol → immunosuppression, inflammation, impaired tissue regeneration.

Neuroinflammation: chronic stress activates inflammatory cytokines – which affect the entire body.

Psychoneuroimmunology: a direct link between psychological state and immune function. Grief, anxiety, depression weaken immunity.

3. Common Psychosomatic Symptoms

Irritable Bowel Syndrome (IBS)
Tension headaches
Back and neck pain
Arterial hypertension
Flare-ups of skin conditions (psoriasis, eczema)
Sleep disturbances
Chronic fatigue

4. How Psychosomatic Disorders Are Treated

Psychotherapy – CBT, body-oriented therapy, EMDR
Stress reduction techniques: MBSR (Mindfulness-Based Stress Reduction)
Medication for symptoms if necessary
Lifestyle adjustments: sleep, nutrition, physical activity

5. Important: Do Not Ignore Physical Symptoms

A psychosomatic component does not mean that physical symptoms do not require medical examination. It is always important to rule out organic causes. Psychosomatics is not a default diagnosis, but a diagnosis made after ruling out organic issues.

Discuss your bodily symptoms with our AI psychologist psybot.app. Read also: Depression and the Body.

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