The Cause of Somatic Complaints in Children and Adolescents

When children say that something hurts, they don't say it to get their parent's attention or to manipulate them. In fact, behind ailments that have no explanation in children, usually lie emotional problems that must be attended to. We explain why.

Written and verified by the psychologist Valeria Sabater.

Last update: 07 February, 2023

Many visits to pediatricians in primary care are linked to somatic complaints. In fact, children often suffer from stomach aches, diarrhea, muscle pain, headaches, or insomnia without knowing exactly why. However, these inexplicable discomforts are still symptoms and can usually provide information about a latent condition or problem that needs identifying.

We all experience somatizations on a daily basis. For instance, a day of fatigue, stress, or a time of greater worry and anxiety always ends up manifesting itself in a painful way in the body. That’s because emotions leave their psychophysical imprints on our bodies, which is something that we all learn over time.

However, somatization complaints are far more distressing in children. That’s because they don’t know what’s happening to them and hence experience the symptoms in a disturbing way. As a rule, somatic complaints are sudden manifestations that are accompanied by changes in behavior. Physical discomfort is a direct consequence of some kind of emotional trigger that children can’t express and often don’t even understand.

In these situations, the role of parents is key. In fact, it’s essential for all parents to know how to detect and respond to the needs of their children.

Somatic complaints in children and adolescents

Some children might visit specialists with their parents with the complaint that they’re vomiting frequently and almost everything makes them feel sick. Their parents think they might have a food intolerance and could be celiac or lactose-intolerant. However, the tests don’t reveal any problems. Something similar happens with adolescents.

Indeed, there are many adolescents who become secretive, feel increasingly exhausted, and suffer from persistent headaches. But, their parents have a tendency to believe that these behaviors are typical of their age and that their discomfort is the result of spending too much time in front of a screen. Clearly, somatic complaints in the child and adolescent population are frequently not well understood or attended to.

A study conducted by Duke University (USA) states that somatic disorders are an especially common phenomenon in children and adolescents. Girls show greater emotional changes, while boys often show more disruptive and challenging behaviors. So, if parents think it’s just a typical age-related issue, they’re wrong.

Consequently, parents and educators must be sensitive to all changes and somatic discomfort in their children. Here’s a list of the most common somatic disorders and the causes behind them.

The manifestation of somatic disorders

Somatic complaints aren’t the product of any organic disease. Moreover, the medical tests and analyses never show any clear origin of why a child is suffering discomfort. These are the most common ways in which they manifest.

• Musculoskeletal pain.
• Constant tiredness.
• Headaches
• Stomach ache.
• Nausea and vomiting.
• Intestinal disturbances such as diarrhea.
• Enuresis (bed-wetting).
• Sleeping problems.
• Nightmares.
• Palpitations and tachycardia.

The causes

Somatization disorders often appear unexpectedly. When they do, they remain stable for six months to two years. This directly affects the child’s quality of life, especially if the latent problem that triggers it isn’t addressed.

These are the factors and underlying realities that usually shape these clinical conditions.

Anxiety and pressures surrounding the child

Johns Hopkins University (USA) conducted a study that stated anxiety disorders lie behind somatic complaints in children and adolescents. The age at which they’re most frequent is around 12 years. At this time, the symptoms are usually more intense and disabling for adolescents and preadolescents.

Academic pressure and even demand that parents project onto them heighten their feelings of anguish and end up, in certain cases, overwhelming them.

Childhood and adolescent depression

Depression in children and adolescents is underdiagnosed and therefore clinically neglected. This is a worrying reality, given that the rates of self-injurious behavior and suicide in the younger population are on the increase.

Behind this serious problem, usually lie family problems, separation from parents, situations of bullying, or even the harmful impact of social media.

Family abuse

Abuse, mistreatment, neglect… One of the causes of somatic complaints in children at an early age is family abuse. Being a victim of this type of situation completely alters their development at all levels. For instance, emotional, neurological, cognitive, etc.

Children’s personalities

Some children and adolescents are perfectionists and place excessive demands on themselves. Others are shy with a tendency to somatize. Furthermore, growing up in rigid and authoritarian family environments causes children to develop characters with tendencies to internalize their fears, anxieties, and worries. Sooner or later, this translates into both mental and physical discomfort.

Treatment for somatic disorders

The first step in addressing somatic complaints in children and adolescents lies in consulting a pediatrician. Firstly, any organic causes must be ruled out and then the psychological ones can be addressed. In these situations, it’s essential to have the supervision of specialist doctors together with psychologists.

It can’t be ignored that organic complaints (upset stomach, insomnia, headaches…) are real, and must be addressed. However, they won’t disappear if their triggers aren’t treated. Therefore, the main starting point is the correct identification of the problem that the child or adolescent is going through.

In addition, the treatment of anxiety disorders, depression, or any other psychological condition should be combined with the following strategies:

• Teach the child/adolescent how their body reacts to states such as stress, worry, anguish, etc. They must understand the cause of their physical discomfort and the process of somatization.
• Teach them relaxation techniques so that they learn, early on, to manage stress.
• Train them in social skills, assertiveness, and problem-solving.
• Cognitive restructuring. Teach them to regulate and understand their thoughts and beliefs in order to develop healthier mental approaches.

Important note

We can’t end this article without highlighting one particular aspect that all parents should understand. It’s the fact that somatic complaints aren’t ways for children to get attention. Their pain and discomfort are real. In fact, children who complain of pain on a recurring basis or whose behavior has changed need professional attention.

As parents, we must validate what they express and demonstrate. We must encourage them to verbalize what they feel and guide them. This means they’ll be able to tell us what’s worrying them, thus giving truth to the pain they’re feeling. In effect, we should be a refuge for them and support them by showing understanding, empathy, and affection.