Psychophysiologic Disorders (PPD):
Info for Patients & General Public

What is A Psychophysiologic Disorder?

Psychophysiologic Disorder (PPD) is the clinical term for mind-body symptoms, meaning symptoms that are caused by neural pathways that develop in response to stress, trauma, and repressed emotions. These learned neural pathways are anatomical changes in the brain, which means that the resulting symptoms are generated in the brain and not “in your head.” The symptoms are very real and can be chronic and debilitating, but the good news is they are also benign and curable!

Case study

Anna suffered from severe scoliosis as a child but was able to live an athletic life, playing soccer every week. Later in her life, after pushing a heavy sofa, she was taken to the hospital and 10 years of increasingly frequent episodes of back pain began. Eventually, she could walk no more than 100 meters and often had to use a wheelchair. Worst of all, she doubted her ability to provide the level of care she wanted for her children. By recognizing her symptoms as PPD and receiving appropriate care, she was able to recover and now enjoys playing soccer with her children.     

More info

Anna is not alone. Every year in the United States, millions of people with very real symptoms face frustration because their symptoms cannot be helped either by conventional or alternative medical treatments. The diagnosis in many of these patients is Psychophysiologic Disorder (PPD) and the symptoms they suffer are perfectly real. The word psychophysiologic means only that the brain and body interact to produce the symptoms, which are not due to mental illness and not self-inflicted.

When diagnostic tests are normal, illnesses can be baffling until proper treatment is provided. Symptoms that can be caused by Psychophysiologic Disorders include:

  • Pain such as headache, back pain, chest pain, muscle or joint pain and abdominal or pelvic pain

  • Constipation, diarrhea, bloating, nausea and irritable bowel syndrome

  • Discomfort in the bladder or during urination

  • Fibromyalgia, chronic fatigue syndrome

Remember, the same symptoms can also result from diseases that can be diagnosed through tests, so it is essential to have a medical evaluation to be sure none of these diseases is present.

Common PPD Questions and Answers

Q: What is a Psychophysiologic Disorder (PPD)?
A: PPD consists of symptoms that are not caused by tissue or structural damage in the body.  The symptoms of PPD can be quite varied and may include pain, insomnia, fatigue, or symptoms of the gastrointestinal or urinary systems.  Recent research has shown that emotions play a much larger role in the experience of pain than previously thought.  PPD can develop as a consequence of past or current life stressors. It is reversible when recognized and treated appropriately.

Q: Could I have PPD even though I don’t have much stress in my life?
A: Often we experience stress without realizing it. For example, being a perfectionist, putting pressure on yourself, putting others’ needs ahead of your own or having a childhood that you would not want your own child to experience can generate more stress than may be immediately apparent.

Q: How are PPD symptoms generated?
A:  The symptoms of PPD are due to altered nerve pathways in the brain that affect the body.  It is common to develop physical symptoms during times of stress such as a tension headache, blushing with embarrassment or a “knot” in the belly.  PPD is an extension of this normal phenomenon that frequently leads to chronic symptoms as the nerve pathways become continuously or intermittently activated.

Q:  I have a tremendous amount of back pain and my doctors told me that I have degenerated discs and a bulging disc.  How can I have PPD when I have these problems in my back?
A:  Research has shown that as people age, it is common to develop entirely painless disc bulges, disc herniations, or disc degeneration. In other words, these “abnormalities” reflect the normal aging process. These findings are rarely the source of pain unless there is definite evidence of nerve compression corresponding to the location of the disc abnormality.  Thousands of people have eliminated their back pain despite the findings on their MRIs.

Q: Can irritable bowel syndrome, fibromyalgia or chronic fatigue syndrome be Psychophysiologic Disorders?
A: These conditions (and many others) result from a change in function of the body rather than an abnormal structure or organ.  PPD is often a significant factor in these conditions.  (If you are uncertain about your own illness, ask your physician if you might benefit from an evaluation of stress in your life.)

Q: How common is it for stress to cause physical symptoms?
A: Studies have shown that over one third of the patients seen by primary care doctors have pain or other symptoms caused by stress.

Q: Are PPD symptoms real or imaginary?
A: The symptoms are real and can be just as severe as those from any other disease.  Some patients with PPD are ill enough to be hospitalized.

Q: Is good treatment available for PPD?
A: Once PPD is recognized, treatment is available and often effective in alleviating symptoms.