Somatic Symptom Disorder (Ssd)

It was almost midnight on a relaxing Rhode Island vacation when Tracey Braham’s 13-year-old daughter, Sarah, came running to her bedside, grabbing her throat. “I can’t breathe. I need to go to the emergency room. I’m dying!”

“As a parent, my first instinct was to help Sarah calm down and try to figure out what was going on with her physically,” says Tracey. “Was she choking? Could it be an allergic reaction?”

Three years earlier, Sarah had been diagnosed with celiac disease, an immune reaction to eating gluten. Sarah swore she hadn’t eaten anything new, but she was clearly suffering. “She said her heart was racing and her throat was swelling shut. She was adamant that she was dying. It was very scary,” says Tracey.

At the emergency room, doctors couldn’t determine what was causing Sarah’s symptoms.

When the crisis passed, the Braham family returned to Virginia Beach with unanswered questions about Sarah’s health. She continued to feel tightness in her throat and fluttering in her stomach. Soon after, her complaints included headaches, dizziness, numbness, sweaty palms, and joint pain.

Sarah reported these symptoms to her CHKD gastroenterologist who examined her and ran tests to try to figure out the cause of her symptoms. But all tests confirmed that Sarah was in good physical health.

“That’s when we were faced with considering whether something else could be causing the problem,” says Tracey.

Sarah was referred to Alexandra Laramee, a licensed clinical social worker at CHKD and manager of the mental health program. This type of referral is not uncommon. Dealing with a chronic physical illness like Sarah’s celiac disease, which requires her to eat a wheat-free diet, can affect a young person’s mental health.

Laramie diagnosed Sarah with generalized anxiety disorder and somatic symptom disorder, which simply means that her anxiety manifests itself in physical symptoms.