Theodoros Manfredi A hypochondriac is someone suffering from ‘hypochondirasis’ (also known as hypochondria), which is described as a preoccupation with their health and well-being and a paranoia regarding illness and disease. Essentially this is a ‘health phobia’ and such a person is known to make repeated trips to the doctor. The DSM-IV describes the disorder as a ‘somatoform disorder’ and it is believed to affect roughly 3% of people in health care settings. Here we will look at the symptoms of hypochondria and what it means.
Symptoms of Hypochondria
Hypochondria is a psychological issue rather than an illness and symptoms will vary slightly from person to person. However they tend to involve the individual interpreting minor symptoms as being indicative of severe illness or of the imminent on-set of severe illness. This belief will often then persist despite the individual heading to the doctor and getting a diagnosis. Even after the doctor has given them the all-clear however, in most cases the patients will continue with the belief that they are suffering from an illness and will question the doctor’s diagnosis. If they receive a diagnosis meanwhile that suggests they do have some kind of health condition, then their concerns will tend to be excessive in relation to a relatively minor problem.
In many cases hypochondriacs will focus on a particular area or a particular problem. For instance they will fixate on heart palpitations, muscle fatigue or gastro-intestinal problems rather than complaining around all three. To be classed as hypochondria the fixation must last three months or longer.
However at the same time hypochondria should not be diagnosed and identified purely by the patient’s trips to the doctor as some hypochondriacs will continue to suffer from their fear without ever speaking about it. In fact they might go to efforts to avoid reminders of the illness this makes the diagnosis difficult. The ICD uses the following diagnostic requirements:
• A persistent (6 month +) belief that they are suffering from one or two serious physical diseases (where no disease is present) or a persistent preoccupation with deformity or disfigurement (this particular form is called ‘body dysmorphia’ in which a patient believes themselves to be fat/ugly/deformed when they are not, often leading to repeated visits to a plastic surgeon)
• Preoccupation with the belief causes distress and prevents regular functioning
• Persistent refusal to accept medical advice
Other disorders however are exclusion criteria – if the individual suffers from schizophrenia or mood disorders then this does not classify as hypochondria.
Other signs that a person might have hypochondria involve a preoccupation with cleaning and repeated washing of the hands etc. They might take many days off of work, or cancel on social appointments. Many other psychological conditions commonly accompany hypochondria and these include depression and obsessive-compulsive disorder (wherein the hand washing and visits to the doctor are the obsessive compulsive behavior).
Problems
Sensitivity to your bodily conditions is of course a positive thing and it will increase the chances of patients identifying potential problems before they arise. However at the same time hypochondria can also often be a negative thing and have negative repercussions. For instance in some severe cases hypochondria it can become completely disabling as people believe they are too ill to go outside, as they go to extreme lengths to avoid germs etc. This can result in their taking many days off of work, or canceling social appointments. This can then of course negatively affect their career and their relationships.
Hypochondria can also lead to other conditions, notably depression and stress which are a result of the obsessive concern. It might also cause agoraphobia as the individuals become too afraid to go outside where they will come into contact with germs. This then leads to a vicious cycle – as the patients refuse to subject themselves to these conditions the belief becomes self-reaffirming and they experience nothing to challenge their faulty beliefs.
Patients might also experience psychosomatic and phantom symptoms and be more sensitive to mild pain and tiredness. This can then result in their experiencing genuine discomfort due to a condition that they do not have. They might also make diagnosis of real conditions more difficult for doctors – particularly if they have encountered the patient many times before and believe them to be ‘crying wolf’. The stress and depression can also cause more problems such as elevated blood pressure and heart rate and reduced immune function. ‘White coat’ syndrome describes a phenomenon in which the individual experiences these symptoms in response to the presence of doctors on medical facilities.
Contributing Factors
There are many ways that hypochondria can come about. As mentioned, conditions such as depression and obsessive compulsive disorder are risk factors, and in other cases the fear might be triggered by deaths or illnesses of those close to the individual. ‘Cyberchondria’ meanwhile is a colloquial term used to describe those who research medical conditions online and then begin to diagnose themselves. Other media may also play a role such as television, films and even the news when reporting on outbreaks. There is also a familial link and this is believed to be a result of both the genetics and the upbringing. A parent who is particularly over-protective of their child and stresses the importance of hygiene to their children may well pass on their concerns and inadvertently cause their children to be overly sensitive.
Cognitive behavioral therapy, in which therapists identify and treat the negative thought patterns leading to hypochondria, has been shown to be an effective treatment. Meanwhile SSRIs (selective serotonin reuptake inhibitors) may be used to treat anxiety disorders where it is disabling.