By April Cashin-Garbutt, BA Hons (Cantab)
Have you ever wondered whether you are worrying about your health too much? According to a new book released by a Northwestern Medicine professor, “we have become a nation of hypochondriacs”. (3)
The ready-availability of the internet certainly makes searching for information on medical conditions very easy. It has led an associate professor to dub our time as “an era of self-diagnosis”. Furthermore, the exchange of health information over internet forums and so forth has even been labelled as “cyberchondria”. (10, 14)
But how much self-diagnosis should we be doing - at what point does this turn into hypochondria? In order to answer this, we first need to know what hypochondria actually is and who it affects. Then perhaps we can look at what we can do about it.
What is hypochondria?
Hypochondria is a condition where you experience anxiety about your own health. This generally involves fearing that you are seriously ill. (1)
The symptoms that a hypochondriac fears about may be real or imaginary. (1) Sometimes a person may mistake normal bodily functions, like sweating or general aches and pains, as symptoms of a serious disease. (2)
It is characteristic for someone with hypochondria to continue to fear that they are seriously ill, even in the face of their doctor assuring them they are not. (6)
Is hypochondria really a medical condition?
In short, the answer is yes. Hypochondria is a recognized medical condition named ‘clinical hypochondriasis’. (3)
The condition is listed under the World Health Organisation’s classification system ICD-10 as hypochondriacal disorder. (8)
Hypochondriasis is also listed under the Diagnostic and Statistical Manual (DSM) IV. It has been proposed that in the DSM V the condition should be broken down into two categories: Somatic Symptom Disorder (SSD) and Illness Anxiety Disorder (IAD). (7)
The former would refer to those patients who are concerned over somatic symptoms; whereas the latter would be reserved for those who have minimal somatic symptoms but are still anxious about having a serious medical illness. (7)
Who does hypochondria affect?
Hypochondria affects both men and women. It is also more likely in those with a history of abuse. This abuse may be physical or sexual. (4) Not all people with hypochondria, however, have experienced abuse in the past. (5)
The prevalence of hypochondria is estimated to be between 1 and 5% and it tends to commence when the patient is between 20 and 40. It can, however, arise in older or younger people. (6) Yet, hypochondria does tend to present its symptoms before a patient reaches 50 years of age. (8)
What triggers hypochondria?
It is not known for certain what triggers hypochondria; however, observing someone close experience a debilitating illness, or indeed experiencing a serious illness oneself, may sometimes lead to hypochondriasis. (6)
Hypochondria may also be triggered by the environment in which a child grows up. This may be particularly relevant if a patient was brought up in a household where illness was heavily focussed on; or if the child received lots of attention every time they were ill. (9)
Symptoms of hypochondria
There are many symptoms of hypochondria. Generally they are associated with a deep worry over being seriously ill, based on some bodily symptoms.
The bodily symptoms over which the worries stem, may involve a range of different body parts. The following parts of the body are most commonly affected:
- Abdominal viscera - this is the abdominal region that includes the stomach, intestines, liver, pancreas, spleen, kidneys and so forth
- The chest
- The head and neck (11, 12)
The physical symptoms the patient experiences lead them to fear that they have a medical problem. This fear persists despite negative test results and assurance from the healthcare provider that the patient does not have a medical condition.
In order to be classified as having hypochondria, the fear of illness must last for at least six months. (1)
Another symptom of hypochondria is that a patient’s fear over having a particular medical condition is heightened by reading about a disease. (13)
Treatment of hypochondria
There are two main types of treatment for hypochondria: talking therapy and medications. (1, 4)
Within talking therapy, there are two main methods to treat hypochondria: psychotherapy and Cognitive behavioural therapy (CBT).
Both of these psychological methods focus on understanding the condition and its symptoms, and talking about ways to cope with them. (4)
Another talking therapy option is for patients to attend “group psychotherapy”. The only problem with these therapies is that many patients will not agree to attend them. (6)
Antidepressant medications are sometimes used to treat hypochondria. Specifically serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants may be prescribed. (1, 15)
Benzodiazepines are also sometimes prescribed, but issues have been raised over their usefulness. (6)