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Jai Ganesh

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Hypochondria

Hypochondria

Gist

People with illness anxiety disorder -- also called hypochondria or hypochondriasis -- have an unrealistic fear that they have a serious medical condition or fear that they're at high risk of becoming ill. They may misinterpret typical body functions as signs of illness.

Summary

Everyone worries about their health at times, but for some people, fears of being ill are so strong, even when they are in good health, that they find it hard to cope with their everyday life.

Someone who lives in fear of having a serious illness, despite medical tests never finding anything wrong, may have somatic symptom disorder, also known as illness anxiety disorder. The condition has also been known by other names, including hypochondria, or hypochondriasis.

Fast facts on hypochondria:

* The main symptom of hypochondria is excessive worrying about health.
* Causes may vary, and could be related to other legitimate health conditions.
* For most people, it is a temporary experience.
* The term as defined by the DSM-5 manual is somatic symptom disorder.

What is hypochondria?

The most common symptom of hypochondria is excessive worrying about health.

A study published in JAMA defines somatic symptom disorder as “a persistent fear or belief that one has a serious, undiagnosed medical illness.”

The authors note that it affects up to 5 percent of medical outpatients. In short, the disorder is a mental health condition where a person worries excessively that they are sick, to the point where the anxiety itself is debilitating.

Worrying about health becomes an illness.

Somatic symptom disorder is a chronic condition.

How severe it is can depend on age, a person’s tendency to worry, and how much stress they are facing.

Details

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.

Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, their concerns are far in excess of what is appropriate for the level of disease. It is also referred to hypochondriaism which is the act of being in a hypochondriatic state, acute hypochondriaism. Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal problems, palpitations, or muscle fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least six months.

International Classification of Diseases (ICD-10) classifies hypochondriasis as a mental and behavioral disorder. In the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR defined the disorder "Hypochondriasis" as a somatoform disorder and one study has shown it to affect about 3% of the visitors to primary care settings. The 2013 DSM-5 replaced the diagnosis of hypochondriasis with the diagnoses of somatic symptom disorder (75%) and illness anxiety disorder (25%).

Hypochondria is often characterized by fears that minor bodily or mental symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one's body. Many individuals with hypochondriasis express doubt and disbelief in the doctors' diagnosis, and report that doctors’ reassurance about an absence of a serious medical condition is unconvincing, or short-lasting. Additionally, many hypochondriacs experience elevated blood pressure, stress, and anxiety in the presence of doctors or while occupying a medical facility, a condition known as "white coat syndrome". Many hypochondriacs require constant reassurance, either from doctors, family, or friends, and the disorder can become a debilitating challenge for the individual with hypochondriasis, as well as their family and friends. Some individuals with hypochondria completely avoid any reminder of illness, whereas others frequently visit medical facilities, sometimes obsessively. Some may never speak about it.

A research based on 41,190 people, and published in December 2023 by JAMA Psychiatry, found that people suffering from hypochondriasis had a five-year shorter life expectancy compared to those without symptoms.

Signs and symptoms

Hypochondriasis is categorized as a somatic amplification disorder—a disorder of "perception and cognition"- that involves a hyper-vigilance of situation of the body or mind and a tendency to react to the initial perceptions in a negative manner that is further debilitating. Hypochondriasis manifests in many ways. Some people have numerous intrusive thoughts and physical sensations that push them to check with family, friends, and physicians. For example, a person who has a minor cough may think that they have tuberculosis. Or sounds produced by organs in the body, such as those made by the intestines, might be seen as a sign of a very serious illness to patients dealing with hypochondriasis.

Other people are so afraid of any reminder of illness that they will avoid medical professionals for a seemingly minor problem, sometimes to the point of becoming neglectful of their health when a serious condition may exist and go undiagnosed. Yet others live in despair and depression, certain that they have a life-threatening disease and no physician can help them. Some consider the disease as a punishment for past misdeeds.

Hypochondriasis is often accompanied by other psychological disorders. Bipolar disorder, clinical depression, obsessive-compulsive disorder (OCD), phobias, and somatization disorder, panic disorder are the most common accompanying conditions in people with hypochondriasis, as well as a generalized anxiety disorder diagnosis at some point in their life.

Many people with hypochondriasis experience a cycle of intrusive thoughts followed by compulsive checking, which is very similar to the symptoms of obsessive-compulsive disorder. However, while people with hypochondriasis are afraid of having an illness, patients with OCD worry about getting an illness or of transmitting an illness to others. Although some people might have both, these are distinct conditions.

Patients with hypochondriasis often are not aware that depression and anxiety produce their own physical symptoms, and mistake these symptoms for manifestations of another mental or physical disorder or disease. For example, people with depression often experience changes in appetite and weight fluctuation, fatigue, decreased interest in gender, and motivation in life overall. Intense anxiety is associated with rapid heartbeat, palpitations, sweating, muscle tension, stomach discomfort, dizziness, shortness of breath, and numbness or tingling in certain parts of the body (hands, forehead, etc.).

If a person is ill with a medical disease such as diabetes or arthritis, there will often be psychological consequences, such as depression. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations of these affective fluctuations, often in the form of medically unexplained symptoms. Common symptoms include headaches; abdominal, back, joint, rectal, or urinary pain; nausea; fever and/or night sweats; itching; diarrhea; dizziness; or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms feel they are not understood by their physicians, and are frustrated by their doctors’ repeated failure to provide symptom relief.

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