What is Hypochondria?
Hypochondria occurs when a person is abnormally concerned about his/her health in a way that doesn’t fit the picture.
It becomes a disorder when it continues for longer than six months, and interferes with a person’s ability to function normally.
The anxiety is significant, and surrounds concern that a person has a serious health condition that has not been diagnosed. Hypochondria is often mocked and/or treated tritely by the sitcoms and romantic comedies. Please know that hypochondria is not funny or cute.
It’s an anxiety disorder that has some close connections to Obsessive Compulsive Disorder, in that the concerns of illness become obsessive and, often a person feels compelled to be reassured by doctors, or self-checking, or the internet that they are not ill.
What does it look like?
Often the symptoms of hypochondria begin during a time of stress. As you can imagine, stress has a person feeling overwhelmed and out of control.
And when a person feels vulnerable, often it is expressed as a concern that one’s health or even one’s life is at risk.
Often people that struggle with hypochondria will have had a serious illness as a child, had a relative with a serious or fatal illness:
- a young adult whose parent dies of lung cancer fears the fatal illness with a mild cough that is part of a regular cold
- a teen has trouble swallowing while a parent is struggling with throat cancer
- a middle aged gentleman has a suspicious mole removed and now is hypervigilant about examining his body for any skin changes.
- a young mom, who’s own mother passed away at 29, starts fearing death and having symptoms of illness in her late 20’s.
A person with hypochondria may seek constant medical reassurance, seek multiple opinions, do extensive research or be involved in frequent checking of symptoms. Conversely, they may avoid physicians and all discussion about the fears to avoid hearing what is the anticipated diagnosis and/or being made fun of.
What can make fears of illness worse?
One of the challenges with hypochondria is that it is an anxiety disorder. And anxiety itself affects the body in real and tangible ways with marked physical effects…feeling of constricted chest, heart palpitations, insomnia, headache, muscle tension, nausea, diarrhea. These symptoms of anxiety are real and measurable…and are, by no coincidence, also symptoms of various other illnesses/cancers/diseases.
You can see where I’m going with this.
When a person is convinced s/he has an illness, they become anxious…and when anxious, physical symptoms can begin. And when the physical symptoms of anxiety begin:
- the tension headache of anxiety becomes a brain tumour
- the chest tightness of an anxiety attack becomes an imminent heart attack
- the diarrhea becomes certain colon cancer
- the “jitteriness” of anxiety becomes a probable seizure
And the symptoms of anxiety further exacerbate the fear of illness, which further increases the symptoms of anxiety, and so on.
An additional factor that can make it worse, is frankly, the internet. The internet can act as gasoline on a fire as there is no shortage of information on any number of illnesses, along with graphic pictures that can horrify. Additionally, anyone can post anything on the internet, so there is a lot of misinformation on the internet.
One last feature of the internet…issues and diagnoses that may be remote and statistically rare, that would remain unknown to the general public can seem common and frequent because of the instantaneous nature of google.
What is the treatment for this unhealthy fear/focus on illness?
First and foremost…rule out real physical illness. Get the symptoms checked out. Know that it is hypochondria and not an actual physical illness.
There are some medications that are effective in treating hypochondria, and this should be discussed with the doctor.
Therapy is also very helpful, to help sort out thought patterns and develop coping strategies to deal with the symptoms and stressors of the illness.
Family and friends can be critical to help a person understand that this is a treatable disorder. In the middle of it, a person can worry they are going crazy, or that others will pull away, or not take the fear seriously. Be firm and gentle in persistently encouraging that a person struggling with health fears get help. It can be helpful to attend a session of therapy with the person who is struggling to hear what they hear, to help them remember what was said, to learn the relaxation/grounding strategies to be able to remind the struggler when it gets especially hard. Family is a tremendous resource in therapy.
What can family and friends do?
First, let’s talk about what isn’t helpful. Naming, shaming and blaming doesn’t work. Name calling, telling the person they are silly/crazy/ridiculous won’t fix anything. Telling a person who is struggling with the fear of a serious illness that s/he is annoying other people or is boring or frustrating, won’t actually help him/her release the fear. Mocking doesn’t help. In fact, it can increase stress, which can, in turn, increase the fear of illness.
Another thing that’s not helpful…telling a person “it’s all in your head”. First off, the person often knows this…and the person isn’t dumb, just anxious! Honestly, can you tell me you don’t have a fear that at some level you know is irrational? I fear hearing fingernails on a chalkboard, spiders, eating insects, and I’m not fond of looking over balconies that are really high in the air. I know that these are irrational–having someone tell me that all of these can be safe won’t actually reduce my fear. Second of all, there are times when the feeling of illness feels so real, that when a person is told “it’s all in your head”…that feels minimizing and disrespectful.
One last non-helpful thing. Don’t argue or do research to dispute the illness, or help with research in a way that will escalate discussion and increase anxiety.
What can you do? Understand that when a person fears s/he is dying it is terrifying.
Be with a person to give them space to be themselves in feeling their anxiety, with empathy and compassion…
- “This is one of those really hard days where you’re really worried again, huh? I know these are tough for you.”
- “Would you like a hug?”
- “Being terrified is awful. You look really stressed. I don’t know what to do, but I want you to know I care””
If you have a relationship of trust, and the person struggling with the fear of illness gives you permission, help with “grounding”–gently reminding the person of truth:
- Would you like me to remind you of why the doctor knows that you don’t have the cancer?
- Let’s review together how we know that your symptoms aren’t what you’re worried about
- Hey…remember the computer isn’t helpful? Why don’t you shut it down?
- Can you tell me what your therapist said to do at times like this? Let’s talk this through
Other strategies that can help you walk alongside a person struggling with fears of illness:
- distraction: Offer to go watch a movie on a completely unrelated topic, go for exercise, out for dinner or a walk or something that can preoccupy a person’s thoughts
- de-stressing. Do some relaxation, or deep breathing, or imagery, or some other strategy that naturally reduces anxiety (and feelings/fears of illness)
- avoid drinking excessive alcohol together which can depress coping abilities
This is a treatable disorder. Connection with others will make a huge difference. Call your doctor, contact a therapist and move through the discomfort in a way that is self-compassionate.