Hypochondria

Generality

Hypochondria is a mental disorder that triggers, in sufferers, the completely unfounded fear of having a serious illness. The hypocondriac individuals, in fact, are people who are convinced that every little malaise suffered is the premonitory sign of a very serious pathology.

This imaginary fear gradually affects the entire existence of the affected subject, from the working sphere to social / emotional relationships.

Indeed, in the most serious cases, hypochondria leads to the improper intake of drugs, depression, frustration, etc.

Healing from hypochondria is difficult, because, in addition to adequate treatment, the patient must work with his psychotherapist.

What is hypochondria?

Hypochondria is a mental disorder characterized by an obsessive and totally unfounded concern about having some serious illness.

Hypochondriacs (that is, patients suffering from hypochondria) are people consumed by the fear of being sick or suffering from something serious, despite all the medical examinations carried out (even the most specific) have shown the exact opposite.

The concerns and fears induced by hypochondria can be so profound that they condition a person's work and social / emotional relationships in a very marked manner.

HYPOCONDRY AND ANXIETY DISORDERS

Hypochondria has some similarities with anxiety-induced disorders (or anxiety disorders ), so much so that often hypochondriacs manifest symptoms similar to anxious people.

Anxiety disorders are at the origin of a sense of unease, similar to fear or excessive worry, with uncontrollable and long lasting connotations.

List of anxiety disorders include social phobia, obsessive-compulsive disorder, generalized anxiety disorder, panic, post-traumatic stress disorder and specific phobia.

WHO'S AFFECTED? Epidemiology

Incidence . The exact number of hypochondriacs in Italy is unknown. In fact, the data on the incidence of the disease are vague and probably underestimated (there is talk of a 1-5% of the population, but further and more in-depth studies would be needed).

Sex . Hypochondria can affect anyone, regardless of sex.

Age Although hypochondria may also affect young individuals, most hypochondriacs are of adult age.

Causes

The precise causes of hypochondria are, at the moment, still unclear.

According to the experts, it seems that the personality and character of the sick individual play a fundamental role, in addition to his life experiences and the education imparted to him.

RISK FACTORS

After countless studies, it has been found that hypochondria is favored by certain situations. These situations, which can be considered real risk factors, are:

• Having suffered, in adolescence, from a very serious illness, which has left an indelible sign of its passage in the psyche of the person affected
• Knowledge of individuals (friends or close family members) with serious pathologies
• The death of a loved one
• Suffering from one of the so-called anxiety disorders
• Being convinced that being healthy means having no physical discomfort or any discomfort
• Living with a family member suffering from hypochondria
• Feeling inexplicably vulnerable to any illness
• The neglect on the part of parents, in adolescence

Symptoms and Complications

To learn more: Symptoms Hypochondria

Individuals with hypochondria manifest the disease in many ways.

First of all, they are obsessed with the fear of having some serious pathology and are terribly afraid of having to suffer the slightest discomfort. This leads them to continually book medical examinations and diagnostic tests (magnetic resonances, echocardiograms, exploratory surgeries, etc.), to contact different doctors for the same problem, to continuously measure vital signs (pulse or blood pressure) and to hijack the theme of each speech towards their phantom disorders.

So, in their spare time, they go to consult medical encyclopedias and medical websites, looking for information and wondering what this symptom might mean; many times, during these searches, they read of a serious pathology and are convinced of being affected of it.

Finally, they assume completely abnormal habits, such as changing their reference doctor frequently, staying near a hospital even in the most unthinkable hours (so that they can reach it faster if they experience some imaginary pain or discomfort) and call their doctor even in the middle of the night.

Table . Summary of classic hypochondria symptoms:

• Unmotivated fear of having some serious illness
• Conviction that any small annoyance / discomfort felt is due to a serious illness
• Book visits on visits and undergo periodic magnetic resonances, echocardiograms etc.
• Change the reference doctor periodically
• Talk to relatives and friends only and exclusively about the imaginary illnesses that you believe you have
• Do continuous research on serious illnesses, both on the internet and on paper texts
• Continuously measure your pulse and blood pressure
• Read about a serious illness and convince yourself that it is the disorder you are suffering from

CARE OF OUR HEALTH ALWAYS MEANS HAVING HYPOCHONDRIA?

Worrying about your health and asking a doctor what this disorder may mean does not necessarily mean being hypochondriacs. Indeed, it is normal behavior and more than justifiable.

In the same way, going to inquire about the possible origins of a perceived symptom is not always synonymous with obsession, but it can be simple curiosity and desire to understand.

Attention: taking care of your health, as well as periodically undergoing certain diagnostic tests (for example, mammography for women), are responsible behaviors and should not be considered hypochondria episodes at all.

WHEN AND WHO ASK FOR HELP?

Hypochondriacs, if they are aware of their mental disorders, must take courage and turn, without shame, to the care of a psychiatrist or a psychologist .

If, on the other hand, they are not aware of their problems and are convinced that every sensation they feel is true, they need help from their relatives, friends or family doctor.

Help a loved one with hypochondria

Some patients with hypochondria are unaware of their mental disorder, in the sense that they are firmly convinced that they suffer from something and believe that their concerns are more than founded.

In order to help these individuals, their relatives or close friends must have a clear and honest dialogue with them, explaining to them what is really wrong. You need tact, because only then can you encourage them to request a medical consultation from a psychiatrist or a psychologist.

COMPLICATIONS

Hypochondria can become an overwhelming and disabling mental disorder, as the lives of those who suffer from it are strongly conditioned by inexistent and unfounded obsessions.

The most serious hypochondria sufferers have problems in the workplace (because they are often absent), difficulties in relating to others (because they speak only of their imaginary diseases), tense relations with their doctor and serious financial problems (due to the costs of the countless medical examinations).

Moreover, their condition can lead to:

• Improper and dangerous use of drugs
• Frustration and irritability
• Depression
• Anxiety disorders
• Drug use due to depression

Diagnosis

A patient with suspected hypochondria must be evaluated not only from the mental point of view, but also from the physical point of view; this is because you have to show that you are actually well and that you do not misuse drugs (see the chapter on complications).

PSYCHIC OR MENTAL ASSESSMENT

The psychic evaluation, which is the responsibility of a psychiatrist or psychologist, consists in the administration, to the hypochondriac patient, of a targeted questionnaire; the answers provided by the patient are then compared with what is reported, regarding hypochondria, in the Diagnostic and Statistical Manual of Mental Disorders ( DSM ). This text (published by the American Psychiatric Association) represents a collection of all the typical characteristics of known mental / mental illnesses, including the criteria required for diagnosis.

According to the DSM, a person is hypochondriac if:

• Based on an incorrect and entirely personal interpretation of some physical discomforts, he has the fear (or belief) of suffering from a serious illness.
• This fear (or conviction) persists even after the comfort of various clinical examinations and reassurances from the doctor.
• This fear (or conviction) causes discomfort and affects the social sphere and work activity.
• This fear (or conviction) continues for more than six months.

PHYSICAL EVALUATION

Physical assessment is the responsibility of a physician and consists of a physical examination and a complete blood test .

With the physical examination, the real state of health of the patient is determined, some of his vital parameters are measured (such as heart rate, blood pressure and body temperature) and, finally, all the information regarding his clinical history is collected * (then pathologies suffered in the past, current disorders etc.).

With blood tests, on the other hand, it is checked that there are no pharmacological substances in circulation (due to improper use) and that the main blood values ​​are all normal.

* NB: for everything concerning clinical history, often the doctor also calls on the patient's family members, so as to have a more than reliable picture of the situation.

Treatment

Treating hypochondriasis is a difficult task, as, in addition to adequate psychological therapy, considerable collaboration is required from the patient; the hypochondriac subject, in fact, must firmly believe in healing and in the advice given to him by the therapist, although they are contrary to his own convictions.

PSYCHOLOGICAL THERAPY

Psychological therapy includes:

• Cognitive-behavioral psychotherapy . Ideal for treating various mental disorders (not only hypochondriasis), the aim is to teach the patient to recognize unfounded concerns and fears (in specialized jargon, "distorted thoughts") and not to be influenced by them. In other words, the patient is taught how to identify the classic symptoms of hypochondria and how to better control them. Cognitive-behavioral psychotherapy includes, in addition to a part "in study" with the psychotherapist, also "homework", whose execution is fundamental to cure. All the teachings acquired during the course of the therapy are a precious baggage, which is good to carry around to avoid relapses.
• Psychoeducation . It consists of illustrating, to the patient and his family, the main characteristics of the mental disorder in place and the best methods for healing. The family members are also given some advice on how to behave towards their loved one.
• The administration of certain psychotropic drugs . The psychotropic drugs administered are the so-called antidepressants . The most commonly used are selective serotonin reuptake inhibitors (SSRIs) - such as fluoxetine, fluvoxamine and paroxetine - and tricyclic antidepressants, such as clomipramine and imipramine.

  NB: if the patient suffers from other associated mental disorders (anxiety disorders, etc.) or physical problems (for example due to improper use of drugs), additional medicines may be prescribed.

COLLABORATION BY THE PATIENT: WHAT IS GOOD?

In order to overcome their mental disorders, hypochondriacs must collaborate with the psychotherapist and firmly believe in the advice of the latter.

This collaboration consists of some fundamental cornerstones, such as:

• Give continuity to therapeutic treatments and believe in their effectiveness . Patients must overcome the temptations to abandon the therapeutic pathway undertaken and be convinced that this is the right path to follow. In fact, it often happens that patients find it difficult to give continuity to treatment and give up prematurely.
• Learn about the disease . The knowledge of hypochondria (psychoeducation) allows the patient to better overcome the most difficult moments.
• Pay attention to what triggers fears and concerns . Sometimes the fears and concerns of the hypochondriac are exacerbated in particular situations. It would be advisable for the patient to analyze what happens in such situations, looking for a possible trigger, to report to his psychotherapist.

  Attention: all this is possible only if the patient knows the characteristics of his illness and the ways to dominate it.

• Keep active . Exercising, such as walking, swimming, running, gardening, etc., helps alleviate the symptoms of hypochondria and its complications (depression, anxiety, frustration, irritability, etc.).
• Avoid using drugs and alcohol . Alcohol and drugs increase depression and anxiety. This is why it is good not to be tempted by the use and abuse of these substances.
• Create a good relationship with your primary care physician . Often, hypochondriacs have a bad relationship with the general practitioner, as they expect continuous consultations from the latter, almost always for imaginary disorders, and the prescription of completely useless diagnostic tests. Also in this case, knowing what hypochondria entails helps the individual who suffers to relate better with the doctors and to accept their refusal to book visits and unnecessary tests.

OTHER ADVICES VALID FOR THE REST OF LIFE

Since the risk of a relapse is more than concrete, individuals with a history of hypochondria must, for their own good, learn to dominate and maintain certain behaviors.

First of all, they have to reject every little temptation that leads them to: change their reference doctor and do research (on the internet or in various medical encyclopedias) on serious diseases.

So, it is good that they keep away from TV programs (or magazines) of seriously ill people, and that they avoid monitoring their pulse or blood pressure, even when the desire is strong.

Finally, if they feel they can't do it without the help of someone else, they can turn to some support group created specifically for hypochondriacs and former hypochondriacs.

Table . Summary of advice that a person with hypochondriasis should follow in the past:

• Do not change referring physicians, even if the temptation is strong
• Avoid searching the internet or elsewhere for serious illnesses
• Avoid watching TV shows or reading magazines that tell of people with serious illnesses
• Resist the temptation to measure your pulse or blood pressure. If you really need to, contact your doctor and rely on him
• Ask family members for help in case of fear or special concerns
• Enroll in a support group for hypochondriacs or individuals with a history of hypochondria.

Prevention

Hypochondria is a preventable mental disorder, also because its precise causes are not known. It is true that previously some favoring situations have been mentioned, however it is difficult to predict who is at risk or not, as, for example, not all people neglected by adolescent parents, or affected by a state of anxiety, get sick with hypochondria.