“Does this look cancerous to you?”
When I was younger, I had one friend who could always be relied on to regale listeners with intimate details of her medical history, and everyone was required to chime in with an opinion on whether her moles looked like melanoma, or whether her jitters could be early symptoms of Parkinson’s. She would show us some perfectly normal-looking body part and explain why she thought it looked sick. Every lump or bump was cancer and every sniffle or sneeze was the pandemic du jour. According to her, her entire body was wasting away. Even the ridges in her nail beds were omens of doom.
She spent much of her free time researching various diseases and going to the doctor. Whenever she told our friends about how her tingling foot was definitely a sign of multiple sclerosis, we always laughed and dismissed her by saying, “Oh, she’s just a hypochondriac.” She didn’t die of any of the imaginary diseases she self-diagnosed, but as it turns out, hypochondria might have been the one disorder she did have.
It’s All in Your Head
Hypochondria is currently considered to be psychosomatic—a mental disorder with physical symptoms. The problem, though, is that with hypochondria, the physical symptoms aren’t really symptoms at all. The human body is full of naturally occurring aches, pains, gurgles, and grumbles, and they don’t usually signify any serious underlying illness. Everyone has experienced random pangs, unexplained fatigue, and other body quirks. Most of us dismiss them as fleeting and harmless moments of discomfort, but the hypochondriac misinterprets them, assuming that they are the harbinger of some horrible and deadly disease.
While it’s normal to become concerned when something in the body feels amiss, people with hypochondria seek out medical help but then refuse to accept it when doctors diagnose them as healthy. In their mind, they are suffering from a disease, and they demand testing and procedures to determine the problem. They tend to get frustrated with the quality of their medical care. To them, any doctor who can’t see they’re sick is a doctor who isn’t doing his job. Some patients even “doctor shop,” visiting multiple doctors looking for a diagnosis.
Doctors estimate that from 1 to 5 percent of Americans suffer from hypochondria. The disorder usually develops during early adulthood and can interfere with work, life, and relationships if it’s left untreated. Some doctors think that hypochondria might actually be a form of obsessive-compulsive disorder (OCD) because of the way that sufferers unrelentingly fixate on their health fears. About 75 to 85 percent of people with hypochondria have also been diagnosed with depression, anxiety, or another mental disorder.
No one knows exactly what causes hypochondria, but doctors guess that it’s related to stress and anxiety. Although it strikes men and women equally, some people may be more at risk for developing the disorder than others. Individuals who were sick as children or who had close relatives with ongoing illnesses may be more susceptible, since they might have underlying fears about death and sickness. Also, people with histories of depression or anxiety or who have recently experienced a traumatic or stressful event tend to experience hypochondria in greater numbers.
A Vicious Cycle
In some patients, the disorder persists for years, and for other people it only goes through periods of severity, but if left untreated, hypochondria can affect a person’s relationships, job, and quality of life. Family and friends can become alienated and irritated by persistent discussions of health and medical details, and people can find their jobs strained when they constantly request time off to visit doctors. Eventually, physical health can be compromised too, under the strain of unnecessary procedures or medications. After spending months or years trying to get a diagnosis and subjecting themselves to medical testing, some hypochondriacs begin having headaches, nausea, or other physical maladies. These symptoms reinforce the person’s opinion that he or she is ill, even though it was the stress of the disorder that brought on the symptoms in the first place.
Many doctors—if they suspect that a patient’s problem is mental, not physical—will request that the person see a psychiatrist or psychologist to try to deal with the root of the problem. Some signs they look for include a preoccupation with an illness for at least six months, disregard for previous diagnoses of good health, and difficulty in maintaining a normal life due to the obsession with illness and disease. Therapy and antidepressant medications both work to relieve the anxiety and having a trusting relationship with a caring and competent doctor is important.
Treating mental disorders is often more difficult and nebulous than treating physical symptoms since no simple antibiotics or surgery can cure hypochondria. Luckily, most sufferers who get treatment go on to live fully normal, productive lives. Then when they ask their friends, “Hey, does this sore look infected?” everyone takes them seriously.