What is hypochondria?
Hypochondria, also known as “disease mania”, is a mental disorder characterized by constant fear of being sick or developing a serious illness. Patients with hypochondria believe that common symptoms are signs of serious illness and visit the doctor with an exacerbated frequency, and may even perform several unnecessary tests.
It is a psychosomatic (or somatoform) disease, in which psychic conflicts lead to real symptoms. Although there is no organic disease behind it, the symptoms of the hypochondriac are real, which makes diagnosis and treatment very difficult. The patient does not fake his symptoms, but he usually amplifies normal symptoms such as simple muscle pain.
Usually, when hypochondriacs appear at the doctor’s office, they complain of symptoms in important areas of the body, such as the head, neck and trunk. Most complaints are in the form of pain, but other symptoms that may appear include itching, diarrhea , dizziness and fever .
It is not such a rare condition: about 10 million Brazilians suffer from it every day. In fact, even ⅓ of the patients who see a doctor get to show symptoms without a physical cause.
Another name for the condition is nosomiphaly , and it can be found in the International Classification of Diseases, 10th edition (ICD-10), by code F45.2.
The term “hypochondria” has a somewhat intriguing history.
Hypo comes from the Greek and means “below”, while kondria means “chest cartilage”, that is, the origin of the disease would be, for the Greeks, below the chest.
This is because, in ancient Greece, Hippocrates developed the “humoral theory”, in which the human body is made up of 4 humors (substances) that, when unbalanced, generate diseases. They are blood, phlegm, yellow bile and black bile.
Below the thorax is the spleen, an organ that would be responsible for the production of black bile ( melas , “negro” + cholé , “bile”). Those who had excess black bile lived sadly: they were melancholic people.
Melancholy people were also those who suffered from various illnesses and were overly concerned about their health. As the spleen is located below the chest, the term “hypochondria” came to be used to describe those people most sensitive to diseases.
It is not known exactly what causes hypochondria. As with most mental disorders, the causes appear to be a variety of factors, including genetic and environmental.
Some hypotheses about why someone develops hypochondria are:
It is believed that some people may experience perceptual changes that make them feel the symptoms much more intense than they really are. For such a person, mild nausea is interpreted as extremely severe nausea.
Lack of information
People with little access to information may not fully understand what a symptom means and, therefore, believe that they are sick when they have a simple symptom of indigestion ( dyspepsia ), for example.
There are those who believe that they deserve a disease as a punishment for something they have done in the past. In such cases, the person waits for the disease, paying attention to each different signal that the body gives.
Being sick has its benefits: attention, affection, the possibility of missing school or work … Therefore, some believe that one of the causes of hypochondria can be a kind of conditioning, especially if it starts during childhood.
A child with very absent parents, for example, may begin to feel ill more often to get attention. In this state, the child receives more affection and grows up with this idea engraved in his unconscious.
Other mental disorders
Not infrequently, hypochondria is associated with other mental disorders, such as anxiety and depression . It is estimated that 75 to 85% of hypochondriacs suffer from another disorder. It can be a sign of any of these conditions, or it can develop from them.
For example, we can think of an anxious person who loses a relative to an illness. After a while, she may start to experience symptoms of the same disease because she is afraid of developing it too, especially if the condition is hereditary.
Some patients with depression tend to live with physical symptoms resulting from their disorder, such as fatigue and unexplained pain.
Although there are many hypotheses for the causes of hypochondria, none of them are certain. However, some risk factors have already been identified, such as:
- Family history of hypochondria;
- Recent stressful events, such as the death of a loved one;
- Serious illnesses during childhood;
- Medical suspicion of a serious illness which, when diagnosed, was not so serious;
- History of child abuse;
- Overprotection of parents during childhood;
- Worried personality;
- Mental disorders such as anxiety, obsessive-compulsive disorder (OCD), personality disorders and depression.
There is, specifically, no list of the most common diseases that hypochondriacs could have. Basically, any disease that the individual is aware of can serve as a basis for him to have symptoms.
Believing that they have a disease, many of these individuals self-diagnose and start consuming medications without first consulting a doctor.
Even if, if a hypochondriac were to consult a health professional, he would most likely leave there thinking that the doctor made a mistake in the diagnosis and that he does need some medication.
If needed, these individuals can even get prescription drugs for other people, since they would not be able to acquire a doctor’s prescription.
The problem is that the lack of guidance when taking medications can lead to other adversities, such as intoxication or gastric problems . All of this only with over-the-counter medications!
However, prescription drugs, especially those that require prescription retention, are much more dangerous because of their side effects. In addition, the patient does not have a notion of which medication interacts with which and, with this, he may end up suffering with several adverse effects.
One type of medication that should not be taken without the express indication of a doctor is the antibiotic . This type of substance helps to eliminate bacteria that are causing infections, but it can be very dangerous when used without responsibility.
That’s because bacteria evolve very quickly and it takes little time for them to build up resistance to drugs. Thus, the incorrect use of antibiotics favors these bacteria to be untreatable.
Another problem is that antibiotics also attack the good bacteria in our body, such as the intestinal or vaginal flora. The result? Other diseases, such as intestinal imbalance, candidiasis, etc.
The symptoms of hypochondria are mostly behavioral. This means that, although the patient has physical symptoms, they are not the true symptoms of hypochondria, but their behavior. Some signs of hypochondria are:
- Constantly worrying about the possibility of having or acquiring a serious illness;
- In older patients, the concern includes the fear of losing memory;
- Believing that mild symptoms and sensations can be a sign of a serious illness;
- Stay alert to your health status easily;
- Read about a medical condition and begin to experience its symptoms;
- Worry about the possibility of having serious illnesses that have no symptoms;
- Do not believe in negative test results or a doctor who says the patient is healthy;
- Make excuses for the negative results such as “the disease is still in the beginning”, “the doctor was very young”, “the exam was badly done”, among others;
- Being overly concerned with the possibility of developing a specific pathology, especially when it is a recurrent disease in the family;
- Feeling so stressed because of the possibility of acquiring an illness that you cannot carry on with a normal routine;
- Check your body repeatedly for signs and symptoms of illness;
- Schedule medical appointments frequently to make sure you have nothing – or the other way around: avoid visiting health professionals for fear of being diagnosed with a serious illness;
- Avoid people, places and activities that may pose a health risk;
- Talk constantly about health and possible diseases;
- Fear of imminent death;
- Search the internet often for the cause of possible symptoms or illnesses.
This last habit, in particular, is harmful because, many times, the patient tries to diagnose himself and does not seek specialized medical help. Or worse: even after consulting a doctor, he still thinks he knows more than he does and insists that he has a certain disease.
Therefore, it is worth noting that the advent of health sites on the Internet is only to help patients already diagnosed to better understand their disease, or to help patients who are suspicious of something to talk to the doctor about it. However, the diagnosis can only be given by the doctor , just as the treatment can only be indicated by a health professional.
The diagnosis of hypochondria can be very difficult, as the patient does not realize that it is a mental disorder and usually seeks a doctor who treats somatopathologies (diseases related to the physical body).
In Brazil, there is no culture of a “family doctor”, as in Europe. This doctor is a general practitioner whom a family trusts and usually visits when they have any symptoms. Here, we go straight to the doctor who seems most convenient: if the symptom is in the heart region, we have already looked for a cardiologist.
This is problematic because the patient changes from doctor to doctor and none of them suspects anything. The hypochondriac ends up doing exams and more exams so that, in the end, he doesn’t have any problems (physical, at least).
Over time, suspicion arises among family members and friends, who follow him closely and realize his excessive health concern. In such cases, it is these people who make the patient seek help with a psychiatrist or psychologist , specialists in mental health .
There is no test capable of diagnosing hypochondria, so the diagnosis is made based on the symptoms and the patient’s history.
According to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of hypochondria can be made using the following criteria:
- Concern accompanied by fear of having, or the idea that you have, a serious illness based on misinterpretation of bodily symptoms;
- Persistent concern, despite adequate and reaffirmed medical evaluation;
- The belief in criterion 1 is not of delusional intensity (as in Delusional Disorder) and is not restricted to a circumscribed concern with appearance (as in Body Dysmorphic Disorder);
- The concern causes clinically significant suffering or impairment in the social, occupational or other important areas;
- The duration of the disorder is at least 6 months;
- The concern is not related to a Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Syndrome, an episode of Blue Depression, Separation Anxiety or other Somatoform Disorder.
It is difficult to say whether hypochondria is curable, especially when it is triggered by other mental disorders, such as depression and anxiety.
Although treatment can cause symptoms to go into remission (that is, they no longer appear), they can come back depending on several factors, such as stressful events or stage of life.
An elderly person who has been treating his anxiety for years may return to have hypochondriac symptoms in old age, since several serious illnesses manifest themselves at this stage of life, for example.
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In large part, the treatment of hypochondria is done with a psychologist , a professional who specializes in mental health.
Psychology brings several approaches that can be used to elaborate the patient’s feelings and thoughts, having a great impact in solving the problem. One of the most used is cognitive-behavioral therapy. Understand:
Cognitive-behavioral therapy (CBT)
Known as CBT, cognitive-behavioral therapy seeks to help the patient to change their behaviors and thoughts from a more elaborate analysis of their underlying thinking pattern and beliefs.
When feeling a different sensation in the body, the hypochondriac has a series of thoughts of which he is not aware that alter the way he reacts to that sensation.
The role of the therapist, in this case, is to help the patient to recognize these automatic thoughts, to evaluate their content and, from there, to be able to change their behaviors.
It is worth remembering that the treatment time depends a lot on the patient’s commitment. If he does not want to be treated or has difficulties to attend therapy sessions, the entire process is hampered.
With CBT, you can:
- Identify fears and beliefs related to the development of serious illnesses;
- Learning new ways of perceiving and interpreting bodily sensations, modifying unpleasant thoughts;
- Become more aware of how concerns and fears change behavior;
- Change the standard response to bodily symptoms and sensations;
- Learn skills to better cope with anxiety and stress;
- Reduce the hesitation to participate in certain activities due to physical sensations;
- Reduce the behavior of checking the body frequently for symptoms;
- Improve functionality in the home, corporate, relationships and other social situations;
- Treat other mental disorders, such as depression.
In addition to treatment with the psychologist, the patient may also end up needing psychiatric treatment. He is the doctor responsible for diagnosing the disorder, treating it with medication and helping you to identify the best treatment approach.
This neurotransmitter is responsible for regulating mood, sleep, libido, among other functions, and proves to be quite effective in the treatment of hypochondria.
Other medications that can be prescribed are anxiolytics , which help to deal with anxiety disorders, which is not uncommon among hypochondriacs.
In fact, it is even possible that the patient needs to take more than one medication, for more than one disorder. All of this will depend a lot on the symptoms, the associated disorders and the organism of each one.
Some medications that can be prescribed for the treatment of hypochondria are:
- Prozac (Fluoxetina);
- Aropax ( Paroxetine );
- Zoloft ( Sertraline );
- Valium (Diazepam);
- Lorax (Lorazepam).
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Hypochondria is a chronic condition, that is, it is not resolved in a short time. In fact, some people will have to live with hypochondriac symptoms for the rest of their lives, or they may return after a long period of remission.
However, psychiatric treatment and psychotherapy can greatly help the life of the hypochondriac individual. From the beginning of treatment, symptoms become more rare, and remission of symptoms is common for many patients.
Even so, there is the possibility of relapse and, therefore, it is important that the hypochondriac follow the treatment correctly and do not stop taking medications without talking to the psychiatrist first.
Because it is a mental disorder, complications related to hypochondria are more linked to relational problems. Are they:
Panic attacks are periods of intense discomfort, in which the patient is affected by excessive fear, anxiety and a feeling of death. There is loss of breath, pain, intense cold sweat, and other sensations that make the patient sure that he is dying.
In general, the symptoms that the hypochondriac feels are weaker than the panic attack, since the latter is characterized by very intense and short-lived feelings.
Problems with family and friends
The stress and excessive fear of the hypochondriac can end up frustrating those who love him, especially if he does not seek specialized help. As the patient is always insecure about his health, it is common for him to ask incessantly about symptoms and diseases that he believes he is developing, which can irritate his neighbors.
Problems at work
Suspected medical conditions cause the patient to end up missing many days of work or have difficulties in meeting their schedules, especially when somatic symptoms are accentuated by the fear of developing something serious.
Common side effects
If the hypochondriac also develops the habit of self-medication, the risks of suffering from frequent side effects are high.
In addition to the actual side effects of each medication, he may also develop esophagitis due to irritation, since the frequent use of medications orally irritates the gastric mucosa.
So much concern, need for care and affirmation can end up making the patient unable to lead a productive life.
Since he is always visiting a health professional or spending on medication, the hypochondriac can bear higher costs than he can provide.
Even if you have a health plan, there are tests that are not covered by the plans, which makes the patient take money out of his own pocket to be able to perform some medical procedures.
Taking unnecessary risks
Every medical procedure involves risks, be it a simple blood test or a radiograph. Therefore, when performing unnecessary exams (since the patient has no condition), he is also exposed to risks that he would not need to go through.
Possibility of developing a serious disease and not being diagnosed
On the other hand, hypochondriacs who avoid the doctor may end up not being diagnosed in time if they are developing any serious condition.
This is harmful because many serious diseases are silent and only show signs when it is too late to reverse the situation.
Possibility of developing another mental disorder
Living with pain or with the belief that something very bad is happening, but not receiving support when you need it, is a risk factor for the development of other mental disorders, such as depression.
You have most likely seen a character in movies, books, series or even novels, who clearly suffers from hypochondria. Some notable examples are:
- Amélie Poulain’s Fabulous Fate: In this film, a tobacconist named Georgette is often seen taking something for alleged stains or inhaling some powder for a possible disease;
- Madagascar: Despite being a children’s animation, the disease is also present here. Melman, the giraffe, is always concerned about his health, always trying to prevent himself, and he lives on taking drugs for no apparent reason;
- The Big Bang Theory: The iconic Sheldon Cooper has hypochondriac symptoms;
- Vida Bandida: In this film, Terry deals with his hypochondria while becoming one of the most successful bank robbers in the United States;
- The Miserable: A student named Joly is always described as an “imaginary patient”;
- Everything Can Work Out: This feature film focuses on an unlikely romance between a young girl and an elderly hypochondriac;
- Le Malade Imaginaire : This is the last piece written by Molière. Its name can be translated as “The imaginary patient”, and it deals with an abusive relationship between a doctor and a hypochondriac, who strictly follows all the orders of the health professional.
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Having to live with such a stressful condition is complicated, especially since the patient has no control over it. Some tips to improve the quality of life are:
Perform annual check-ups
Just because the hypochondriac should stop going to the doctor so much, it does not mean that he should not take care of his health, going to the doctor every year.
This practice is important and helps to prevent several serious diseases that, if discovered early, have a good prognosis.
Patients who are afraid of receiving a diagnosis and avoid the hospital at all costs must also take care of their health. Especially because it is in this way that dangerous diseases will be addressed early, preventing the quality of life from declining.
Practice relaxation techniques
Did I mention that hypochondria is an extremely stressful condition? Well then, at these times, it is important to take care of your emotional stress, which is bad for the health of the body as well.
So, betting on relaxation techniques like meditation can help the hypochondriac to maintain a nice quality of life.
In the midst of crises, it is complicated to be taking a lot of medicines, isn’t it? Therefore, acupuncture can be a good option to deal with the symptoms that the hypochondriac feels.
This ancient Chinese technique uses pressure points to treat pain in specific locations. And even better: it’s not just belief! There are several studies that prove its effectiveness.
Therefore, if the hypochondriac has already confirmed that his pains are not the product of a real condition, he can easily treat the pains by scheduling an acupuncture session.
As it is a mental condition, it is very difficult to talk about ways to prevent it, since the causes of hypochondria are not very well known.
Therefore, the most that can be done is to give some tips to minimize the possibility of presenting the picture. Some tips are:
- Have healthy habits, such as a balanced diet and physical exercise. This decreases the chances of developing certain types of diseases, especially chronic ones;
- If you have symptoms of anxiety, seek professional help to prevent them from becoming stronger and impacting your life;
- Learn to recognize your stress and how it affects your body. This way, you will know if it is, in fact, a psychosomatic symptom;
- Avoid the consumption of recreational drugs such as alcohol and tobacco, as they tend to worsen symptoms of mental disorders in general;
- Avoid researching diseases and symptoms on the Internet unnecessarily, as this increases the chances of starting to be suspicious of more serious diseases that have generic symptoms.
Although very common, not everyone understands what hypochondria is and often even make jokes about the condition! However, this is a serious matter that needs to be addressed.
If you know someone who is constantly concerned about their health, be sure to show them this article and advise them to seek help!