HYPOCHONDRIA

People who suffer from an exaggerated concern about their health are described as hypochondriacs. However, hypochondria should always be taken seriously as it is a sign of emotional disturbance and specialist may be needed to uncover and deal with the r

A key factor in hypochondria is a family background in which the need to take care of one’s health was overstressed. Early exposure to chronic illness in one or both parents or grandparents or deaths of near relatives can also have a profound effect on a developing child, who might grow up with a fear of illness or death. Excessive interest in keeping fit may be another subtle factor, for although it may be very important to exercise regularly, there is a limit to the amount of time that needs to be taken up this way.

ANXIETY AND DEPRESSION

There are a number of psychiatric disorders which are commonly found to be associated with hypochondria. The first is an anxiety state: the unpleasant apprehension that something awful has or is about to happen. This is accompanied by a number of changes in the body’s functions: increased heart and breathing rate and excessive sweating, especially of the palms of the hands and under the arms. Appetite may be lost or, in some people, it may increase dramatically. Either diarrhea or constipation may occur. Sleep may be disturbed, dizzy feelings may be experienced and fainting might happen. In women there may be changes in periods which can become infrequent or irregular. Hypochondriacs focus on any of these anxiety produced symptoms, which are thought to be due to a disease which may be feared, like cancer or heart disease.

Depressive states are a second contributing factor. Usually these arise following some unhappy even t such as a serious illness in the sufferer or a loved one, or possibly a breakdown of an important relationship. Occasionally there may be some long-standing emotional conflict which has not been resolved, but which continues to smoulder deep in the mind. Again, bodily functions may be disturbed, usually slowed down in some way, and so lead to further feelings of depression or anxiety. In severe depressive statues delusional thoughts may develop, so that the person’s fear of cancer becomes a belief that he or she actually has cancer.

OBSESSIONS AND HYSTERIA

Obsessional states occur either through family environment, or the tendency may he inherited through genes. Persistent thoughts arise that something has gone wrong in our bodies, and we tend to ruminate over it. Often repetitive movements or habits develop; these are sometimes described as rituals, and may be related to numbers, such as touching the doorknob six times before turning it. Alternatively, patients may become obsessed that they have a particular disease which may be related to deep guilt feelings related to events in his or her past.

The mental make-up of hysterical states may be inherited, which can become obvious when under stress. There is an exaggeration of ordinary bodily feelings, or symptoms of simple ailments. There may be a strong feeling that everything is out of control, so that the person develops an intense fear that his health or even life is threatened.

PSYCHOTIC DISORDERS

Illnesses such as schizophrenia and maniac-depression are well-known psychotic disorders in which hypochondria can appear. Symptoms may be bizarre or grotesque, and the patient may imagine that his or her body is ‘crawling with insects’, filled with mould’, ‘shrinking’ or ‘swelling up’. Increasing interest in the body’s functions may lead to severe introspection, even complete withdrawal from al l outside activities.

Finally, some accident victims may develop a persistent belief that their injuries have left them with some permanent disability or handicap, even though their recovery has been complete. This is more common with patients with some pre-existing psychiatric illness.

SYMPTOMS

There is a tendency to have many different symptoms, sometimes one after another, or even all at the same time. Alternatively, there may be one continuous single symptom which is the sole centre of attention. Usually the description is so graphic that a diagnosis of hypochondria is likely, particularly when there are complaints about the body’s functions.

DANGERS

There can be difficulty in separating off symptoms that may be due to some other serious physical illness which is hidden by the marked anxiety about the symptoms complained of. A full examination must be made and doctors must be continually on their guard in case the patient does actually develop a real illness.

TREATMENT

Simple reassurance by the doctor might help in the early stages, but is generally only the doctor who feel reassured by negative clinical findings. Hypochondriacs are often unable to accept such findings and reassurance, and they remain convinced that they have some dreaded disease and that the doctor is not tranquillizers and anti-depressant tablets are usually of no real help.

In hypochondria, as in all illnesses, it is the cause and not the symptoms which must be treated. The family doctor is probably in the best position to help the patient, but it may be necessary to call in specialist help. A psychiatrist or psychotherapist could help reveal and deal with the underlying psychological or emotional disturbance, and thus help to effect a cure.

Occasionally, however, sever hypochondria has to be accepted as a state of mind that has to be endured by the patient, by his or her relatives and friends and by the doctor. Fortunately, the passage of time often brings about changes in the patient’s life situation, which reduce the intensity of hypochondriacal feelings and this brings relief.

OUTLOOK

If hypochondria is recognized early enough, it may be possible to bring about a satisfactory resolution, but in more severe cases, the outlook is poor. Although it can safely be said that no-one dies from hypochondria, nevertheless the depression can occasionally become so profound that the possibility of suicide must be kept in mind and all preventive measures taken. For most, however, symptoms gradually lessen, and many hypochondriacs reach a ripe old age.