To the average person, many bodily sensations (e.g., warmth, twitching), functions (e.g., sweating, blood pressure changes), and minor abnormalities (e.g., blemishes, uneven skin tone) are barely noticed. And if noticed, they are soon forgotten. Not so for people with hypochondriasis, a condition characterized by the fear that one already has or could have a serious illness. For these patients, many harmless symptoms are potential signs of disease.
In this article, we examine what hypochondriasis is and how it is treated.
Symptoms and risk factors
In hypochondriasis, various bodily symptoms and changes are misinterpreted as signs of hidden and dangerous diseases. For instance, chest tightness, changes in bowel habits, or generalized aches could be misinterpreted as evidence of heart disease, cancer, or COVID-19.
Not surprisingly, patients with hypochondriasis repeatedly check their bodies for signs of disease. They also engage in self-diagnosis; for example, they spend countless hours reading medical books or Googling symptoms.
Certain people are more likely to develop hypochondriasis. According to an article in CNS Drugs, potential risk factors for this condition include the following:
- Female gender
- Younger age
- Current mental illness (e.g., anxiety, depression)
- Personality disorders
- Sensitivity to bodily sensations
- Past serious illness
- History of abuse
- Lack of education
- Lower-income and occupational levels
Hypochondriasis and unnecessary medical visits
Individuals with hypochondriasis usually avoid going to the doctor—just as they avoid other disease-related stimuli, such as health news or sick people. Of course, fear of already having an undiagnosed disease may motivate them to seek help immediately.
Doctors often find individuals with hypochondriasis difficult to treat. After all, doctors have limited time to spend with each patient, so they find it challenging to treat those who bring a long list of complaints to the visit.
In addition, patients with this condition tend to request more tests than do other patients, yet do not feel reassured by the negative test results or by the doctor. Why? Commonly because they feel their concerns are going unheard or the doctor does not know how to diagnose or treat their illness.
Sometimes patients with hypochondriasis go “doctor shopping,” hoping to find a health professional who will help ease their anxiety. Unfortunately, in search of reassurance, some end up undergoing unnecessary, costly, and potentially harmful medical procedures.
Psychological and pharmacological treatments
Hypochondriasis can be treated with medications, psychotherapy, or both. Effective psychological treatment for this condition is cognitive-behavioral therapy (CBT). CBT targets dysfunctional beliefs and maladaptive behaviors.
Some dysfunctional beliefs in hypochondriasis include the following:
- Misinterpretation of bodily symptoms
- Viewing the self as weak and vulnerable
- Viewing doctors as highly error-prone and untrustworthy
- The assumption that worry is useful
- The view that it is possible to be absolutely certain about things (e.g., health)
In therapy, patients are taught how to examine the evidence for these and other dysfunctional beliefs, and how to use logic to come to more rational conclusions about their health.
Behavioral interventions are also important. An effective behavioral technique is repeated exposure to feared or avoided stimuli without the use of safety behaviors. For example, patients might be encouraged to watch medical TV shows but to refrain from compulsive body checks or reassurance-seeking afterward.
Relaxation techniques (e.g., yoga, mindfulness meditation) may also reduce the severity of physical symptoms and lower vigilance to threats.
Perhaps the most important goal of therapy is to help individuals with hypochondriasis improve their general functioning. This means assisting them to develop healthier habits, build better relationships, and improve their functioning in major life areas, such as work or school.