Hypochondria: When everything revolves around health and illness: fear of illness and its consequences

23. April 2020

In technical language, fear of illness is called hypochondriasis disorder or hypochondria. People suffering from this mental disorder worry excessively about their physical and mental health. They react negatively to the smallest physical changes or perceptions and interpret them as signs of serious illness.

What makes people with illness anxiety “tick”

Our body is a marvel, but it doesn’t always work perfectly. Every now and then it pinches and twinges, itches or burns. The vernacular calls these short-term symptoms “aches and pains” or “niggles.” Most people who notice them, are briefly annoyed, but then get back to their work. It is often the case that the symptom disappears again on its own and no medical treatment is necessary.

Permanent guest in the doctors’ waiting room/No doctor visits 
People with illness anxiety, however, become alarmed at the slightest symptom: What is wrong with my body? Am I seriously ill? What does this symptom represent? Am I going to die from the underlying disease? Affected persons tend to observe their bodies very closely and to examine them themselves, for example by palpation, listening or keeping a record (e.g. of blood pressure, pulse, weight…). Experts call this behavior “body checking” (Bleichhardt & Weck, 2007). Some affected persons thereby appear as if they are literally on the lookout for symptoms that they can interpret as signs of a serious illness.

Excursus: In their book on illness anxiety, Bleichhardt and Weck (2007) write that there are certain illnesses that sufferers worry about in clusters. These include cancer, cardiovascular diseases, AIDS, and neurological diseases such as dementia or multiple sclerosis.

From the overemphasized symptoms and pressing concerns, many sufferers feel the need to discuss their symptoms directly with a physician. They are permanent guests in their doctors’ waiting rooms. They need constant reassurance that everything is fine with them. Other sufferers, on the other hand, never go to the doctor because they are very afraid that an actual illness will be discovered in them and that their worst fears will thus come true.

Excessive preoccupation with diseases
Often, although they are actually suffering from their fear, they are very interested when it comes to topics such as diseases, infections or health hazards. Many inform themselves very conscientiously, and hope to get so their fear under control. Unfortunately, this often has an opposite result and negative consequences: The more information is gathered, the stronger the fear becomes. Some sufferers can no longer concentrate on their work or conversations at all, because worrying about their health is so paramount. These feelings of anxiety can escalate into panic attacks that leave sufferers completely unable to act.

Excursus: In rarer cases, illness anxiety can occur when there are no physical problems at all. The mere premonition or imagination of a disease is sufficient to produce anxiety. Some experts speak, if the fears refer solely to the future, of a disease phobia and not of hypochondria.

Anxiety of illness as a subtype of somatoform disorders

Although it is a form of anxiety, illness anxiety is not categorized as an anxiety disorder. From a professional perspective, it is a subtype of somatoform disorder. This somewhat complicated term represents mental disorders that affect the body and physical well-being. Somatoform disorders include other medical conditions, such as:

Somatization disorders: physical complaints whose cause can not be found (eg, headache or back pain, dizziness, sweating, tinnitus), or
Pain disorders: pain for which there is no obvious medical explanation.

It is only correct to speak of a mental illness requiring treatment when the symptoms lead to significant suffering and impairment of daily life. This also applies to the fear of illness or hypochondria: professional help is needed when the fears about health are very difficult to control and make heavy demands on mental resources and life satisfaction.

Evolution of illness anxiety
Research on hypochondria has not yet fully figured out what causes such a disorder to develop. Probably personality traits like high anxiety or insecurity as well as parental upbringing play a role. If the parents were already very anxious about illness and always meticulously checked the child’s health, the children also tend to be anxious about their bodies (Watt & Stewart, 2000). Another risk factor for the development of illness anxiety is negative experiences with illness in oneself or close relatives.

Current: Illness Anxiety in Times of the Corona Pandemic

People with illness anxiety are experiencing the Corona pandemic particularly intensely. The news is full of information about the virus, possible symptoms, and advice about hygiene. Everything is about Corona. False reports circulate through the Internet, stoking fear of the disease. Never before has the health of the entire world been so present in the media as it is today. Fears for one’s own well-being are triggered.

Excursus: Most people are probably familiar with the “Dr. Google” phenomenon. A seemingly harmless physical symptom is entered into a search engine and suddenly a whole universe of potential diseases opens up. This can be very frightening and really set the worry spiral in motion. Studies have been able to show that worrying about one’s health can be exacerbated by Googling symptoms (Pollklas et al., 2020). At the times of the Corona pandemic is thus particularly true: information sources with care select and consume in moderation!

Treatment of Disease Anxiety

It is not so easy to convince people with illness anxiety of the need for psychotherapeutic treatment. After all, they suspect their problems are physical, not psychological. They often feel misunderstood and rejected by the offer of psychotherapy.

Nevertheless, psychotherapy is advisable in the treatment of illness anxiety! Affected persons can learn, e.g. in a cognitive behavioral therapy, to deal better with their fears. For this purpose, they learn about the mechanisms and background of anxiety, for example, in psychoeducation. Step by step, reassurance and control behaviors are then reduced. An appropriate way of dealing with the body and body symptoms is established and practiced.

References

(1) Bleichhardt, G., & Weck, F. (2007). Cognitive behavioral therapy for hypochondriasis and illness anxiety. Heidelberg: Springer

(2) Pollklas, M., Widemann, L. Lochschmidt, M., Plakhuta, A., & Gerlach, A. L. (in press). Cyberchondriasis – The Effect of Searching the Internet on Health Concerns. Journal of psychology. IF: 1.18

(3) Watt, M. C. & Stewart, S. H. (2000). Anxiety sensitivity mediates the relationships betweenchildhood learningexperiencesandelevatedhypochondriacal concerns in young adulthood. Journal of Psychosomatic Research, 49, 107-118.

Categories: Anxiety disorders

Friederike Reuver
Autor:in Friederike Reuver
"Die LIMES Schlosskliniken haben sich auf die Behandlung von psychischen und psychosomatischen Erkrankungen spezialisiert. Mit Hilfe des Blogs möchten wir als Klinikgruppe die verschiedenen psychischen Erkrankungen näher beleuchten und verschiedene Therapien sowie aktuelle Themen vorstellen."

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