Hypochondriac disorder: The belief that one is suffering from a physical illness.

19. July 2021

The terms “hypochondria” or “hypochondriac” are used colloquially by many people. They refer to people who are constantly worried about their health and are afraid of suffering from various physical diseases, such as cancer. However, a diagnosed hypochondria (or hypochondriasis) disorder, as it is known in medical jargon, can take on far greater proportions and cause severe suffering in those affected. But what distinguishes occasional health concerns from hypochondriasis disorder, and how is hypochondriasis disorder treated? This blog article provides answers to these questions.

Main features of hypochondriasis disorder

The main feature of hypochondriasis disorder is the belief that one is suffering from a physical illness. This belief triggers intense anxiety, tension, pressure, and despair in sufferers. Often, they believe that the illness is not recognized only because professionals do not use the correct diagnostic tools or are not appropriately trained. Crucial is that patients do not “make up” the symptoms. The symptoms are actually present and subjectively noticeable. But there is no physical cause.

Excursus: A hypochondriacal disorder can refer to any disease. However, there are diseases that sufferers suspect are clustered in themselves. These include cancers, autoimmune diseases, diseases of the nervous system (for example, multiple sclerosis or dementia), infections (for example, HIV) or heart disease.

It is important to determine whether this may be a transient hypochondriac disorder for understandable reasons. For example, those affected by a heart attack, stroke, or similar serious illness are understandably very sensitive to physical symptoms. Similarly, in the current Corona pandemic, many people are more alert to symptoms of illness and worry more quickly.

Hypochondriac disorder, simulation, or disease phobia?

Hypochondriac disorder must be carefully distinguished from other medical conditions. For example, there is a risk of confusion with the disease phobia. Here, there is a strong fear of diseases, but the affected do not feel any physical symptoms. Their fear is therefore mainly triggered by thoughts and feelings. The difference to simulation is also significant. Simulation is an insistence on physical symptoms, but they are not present in reality. Most often, simulation has the goal of achieving a specific diagnosis. The background may be a retirement, the evasion of benefits, or the release from obligations.

Hypochondriac disorders are difficult to detect

Many years often pass before a hypochondriac disorder is diagnosed. Of course, numerous physical diagnoses are first performed, often at the massive insistence of the patient. It becomes pathological when the conviction of having a serious physical illness persists, even when a medically clear finding contradicts it. Often an odyssey of doctor’s visits then begins. New specialists are constantly consulted. Reconfirmation that there is no serious illness often provides brief relief, but the old fears and doubts very quickly creep back in.

Indications of hypochondriac disorder

Gradually, everything revolves around the supposed illness in those affected. Often the so-called “body checking” is present in a pronounced form: The body is scanned and examined, there is a constant check of heartbeat, blood pressure, weight, performance, breathing volume or skin changes. In addition, there is a strong reassurance behavior, i.e., affected persons repeatedly ask the people around them whether they have noticed any changes or symptoms. The Internet is also constantly used as a source of information, with the great disadvantage that often only the worst symptom courses and manifestations are described there. This reinforces the vicious circle of fear.

Excursus: In extreme cases, a so-called hypochondriacal delusion can develop. In this state, the affected are no longer accessible and increase to an extreme extent in the fear of suffering from an incurable and undiscovered disease..

Where does a hypochondriacal disorder come from?

The genesis of hypochondriacal disorder, as with all mental illnesses, is highly individual. Nevertheless, some risk factors can be identified. Patients often bring with them unfavorable learning experiences on the subject of illness and dealing with physical symptoms. On the one hand, it is possible that a very anxious and insecure approach to illness and bodily symptoms was taught from early childhood. On the other hand, it is also conceivable that bodily symptoms, or other inner feelings, such as worries, fears or anger, were trivialized and never discussed. However, often no appropriate handling of bodily sensations was learned, so that they are quickly reacted to with strong fears.

Distorted perception and stress in hypochondriac disorders

The level of perception also plays a role in hypochondriac disorders. Each of us knows the phenomenon of selective perception: if we are always mentally on the same topic, we more often perceive things that are related to that topic. Thus, when everything revolves around illnesses, even weakly pronounced bodily symptoms enter our consciousness. Since the perception of body symptoms is occupied with strong anxiety, the body reacts with stress. The experience of stress further aggravates the situation, because under stress the perception of bodily symptoms is sharpened and calming down and relaxation become increasingly difficult.

Excursus: Hypochondriac disorder may be accompanied by other psychological disorders. For example, it may occur in conjunction with anxiety disorders or depression, or it may promote the development of these.

The treatment of hypochondriac disorder

The treatment of hypochondriac disorder presents a challenge. After all, those affected suffer precisely from the strong conviction that they actually have a physical illness! If then the possibility is named that also psychological parts can lie behind the symptomatology, it often comes to strong resistance. A cautious approach is necessary. Step by step, those affected learn during treatment how body symptoms, fears, learning experiences and stress are interrelated.

Over time, a new way of dealing with one’s own body and its sensations is learned and the fear of suffering from a disease decreases. Worry, reassurance behaviors and the constant visits to the doctor are reduced and the time and energy thus gained can greatly enhance the quality of life. Patients find the balance between a healthy attentiveness to their own body necessary preventive examinations on the one hand and an excessive preoccupation with possible illnesses on the other.

Since physical and psychological symptoms go hand in hand in the clinical picture of hypochondriac disorder, psychosomatic treatment makes sense. Here, the LIMES Schlosskliniken as specialist clinics for psychosomatics and psychiatry offer the appropriate treatment.

References

(1) Kapfhammer, H. P. (2008). Somatoform disorders. The Neurologist, 79(1), 99-117

(2) Lahmann, C., Henningsen, P., Noll-Hussong, M., & Dinkel, A. (2010). Somatoform disorders. PPmP-Psychotherapy- Psychosomatics- Medical Psychology, 60(06), 227-236

(3) Langs, G., Bachmann, M., Schramm, S., & Nutzinger, D. O. (2002). Subjective models of illness in patients with panic disorder, hypochondriasis, and somatization disorder. Behavioral Therapy, 12(1), 19-25.

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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