Hypochondriasis: Symptoms, Causes and Treatment
Hypochondriasis or hypochondria is the medical term given to a condition in which the person believes he has a serious medical illness even though symptoms are minimal. It is a mental and emotional problem rather than a physical illness. However, the hypochondriac feels that he suffers from a serious illness and that the doctor has overlooked it or been negligent. He is worried about having a grave medical illness even after consulting a doctor and/or getting investigated.
Causes of hypochondriasis
History of physical or sexual abuse in childhood
A serious illness in childhood
Losing a loved one due to a disease for e.g. cancer
A recent stressful event or calamity.
It usually occurs in early adulthood and affects men and women equally.
Symptoms of hypochondriasis
A hypochondriac generally has symptoms of restlessness, nervousness or anxiety. The symptoms may be generalized like body ache or may be related to one system for e.g. the digestive or cardio-vascular system.
If the symptom is causing distress for e.g. severe abdominal pain or recurrent headaches it will have to investigated and treated accordingly.
If the person has a psychiatric condition like anxiety or depression, it has to be treated promptly.
The hypochondriac may consult many doctors for the ailment but may not be satisfied with their diagnosis. He may ‘shop around’ till he finds a doctor that agrees that he is suffering from a life-threatening or serious ailment.
The affected person assumes the worst for e.g. a headache may get him worried that he may have a brain tumour.
Diagnosis of hypochondriasis
The physician will come to this diagnosis after taking a complete medical history and conducting a thorough examination. He may or may not find any abnormality in which case he may refer the person to a psychiatrist or mental health professional. Gentle probing may reveal that he had consulted several doctors for the same complaint.
Tests to detect hypochondriasis
The physician should examine the system which the patient complains of in a thorough fashion for e.g. in case of severe abdominal pain the gastro-intestinal system should be evaluated by a gastro-enterologist and appropriate investigations should be advised. Also sometimes it may be difficult to prevent the person from undergoing unnecessary tests but the doctor should try his level best.
Treatment of hypochondriasis
The physician should develop a rapport of understanding with the person and allay his fears. Giving reassurance that the problem is not serious is of vital importance. Regular monitoring of the person is important to treat a genuine complaint and distinguish it from the patient’s worried disposition. People with this condition are not lying about their symptoms, they truly believe they are gravely unwell.
Conditions like anxiety or depressed mood can be treated with appropriate medication.
Psychotherapy is important to enable the person to calm down and address his fears rationally.
Complications that may arise
The symptoms or episodes can recur over time resulting in unnecessary tests which may drain the patient financially.
In hypochondriacs, the doctor may end up neglecting a genuine medical illness by attributing the complaint to hypochondriasis..
Prognosis of hypochondriasis
This is a chronic condition with no known cure. Supportive care from family and the primary physician is important for his well-being.
There is no way to prevent hypochondriasis.
Dr Nisreen Nakhoda