physical feeling, and predisposition to anxiety all may play a role. Most hypochondriacs will also suffer
from other anxiety disorder such as panic disorders, generalized anxiety disorder and obsessive
compulsive disorders.
My experience with hypochondria happened after my father became ill with lung cancer. I had
always been an anxious person, and have always had a slight preoccupation with my health. I have
found that I display very similar trait to someone suffering with obsessive compulsive disorder. For
instance, when I experience a new “symptom,” I must examine myself periodically in order to soothe
myself. Unfortunately, this cycle only perpetuates the condition. It causes a sort of positive feedback
reaction, which in turn causes me to examine more and more, until it gets to the point where I must go
to the doctor or the emergency room.
In the modern world, a common trigger for hypochondria is the internet. “Cyberchondria” is a
colloquial term describing someone who searches symptoms on the internet. Websites such as WebMD
provide information on many disease. A hypochondriac may mistakenly match their symptoms up with
serious diseases and become very distressed. In my experience, there are many times where I have
looked up not only symptoms, but for support groups discussing hypochondria. It has helped, but in
many ways has also made the anxiety worse. Many times, I have found, support group will end up
becoming a gathering of hypochondriacs feeding off of each other's disorders, giving bad advice and
triggering anxiety.
At the moment, the best treatment for hypochondria is a mix of medication and cognitive
behavioral therapy. Generally, an antidepressant will be prescribed. Current research has been
showing positive results from fluoxetine, an SSRI also known as Prozac. I will be discussing the
cognitive behavioral therapy approach. Cognitive behavioral therapy is an approach that focuses on the
thoughts and behaviors associated with hypochondria. It is also used for the treatment of obsessive
compulsive disorder and panic disorders. Since hypochondria has similarities between the two, it is
believed to be an effective treatment.
Many of the behaviors of hypochondria are associated with anxiety due to a perceived threat. The
intensity of the anxiety will generally vary from a small feeling of discomfort to a full blown panic
attack. In my experience, the hypochondria first started with a panic attack, which I believed was due to
a heart attack at the time. I had an intense tightness in my chest, a lightheaded feeling, as though I were
about to faint, which is a partially loss of vision (also known as a gray out). After the initial attacks, I
experienced chest pains every so often and still associated them with heart issues, even though I had
gone to the emergency room twice.
One behavior, which is strikingly similar to obsessive compulsive disorder is checking. A
hypochondriac may check his pulse, examine himself, weigh himself frequently due to the fear of
wasting away. Sometimes, checking may even exacerbate symptoms, such as someone constantly.
feeling for signs of oral cancer may cause sores due to irritation. When I have checked myself, it has
often involved using a home blood pressure monitor as well as feeling for lumps and swollen glands. It
tends to be a compulsion, and often becomes habitual.
Often, it is very difficult to treat hypochondria, since the patients tend to be so convinced that there
is something gravely wrong. One of the biggest roadblocks in treatment is reassurance seeking. As
mentioned before, a hypochondriac will seek tests hoping for a negative result. He may also seek
alternative treatments such as homeopathy. When a hypochondriac receives this reassurance, it will
merely perpetuate the condition. Similar to checking, a hypochondriac will learn that this behavior will
provide a temporary ease to the anxiety. After the initial feelings of calmness have worn off, the
hypochondriac will feel the need to seek further reassurance, and so the cycle continues.
I have often sought reassurance through doctor's visits. There was a time when I was
experiencing tightness in my chest which at times made it difficult to breath. I ended up making an
appointment with the doctor, who, since I was a smoker, gave me a chest X-ray. The results came back
normal, and surprisingly my symptoms went away for quite some time. For about a month, my
hypochondria was relatively tame. Then, I started experiencing new symptoms. This time it was a
feeling of a lump in my throat. This started a new cycle of reassurance seeking.
Finally, a less apparent behavior is avoidance. This is when a hypochondriac will avoid activities
that perpetuate symptoms. For a long time, during my heart problem phase, I had a love-hate
relationship with physical exercise. I tended to avoid any intense exercise that would bring my heart
rate over 110 beats per minutes due to the fear of a deadly arrhythmia. I would often get up and flee the
gym when this happened.
Now, I would like to bring attention to the cognitive side of hypochondria. One of the most
outwardly apparent symptoms of hypochondria is preoccupation. Most hypochondriacs are preoccupied
by their perceived ailments much of the time. This is the factor that may take the most emotional toll on
relationships. A hypochondria will rarely have a conversation where her health is not brought up at
least once. It is also very distressing for the hypochondriac, who may not be able to fully enjoy herself
due to her health concerns constantly being in the back of her mind.
A hypochondriac may also be very acutely aware of his own bodily sensations. Bodily focusing is
when a hypochondriac focuses intently on his physical sensations. This can be closely linked with
the behavior checking. However, one must be careful not to confuse the two. Generally, when a
hypochondriac becomes acutely aware of physical sensations, it will be around the area of concern.
This keen awareness has played a key role in my hypochondria. Due to the increased awareness of my
head and neck areas, I have often felt as though a simple neck ache was actually pain from a malignant
tumor on a lymph node. Indeed, awareness of my physical sensations has been an enormous trigger to a
long session of self-examination.
Selective attention is when a hypochondriac will only pay attention to sources of information
which confirm his worst fears. Often a hypochondriac will stay up until the wee hours of the morning
reading medical texts, however I negative test result from the doctor will be promptly ignored and
forgotten about. Over time, hypochondria may lead to depression due to the belief that there is a serious
illness present. I have experienced some terrible depressive symptoms. I have stayed up thinking about
going through chemotherapy, disfiguring, even imagining my own funeral.
Fortunately for the hypochondriac, there is hope. With the right therapist, cognitive behavioral
therapy may be a highly effective treatment for hypochondria. However, in order for to work, the
patient must be engaged in treatment. It may be very difficult to engage a patient in treatment due to the
patient being put into treatment semi-involuntarily. Often, a patient will seek therapy due to ultimatums
from love ones, or a doctor's refusal to treat the patient any further until he has undergone
psychological evaluation. Therefore, the therapist must proceed with caution. I must, however, remark
that many hypochondriacs are keenly aware of their condition and seek help voluntarily. Unfortunately,
this does not make treatment very much easier.
During treatment, the patient will often be asked to do some self-monitoring. A typical approach
would be to have the patient keep a daily journal on her physical symptoms and thoughts. This is
helpful because the therapist can monitor the patient's daily experience, and can provide prompts for
discussion.
Cognitive restructuring is the part of the treatment where the therapist will ask the patient to note
all of the evidence he has for being ill, as well as the evidence against it. The therapist will then inform
the patient of the cognitive errors, as well as teach rational responses to situations where anxiety is
provoked. The therapist will also have the patient come up with his own rational responses. The
therapist will then construct behavioral experiments in order to test out responses. I have found that
citrus drinks such as orange juice and lemonade promote phlegm build up in my throat. This has helped
me realize, through seeing an actual cause, that it would be highly irrational to believe that there is any
sort of growth in my throat.
If avoidance is present, a therapist may use exposure and reassurance prevention. A patient may
be exposed to a light trigger such as exercise. The patient will then be taught to react appropriately to
the symptoms present. On top of this, it is important to prevent the patient from seeking out
reassurance. Family members may be instructed to say something such as “I'm sorry, but I'm not able to
answer that question.” It is also important for the patient to work with the physician in order to prevent
the patient from seeking reassurance from the therapist. In cases of “cyberchondria,” the patient should
also be urged not to seek reassurance on the internet.
Finally, it is important for the patient to identify and re-attribute his beliefs. For example, a patient
suffering from a side stitch may write down other symptoms such as overexertion, lying down on the
wrong side, etc. and realize that he is not suffering from a hernia.
It is important for the patient to know that recovery will not occur overnight. It is a lifelong
process. Although I have made leaps and bounds in my treatment, I still have many outbreaks.
However, I deal with them now in a much more rational way and they are far less intense. In addition
to cognitive behavioral therapy and support from my family, I have also found mediation to be quite
helpful. For many sufferers, hypochondria tends to be at its worst in stressful situations. I have found
that if I take a moment to breath, and accept the situation at hand, I am much less stressed. It is my
hope that this essay will shed some light on treatment for hypochondriasis, as well as better the
understanding by sharing a personal perspective. Finally, I hope this will inspire other hypochondriacs
to embark on the journey of getting their lives back.
Heath, Stephen University of Cambridge, UK Hypochondria: Medical Condition, Creative Malady. Brain: A journal of Neurology
Researchers Study Interpersonal Effects of Hypochondriasis, Science Daily July 14, 2003
Hilary M. C. Warwick , Cognitive Therapy in the Treatment of Hypochondriasis, Advances in Psychiatric Treatment 1998
Schwartz, Steven, Abmormal Psychology: A Discovery Approach 2000
Hypochondria:Causes,Mayo Clinic http://www.mayoclinic.com/health/hypochondria/DS00841/DSECTION=causes
by
fissionesque (student)
