New Thoughts about Treating Hypochondria

Last week, I wrote about what it meant to be a public psychologist. This week I would like to talk about a particular psychological disorder which affects many people, both in the family and in the workplace. The disorder is one that has traditionally been called “hypochondria”, but has now been reclassified as two disorders: “Somatic Symptoms Disorder” and “Illness Anxiety Disorder”.  It involves a preoccupation with the belief that one has, or is in danger of developing, a serious illness.

Many people with health anxiety are often unable to function or enjoy life due to their fears and preoccupations. They become preoccupied with bodily functions, minor physical abnormalities, or physical sensations . They might worry about a specific organ (their heart) or disease in the news or in their office. It is also important to note that symptoms of anxiety produce very real physical symptoms such as dizziness, headaches, stomach aches, tingling in the extremities, and heart palpitations. However, they are reluctant to seek mental health treatment because they believe very strongly that their condition really comes from a medical illness when there is no evidence of disease.

Dealing with somebody who is a hypochondriac it is extremely difficult for both family members and supervisors in the workplace. How to determine whether one is ill or not, is a very personal matter. It’s difficult to tell someone that their Illness is in their head and not in their body (as if the body and the mind are separate; of course, which they are not).

Personally, I know the difficulty of living with someone who has hypochondria.I grew up with a mother, who was convinced, during her whole life, that she was suffering from some sort of fatal disease of one type or another. She lived in the constant fear that she was dying of imagined diseases. To her they were not imagined. They were very real and very scary.

As a child, of course, as I had no ability to differentiate between what was real and what was imagined, and so I also lived in fear of losing my mother.  No matter what the doctor said or what the tests showed, she was convinced that she had heart disease or cancer.  Ironically, she did eventually die of cancer, but not until she was 82, one year after it had been diagnosed.

Today, given the new research on hypochondria, my mother might have received very different treatment. Rather than trying to be reassured that she did not have a dreaded disease, she would’ve learned that she did have a disorder which was caused by defective thinking about herself and her body. She would’ve learned about how her health anxiety and body vigilance were causing her problems.  She also would have learned that her symptoms were treatable through cognitive behavioral therapy, which today she would have been more likely to receive.  Her doctors would have learned that it is much more effective for doctors to focus on what it is than what it is not.

Just recently, I have learned a lot about this new approach to treating hypochondria from an article in the New York Times by Jane Brody.  Miss Brody reports that as many as 5 % of patients visiting doctors offices believe they have a serious diagnosed medical illness when none can be found.  The persistent anxiety itself becomes a debilitating illness.

Aside from her hypochondria, my mother was a caring and talented person.  She had great skills as a singer and actor, but unfortunately her anxiety got in the way of her ability to perform.  I think it is no accident that I chose psychology as a profession, and that I have studied cognitive behavioral therapy for 50 years.  It has helped me realize that many disorders are disorders of the mind, and that if people can learn to change their thinking patterns, they can manage to live well even with such conditions Obsessive Compulsive Disorder, Anxiety, Depression, and Hypochondria.

So what should you do if someone you know well may be suffering from “Health Anxiety”?

  1. Tell them you are sympathetic to their fears and pains, but that there is a new way of thinking about their problem which may be helpful to them.
  2. Refer them to Jane Brody’s article.
  3. Help them find a therapist who is versed in cognitive-behavioral therapy and who understands anxiety disorders.
  4. If you are a supervisor and someone is asking for a lot of time off to deal with health problems, and you suspect they may be suffering from hypochondria, you are facing a complicated problem.  You might yourself want to talk to someone about how to approach this employee and to get guidance on the delicate matter.
  5. If you are a family member, be sure that children understand the problem, and be aware of referral resources and help that is available to help everyone involved.

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