Series of articles "How to heal the soul?" Part 8 - Hypochondria!
Do you know someone who is in pain all the time and who is forever complaining about their health and trying to find reasons for their unwellness, but they can’t? There is quite a high probability that the main disease of this person is not related to the organs and body parts that he complains about, but is based on a psychological disorder – hypochondria. This person really suffers a lot from his psychological problems, but does not realize or deny it. Hypochondria is a belief in the existence of a serious illness or the belief that it will definitely develop in the future. The most common fears are diseases of the heart, gastrointestinal tract, genitals or brain. A person is convinced that no doctor is able to detect this disease, despite multiple examinations, so after a short break, he repeats all the examinations again and again, believing that something will be discovered.
Along with hypochondria, a person often suffers from other mental disorders – depression, panic attacks, generalized anxiety. At the same time, it can also exist independently without the background of other diseases.
Hypochondria is a way of controlling your life. It is important to note that over-controlling parents are important psychosocial factors. Taking control of your health as an adult is like a continuation of what your parents did in childhood. The reason can also be insufficient control by parents – they are allowed to do whatever they want in childhood, as a result of which the responsibility for one’s life is too great from childhood and manifests itself in adult life as excessive control and anxiety about one’s health.
Hypochondria is essentially a type of psychological defense mechanism – mental tension due to unresolved problems is too great, attention is diverted from these problems to one’s own health. The core of hypochondriasis consists of the fear of death and the instinct of self-determination – after emotional saturation, they are more intense than any internal unresolved conflict, therefore concerns about one’s health take the first place, while the internal unresolved conflict moves to the background.
Physiological processes and improper regulation of the autonomic nervous system also play a certain role, for example, the amount of serotonin in the body decreases. A decrease in the level of serotonin lowers the pain threshold – even a small irritation of pain is felt by the hypochondriac as very strong or certain parts of the brain are more sensitive to impulses from the organs and this information is misinterpreted: an increased pulse during anxiety is perceived as a heart attack, stomach distention after eating is perceived as a stomach ache.
The ban on being healthy and happy.
Prohibition to enjoy life. From childhood, there is a belief that “I am bad, therefore I must suffer”. Pain and symptoms of all kinds of diseases are perceived as a punishment for any “bad” and “unacceptable” behavior.
Caring for yourself. Concerns about your health, endless tests and all kinds of investigations serve as self-care.
Receiving love and attention from others. Complaining about his illness to the people around him, the hypochondriac expects to be listened to carefully and someone will take care of him.
How to recognize hypochondria?
- 1. Recurrence of bothersome symptoms requiring medical examination, even if there is objective evidence that the patient does not have any physical illness.
- 2. A person with hypochondria categorically denies and does not believe that the cause of physical symptoms could be psychological problems.
- 3. Complaints have a dramatic nature, but demonstrative elements can be seen in the behavior.
- 4. A person with hypochondria constantly thinks that he might have a serious physical illness.
- 5. Normal body sensations can be interpreted as signs of illness.
- 6. Attention is focused on one or two organs or organ systems.
- 7. A person with hypochondria tries to manipulate family members and people around them.
- 8. A person with hypochondria tries to overcome physical symptoms with self-medication methods or by choosing a sparing regimen.
- 9. Conviction about the existence of the disease lasts at least 6 months.
TEST - Hypochondria Self-Assessment Test - The Whitley Index
Below is a list of questions about your health. For each statement, you should choose the number of points, to what extent the statement is true for you.
- 1 = Does not suit me at all
- 2 = Somewhat suits me
- 3 = Moderately suitable for me
- 4 = I agree to a large extent
- 5 = I completely agree with
- 1. Do you worry a lot about your health?
- 2. Do you think that something is going wrong in your comb?
- 3. Is it difficult for you to forget about yourself and think about other things?
- 4. If you feel bad, but someone else tells you that you look better, does it irritate you?
- 5. Do you always carefully observe what is happening with your body?
- 6. Are you worried about frequent pain?
- 7. Are you afraid of illness?
- 8. Do you worry about your health more than other people?
- 9. Do you think that the people around you take your illness lightly?
- 10. Do you find it difficult to believe the doctor when he/she says that you have nothing to worry about?
- 11. Are you worried that you have fallen ill with something serious?
- 12. If your attention is drawn to a disease (through TV, radio, newspapers, acquaintances), do you worry about (i) contracting it yourself?
- 13. Are you bothered by several different types of symptoms?
- 14. Do you often notice any symptoms characteristic of a certain disease?
Then count the points. People without hypochondria usually have between 14 and 28 points. 28 to 32 points is the threshold level, in which case consultation with a psychotherapist, psychiatrist is desirable. The number of points from 32 to 55 indicates the presence of hypochondria, in which case consultation with a psychiatrist, psychotherapist is required.
A panacea for hypochondria!
Hypochondria can be confirmed only when possible diseases and pathologies of the organs to which the complaints refer are excluded.
As it was said earlier, a fairly effective method for treating hypochondria is psychotherapy. Its purpose is to help you realize and resolve your inner conflict. In this way, the emotional tension that led to the activation of protective mechanisms is reduced. During psychotherapy, it is not hypochondria itself that is treated, but the cause of hypochondria, as well as it helps a person to find another way to receive the “secondary benefit” that is received with the help of hypochondria – how else to control your life, how taking care of yourself and how to get love and attention in a different way.
The use of antidepressants also gives a good result in the treatment of hypochondria, especially if hypochondria has developed together with depression. Antidepressants help to stabilize the activity of the autonomic nervous system and the levels of neurotransmitters (serotonin, dopamine, etc.).
In very rare cases, hypochondria can be one of the symptoms of schizophrenia. In that case, primary schizophrenia should be treated with neuroleptics.
Authors of the article: doctor-resident in psychiatry Alina Kuznetsova, doctor-psychiatrist Pēteris Zālītis
Literature used:
- [1] The Whiteley Index, WI; Pilowsky, I. (1967). Dimensions of hypochondriasis. British Journal of Psychiatry, 113, p. 89-93.
- [2] Fisher JE, O’Donohue WT Practitioner’s Guide to Evidence-Based Psychotherapy. USA, 2006, p. 313-323.
- [3] Holder-Perkins V, Wise TN, Williams DE. Hypochondriacal Concerns: Management Through Understanding. Primary Care Companion to The Journal of Clinical Psychiatry. 2000;2(4):117-121.
- [4] SSK-10, code F45.2 http://www.spkc.gov.lv/ssk10
- [5] Kulakov С. A. Fundamentals of psychosomatics. — СПб.:Речь, 2003. — 288 с.