Unfounded health anxiety, called hypochondria, is an increasingly common condition. Experts blame the Internet for this.
Anxiety disorder
The suspicion of extreme weakness of one’s own health is a widespread, but not a new problem. Today it is called anxiety and this term is gradually replacing the word “hypochondria”, which entered medicine back in ancient Greece. Literally translated, it means “subcostal region”, because this very area, according to the aesculapists of that time, was the source of melancholy, as well as certain “vapors” that caused painful sensations that were not supported by any known disease.
Over the past 2,500 years, the term “hypochondria” has changed its meaning many times, but eventually came to refer to a person’s false belief that he or she has a disease. Today, physicians prefer not to use it because it is considered offensive and stigmatizing, and the phenomenon itself is divided into two parts: a somatic disorder and an anxiety disorder related to health concerns.
Often the trigger for hypochondria is the illness or death of a loved one, or a serious physical illness such as a heart attack. However, the roots of the problem can go back to childhood. How concerned were parents about their child’s health? How did they deal with his or her childhood illnesses? Were they hypochondriacs? All of this could make a big difference. Health anxiety is manifested by intense concern and fear of the potential for serious illness, as well as excessive attention to minor physical ailments. It is also characterized by somatosensory amplification, i.e., the tendency to perceive normal sensations as relatively intense, disturbing, and dangerous.
All somatic manifestations of this condition have psychological causes, which creates a vicious circle. The person feels anxiety about his health. Anxiety causes the release of adrenaline, which is accompanied by rapid heartbeat, respiratory distress, sweating, tremors, headache, etc. These symptoms further convince the person that he or she is seriously and possibly terminally ill. These symptoms further convince the person that he or she is seriously and possibly terminally ill.
Scope of the problem
Although there are no official data on the prevalence of hypochondria in general, individual researchers say that this disorder is quite common. For example, Australian scientists have estimated that excessive health anxiety affects almost 6% of the adult population of this continent.
Hypochondriacs are most commonly found in outpatient clinics and hospitals, as these are the people who are most likely to see doctors. Peter Tyrer, a psychiatrist at Imperial College London (UK), conducted a large-scale study of this anxiety disorder in 2011, examining visitors to five outpatient clinics specializing in cardiac, respiratory, neurological, endocrine and gastrointestinal conditions in London, Middlesex and North Nottinghamshire. He and his team found that nearly 20% of visitors to these clinics had significant anxiety about their health and were clearly in need of psychological counseling.
At the same time, it has been found that because of the emphasis on the physical cause of symptoms, primary and secondary care physicians very rarely refer people with health anxiety to psychiatrists. Patients do not get the psychological help they need and their illness progresses. Tyrer estimates that cardiologists or general practitioners are almost 20 times more likely to deal with people with hypochondria than psychotherapists.
Another aspect of the problem that Tyrer’s team noted was the economic impact. It turned out that outpatient appointments related to health anxiety alone cost the UK health system £420 million a year. And that’s not counting the costs associated with unnecessary examinations. Hypochondriacs often insist that their doctor order additional tests or examinations.
A new species, cyberchondria
Recently, the prevalence of anxiety about one’s health has been steadily increasing. And this is due to the so-called cyberchondria, or the “Dr. Google” effect. These informal terms refer to the unwarranted escalation of concerns about one’s symptoms after searching and reviewing information on the Internet.
The first systematic study of this phenomenon was conducted in 2008 by Microsoft employees Ryan White and Eric Horwitz. They found that in about 50% of people, seeking information about their symptoms reduced anxiety, but in contrast, in one in five people, it increased it.
The gold standard of treatment for hypochondria, like any other anxiety disorder, is cognitive behavioral therapy. Exercise can also be an excellent tool for managing anxiety symptoms, as it helps to reduce adrenaline levels.
Web diagnostics can cause great anxiety for users who believe they have incurable and serious illnesses. By analyzing search queries and pages visited, researchers have noticed that people often associate common symptoms (e.g., headaches) with rather rare and unlikely diseases (e.g., brain tumors) and regularly repeat their search at for days and even months to find more and more evidence of the imagined problem.
Erroneous self-diagnosis based on information gathered on the Internet not only aggravates the psychological state of the hypochondriac, but also greatly prevents doctors from collecting data on the true condition of the patient and make the correct diagnosis. A patient who has “found” a disease on his own unconsciously exaggerates its manifestations and omits those symptoms that do not fit into it.
What can I do to help a hypochondriac?
GPs and pharmacists have the most contact with hypochondriacs and can easily identify people who are more concerned about their health than others. These people often go to the pharmacy just to ask questions or clarify, but they are not really looking for information, but rather for confirmation of their concerns.
Ideally, after recognizing an anxiety disorder, the pharmacist should persuade the patient to seek psychological help. You may try to emphasize the relationship between anxiety and the somatic manifestations of the illness. Ask the client, whether his condition worsens at times when he is thinking hard or worrying a lot about his illness. Explain to him what processes occur in his body when anxiety and stress take over. And tell him how psychologists help him cope with these conditions, for example, with cognitive behavioral therapy.
But even if the pharmacist does not risk broaching the difficult subject of mental health with the client/tangata whai ora, they can help by simply giving the client/tangata whai ora a chance to talk about their anxiety. For people with hypochondria, this is really important. They often suffer from the fact that professionals do not spend enough time with them and do not treat their problems with the attention they deserve. They are afraid that if doctors find out about their anxiety, they will write it off, not take them seriously and miss a physical illness. And their fears are not unfounded, because hypochondriacs are not immune to serious illness.
