Hypochondriasis: excessive and distressing preoccupation

Hypochondriacs have an excessive concern for their health, fear of death, and are constantly self-observing their bodily functions. Any inconsequential manifestation in their body is interpreted as something that can compromise their life. Do you want to know if you are a potential hypochondriac?

I invite you to answer the following questions. The answers are dichotomous: Yes or No.

1- When someone tells you that he/she suffers from a disease, do you start to find the same or similar symptoms and think that you have the same pathology?

2- When you hear about illnesses, do you feel bad, anxious, afraid or distressed?

3- When you notice something unusual in your body such as dizziness, muscle pain or headache, you think something is wrong, you get anxious and you have to go to the doctor immediately?

4- Do you visit more than two or three doctors for the same symptom or discomfort?

5.- Do you frequently search the Internet for diagnoses that you think you have?

6- When you have a discomfort or symptom, do you check, touch or look at it constantly?

7- Do the people around you think that your attitude and concern about illness is exaggerated?

If you answered yes to three or more of the seven questions, it is very likely that you have a problem of hypochondriasis.

What is hypochondriasis?

It consists of the worry, fear or conviction of suffering a serious disease based on the unrealistic interpretation of signs or physical sensations. Exaggerated perceivers of bodily sensations. Hypochondriacs amplify them in their mind, triggering torturous mental ruminations of a catastrophic type. Which cause them a feeling of constant threat and fear.

The hypochondriac is characterized by a litany of diverse, confused and nonsensical complaints. The most common sites are the abdominal viscera, chest, head and neck, but they can be in any part of the body or in the form of a generalized feeling of fatigue and discomfort. Sometimes there is a curious mixture of specific and minute complaints with more diffuse and vague ones.

Other less obvious and more subtle facts characterize the patient’s behavior. He presents his complaints in extensive detail and with an urgent and insistent pressure to speak. He punctuates his symptoms by pointing out the affected parts, or by demonstrating what he considers to be an alteration of functioning, or by pointing out a structural lesion, usually small and insignificant.

His thoughts are totally focused on his bodily complaints, or on his unsuccessful attempts to find help and relief. He uses medical terms that he has acquired from his previous contacts with physicians or from his frequent reading of medical texts and articles. He is worried and anxious. Characteristically, he persists in restlessness despite having been given appropriate medical information and full support about his health.

Some patients develop a pattern of frequent medical visits, others stick to a single specialist whom they consult repeatedly on the slightest pretext, and there are those who wander from one doctor to another undergoing endless examinations and evaluations.

It is important to recognize that many hypochondriacs provoke feelings of frustration and resentment in their physicians, which makes it difficult to treat them objectively. The tendency to refer such patients to a colleague or another clinician undoubtedly strengthens their already natural inclination for multiple consultations.

Somatoform disorder, current term for hypochondriasis.

Somatoform disorder replaces several previously used diagnoses, such as somatization disorder, hypochondriasis, undifferentiated somatoform disorder, and related diagnoses. They all involve somatization, the expression of mental factors in the form of physical symptoms, e.g., pain, weakness, fatigue, nausea or other bodily sensations. The person may or may not suffer from a physical disorder that causes the symptoms or contributes to their onset.

Physicians used to diagnose this type of mental health disorder (sometimes called a psychosomatic disorder) when the person reported physical symptoms that were not explained by a physical disorder. However, such an approach is problematic for several reasons:

It is sometimes difficult for the clinician to determine whether or not a person is suffering from a physical disorder.

It is usually not appropriate to establish a diagnosis of mental disorder simply because physicians cannot find a physical cause for the symptoms. It may be that the test results were wrong or that the wrong tests were used.

Many people may have a physical disorder, but their reaction to the symptoms may be so excessive or inappropriate that they may also be considered to have a mental health disorder.

Distinguishing between physical and mental symptoms sometimes leads the person to think that the doctor does not believe that their symptoms are real.

Because of this, physicians now base the diagnosis of somatoform disorder on the person’s response to their symptoms or health problems.

The main criterion for diagnosing somatoform disorder is that the person’s preoccupation with his or her physical symptoms is so strong that it causes considerable distress and interferes with daily activities.

It should be clear that people with this condition do not produce the symptoms intentionally. Many of them do not realize that they suffer from a mental health disorder, and are convinced that their symptoms have a physical cause that requires medical attention. As a result, they usually continue to pressure physicians to repeat tests or prescribe additional tests even though, after a thorough evaluation, no evidence of a mental health disorder has been detected.

Diagnosis of somatoform disorder

The diagnosis is made on the basis of specific criteria. These are the most important guidelines:

– The person presents symptoms that worry him excessively and/or disturb his daily life.

– They constantly think about the possible severity of their symptoms.

– They feel extremely worried about their health, which causes anxiety and distress.

– She invests an excessive amount of time and energy on health problems.

– Symptoms persist despite doctors explaining that tests performed do not show alarming results.

To determine whether the symptoms are due to a physical disorder, physicians conduct a thorough examination and often order tests.

This disorder may be overlooked in older adults because certain symptoms, such as fatigue or pain, are considered part of aging or because the concern is considered understandable in older people, who often have several serious medical problems and take many medications.

The treatment of choice is cognitive-behavioral therapy.

Even when the person maintains a good relationship with their primary care physician they are often referred to a psychiatrist. Psychotherapy, particularly cognitive-behavioral therapy, is the most effective treatment.

The person with somatoform disorder benefits from a supportive and trusting relationship with his or her doctor, who can coordinate care, offer treatments to alleviate symptoms, visit regularly, and avoid unnecessary tests and treatments.

However, the practitioner should also remain alert to the possibility that the person, at some point, may develop an organic disorder that requires appropriate assessment and treatment. New and different symptoms should not automatically be assumed to be caused by the somatoform disorder.

Summary:

Hypochondriacs present symptoms that worry them excessively, they frequently think about the possible seriousness of their ailments, they feel anxious about their health, which causes them anxiety and distress. They are currently diagnosed with the term Somatoform Disorder.

Translated by Aliani Rojas Fernandez