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About Health Anxiety/Hypochondriasis

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Health Anxiety/Hypochondriasis

Health Anxiety/Hypochondriasis is a type of somatoform disorder, a mental illness in which a person has symptoms of a medical illness but the symptoms cannot be fully explained by an actual physical disorder.

People with hypochondria are very worried about getting a disease or are certain they have a disease, even after medical tests show they do not. These people also often misinterpret minor health problems or normal body functions as symptoms of a serious disease. An example is a person who is sure that her

headaches are caused by a brain tumour. The symptoms associated with hypochondria are not under the person's voluntary control and can cause great distress and/or interfere with a person's normal functioning. Hypochondria can occur at any time of life but most often begins in early adulthood. It appears to affect men and women equally.

What are the symptoms of health anxiety/hypochondriasis

Most people with hypochondria (often called hypochondriacs) are worried about having a physical illness. The symptoms they describe can range from general complaints such as pain or tiredness to concerns about normal body functions such as breathing or stomach noises. People with hypochondria are not faking or lying about their symptoms, they truly believe they are sick.

Warning signs that a person might have hypochondria include:

  • The person has a history of going to many doctors. He or she may even "shop around" for a doctor who will agree that he or she has a serious illness.
  • The person recently experienced a loss or stressful event
  • The person is overly concerned about a specific organ or body system such as the heart or the digestive system
  • The person's symptoms or area of concern might shift or change
  • A doctor's reassurance does not calm the person's fears and he or she believes the doctor is wrong or made a mistake
  • The person's concern about illness interferes with his or her work, family and social life
  • The person may have anxiety, nervousness and/or depression

What causes health anxiety/hypochondriasis?

The exact cause of hypochondria is not known. Factors that might be involved in the development of the disorder include:

  • A history of physical or sexual abuse
  • A history of having a serious illness as a child
  • A poor ability to express emotions
  • A parent or close relative with the disorder. Children might learn this behaviour if a parent is overly concerned about disease and/or overreacts to even minor illnesses
  • An inherited susceptibility for the disorder

How is health anxiety/hypochondriasis diagnosed?

Diagnosing hypochondria can be very difficult because people with the disorder are convinced their symptoms are caused by a medical illness.

When symptoms appear, the doctor will begin his or her evaluation with a complete history and physical examination. If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, doctors who are specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist makes a diagnosis based on his or her assessment of the person's attitude and behaviour and the fact that physical illness has been ruled out as the cause of the symptoms. The psychiatrist or psychologist may administer a personality assessment to confirm the diagnosis of hypochondria or somatoform disorder.

How is hypochondria treated?

A main goal of treatment is to help patients live and function as normally as possible, even if they continue to have symptoms. Treatment also aims to alter the thinking and behaviour that leads to the symptoms.

As with other somatoform disorders, hypochondria can be very difficult to treat. This is due, in part, to the fact that people with this disorder refuse to believe their symptoms are the result of mental or emotional rather than physical causes.

Treatment for hypochondria most often includes a combination of the following options:

  • Supportive care. In most cases the best course of action is for the person to stay in regular contact with a doctor. Within this doctor-patient relationship the doctor can monitor the symptoms and stay alert to any changes that might signal a real medical illness. The doctor's main approach is likely to focus on reassuring and supporting the person, as well as preventing unnecessary tests and treatments. However, it might be necessary to treat some of the symptoms such as severe pain.
  • Medication. Antidepressant or anti-anxiety drugs are sometimes used if a person with hypochondria also has a mood disorder or anxiety disorder.
  • Psychotherapy. Psychotherapy (a type of counselling) can be helpful in changing the thinking and behaviour that contribute to the symptoms. Therapy can also help the person learn better ways to deal with stress and improve his or her social and work functioning.

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