Are you concerned you might be a hypochondriac? A hypochondriac is someone who is unusually or unnecessarily anxious and concerned about their health. Everyone worries about their health to some extent, so how do you know when you’ve crossed the line to being a hypochondriac?
History of the term “hypochondriac”
Use of the term hypochondriac in its current meaning, viz., someone preoccupied with imagined medical problems, dates back to the 19th century. People have used the term less often since the late 20th century. It is getting gradually replaced with other terms like “illness anxiety.” Psychiatrists and psychologists used hypochondriasis as a formal psychiatric diagnosis until 2013.
In its casual use, one connotation of the term “hypochondriac” is a lack of reasonable grounds for thinking one has a medical illness. For example, if someone becomes convinced they have lung cancer because they coughed a couple of times last week, they might be called a hypochondriac. People often use the term dismissively, saying things like “she’s always worried about some illness, it’s crazy — if you ask me, it’s just hypochondria.”
However, worry about imagined illness can be a very distressing problem. For some people, it can profoundly affect the way they live their lives.
A new understanding of the problem
In 2013, the American Psychiatric Association published an updated version of its widely used system of diagnostic categories. This system is described in the fifth edition of the Diagnostic and Statistical Manual, or DSM-5. The DSM-5 eliminated the diagnosis of hypochondria and replaced it with two new categories: illness anxiety disorder and somatic symptom disorder. Illness anxiety disorder is the diagnosis that most closely maps onto the common conception of hypochondria.
What are the signs of being a hypochondriac?
- Large amount of time spent worrying about having a serious illness
- Frequent visits to medical professionals
- Frequent questioning of loved ones – “do you think I have xxx illness?”
- Excessive time spent checking symptoms and learning about illnesses on the internet (more on this below)
- Frequent calls, emails or texts with medical providers about medical concerns
- Interpretation of physiological sensations as signs of serious illness when most others would not draw this conclusion
- Concern about illness leads to impositions in lifestyle, like avoiding travel, work, or other plans
Internet medical research
Thanks to the internet, researching medical diagnoses and troublesome physical symptoms has never been easier. There are websites like webMD and the website of the National Institutes of Health that have amazing amounts of quality medical information. Some medical websites even have apps with symptom checker features! For most people this is a great convenience. But for people with illness anxiety, it is a curse.
Before the internet, someone concerned about a medical condition would need to call or visit the doctor. However, this option often dried up if the doctor became tired or annoyed at answering the many questions.
Now, unlike scheduling medical appointments, “asking Dr. Google” can be done anonymously and without concern about negative feedback from healthcare providers. Internet research, when done repetitively, can make the anxiety and distress of illness anxiety disorder much worse.
Internet research about health conditions feels addictive to the hypochondriac who craves reassurance that he or she is not ill. If one symptom on a health website’s list doesn’t match what he or she is feeling, they can take some comfort in that. This relief can be habit forming.
Unfortunately, sometimes the internet medical research has the opposite effect. Finding just one symptom that matches his or her experience can lead to a downward spiral of catastrophizing and worry. Often the hypochondriac will try to remedy this by doing more internet research. It then becomes a massive, miserable time sink.
What does cognitive-behavioral therapy for hypochondria look like?
Cognitive-behavioral therapy (CBT) for hypochondria typically involves two primary components.
- education about the condition and the anxiety that fuels it, and
- learning specific and important skills that will help you handle this anxiety more effectively.
These skills can vary a bit from person to person, but will often involve learning to tolerate the feeling that precedes a checking behavior (e.g., looking up medical information on the internet, calling your doctor, or checking your blood pressure).
A hypochondriac will often assume that acting out of anxiety is the best way to feel better. However, the opposite is often true. In the long term, feeling better will involve changing some habits. CBT is often the most structured and effective way to accomplish such a change. Consult with a cognitive-behavioral therapist to find out if CBT can be helpful for you or a loved one.
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