A hypochondriac is a person with hypochondriasis. The modern definition of hypochondriasis is severe anxiety concerning health or fear that death is imminent. Hypochondriasis was a diagnosis at one time, but it is no longer listed in the Diagnostic and Statistical Manual, or DSM. The official diagnosis is either somatic symptom disorder or health anxiety disorder.
Hypochondriac Prevalence
An estimated one out of twenty Americans who seek regular medical care may be hypochondriacs. The numbers are hard to determine accurately. Hypochondria usually starts in young adulthood and affects both men and women. A person may be a hypochondriac without ever realizing it, while some people with physical health problems believe they are hypochondriacs.
Health Advisories
Frequent, and continuously-changing public service announcements concerning health and health care can negatively influence people with hypochondria. Public announcements and health advisories cover a wide range of illnesses and conditions, including cancer. These communications are intended to encourage people to be wary of subtle symptoms and visit a medical professional regularly to catch potential health issues early. This type of information is beneficial to public health overall, but it also reinforces the anxiety felt by people with hypochondria.
Public Awareness Campaigns
A professor from Northwestern University’s Feinberg School of Medicine believes the practice of designating specific months and dates to a variety of disorders may have unintentional consequences. Such practices do provide information and raise awareness, but the information provided isn’t detailed or extensive. The campaigns organized for each month bring numerous health issues into the public eye. People with hypochondria feel increased anxiety during these events.
Internet Use
The internet has significant potential to trigger or worsen hypochondria. The wealth of information available online is impressive, although some of it is not accurate. A person with hypochondria experiencing minor symptoms can quickly find multiple serious or fatal diseases and conditions with similar symptoms. A natural bias comes into play when people are searching for information after forming a belief or making a decision. People may unintentionally seek out information that confirms what they already believe while dismissing evidence to the contrary.
Childhood Risk Factors
Personal risk factors for developing hypochondria often stem from childhood. Neglect or abuse may lead to hypochondria as an adult. A serious childhood illness or a parent diagnosed with a serious illness may also contribute. Children with anxious parents prone to panic in response to minor injuries or illness are at the highest risk of developing hypochondria in adulthood.
Theory of Amplification of Sensory Experience
The theory of amplification of sensory experience states that people with hypochondria feel stronger internal sensations than the average person, and they pay closer attention to sensations within their bodies. The focus on minor discomfort or slight changes leads to magnifying the actual pain or discomfort. A person with hypochondria may be convinced that something is very wrong and causing intense symptoms before seeing a medical professional or doing any research.
Theory of Distorted Interpretation
The theory of distorted interpretation of symptoms states that the internal sensations people with hypochondria feel are not stronger than those of other people. This theory considers exaggerated perception and interpretation of internal sensations as the cause of hypochondria. An overreaction to minor sensations causes a great deal of stress. The stress may lead to more intense internal sensations, and it becomes a continuous feedback loop.
Diagnosing Hypochondriacs
Physicians diagnose hypochondria or somatic symptom disorder through observation and communication. A physical examination is the first step. The physician needs a complete medical history and will ask questions related to reported symptoms. Eliminating possible physical causes of symptoms cannot diagnose hypochondria. Rather, doctors base the diagnosis on how the person describes thoughts, feelings, and behaviors associated with the illness. Physicians may suspect hypochondria if words, tone, and demeanor are excessive for the symptoms or illness described.
Somatic Symptom Disorder
Anyone with a diagnosis of hypochondria when the DSM-5 was released probably saw the diagnosis change. Most diagnoses were changed to somatic symptom disorder or SSD. People with SSD often experience fatigue and pain ranging from mild to severe. SSD can cause upheaval personally and professionally. Employment may be difficult to maintain during symptom flare-ups, and the person with SSD can feel alone with no support.
Health Anxiety Disorder
Health anxiety disorder or HAD is an excessive fear of physical illness. It can also manifest as a firm belief that common, minor symptoms are the result of rare diseases. Approximately 25% of hypochondria diagnoses have been changed to health anxiety disorder diagnoses. People with SSD tend to focus almost exclusively on physical symptoms, while people with HAD are worried about catching or developing a serious condition. HAD is more common in women. People with HAD may look for signs of illness, such as breast lumps or skin cancer, much more often than necessary. HAD can also lead to avoiding doctors completely because of excessive fears.