Pooja can't sleep. She's worried she might have a brain tumour. Her doctors say she's fine, but she still feels something's wrong. Sometimes she gets headaches or feels dizzy for no reason. She became frustrated because her doctor couldn't provide a conclusive diagnosis. This led her to search for answers online, where she came across information about brain cancer. She's read lots about it, and some symptoms match hers, but not all. She really wants to call her doctor. 

Pooja suffers from hypochondriasis, which means she's overly worried about having a serious illness or getting one. This problem can make it hard for her to do well at work or with family. 
People with hypochondriasis often focus on small body changes or sensations, like headaches or stomach aches. They might also worry a lot about one specific illness, like cancer. Sadly, many people living with this condition are convinced they have real medical issues. It is often unexplainable why some people tend to express distress mainly through physical complaints or why they continue to believe they're ill despite reassurance from doctors. However, many with illness anxiety avoid seeing mental health specialists and don't acknowledge the psychological aspect of their symptoms.

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Understanding Illness Anxiety Disorder

Health anxiety disorder or hypochondriasis is a chronic mental illness in which people have an unrealistic fear that they have a life-threatening disease. They may misinterpret even after medical tests with no apparent issues that something is wrong with them. In other words, people with this disorder live with the notion that they are sick and cannot change how they feel about it. For them, the fear is real. People diagnosed with hypochondriasis have four times higher risk of death from suicide. 

A 2023 study in Australia by BMC Public Health looked at how common hypochondriasis is in the general population. They found that about 5.7 per cent of people experience it at some point in their life, with the highest occurrence happening during middle age. 

Dr. Namita Singh, Consultant Neuropsychologist at Apollo Hospitals, Jubilee Hills, Hyderabad explains more about excessive stress & anxiety issues in people. She explains that human beings are creatures of habits and these habits at some point in our lives may take the form of stress. Sometimes, this stress leads to anxiety that something is not right, something is fearful inside me and things are not happening as I wished. Early age trauma may play a huge role in forming a person’s perspective of life and health. She further explains, ‘Nowadays the rise of social media and hoax news about certain medical conditions circulate faster than anything. This can also trigger a person’s conscience, making them believe that they may have some health concerns. 

 

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Clinical Presentation of Hypochondriasis 

The exact causes of sickness anxiety disorder are unknown, but several things seem to increase the risk of developing it. It may be due to spending a lot of time online researching health issues that might raise the risk. Having a serious illness as a child, or if a family member had a serious medical condition, could be a factor.
People with anxiety disorders, like generalised anxiety disorder, may be more likely to develop illness anxiety disorder. Besides, growing up in a family where health worries were common, or if parents were very concerned about health, might also increase the risk.

• Almost everyone worries sometimes about getting sick.
• People with hypochondria constantly fear they have a serious illness.
• They believe symptoms anywhere in the body mean something serious.
• For example, a headache might make them think they have a brain tumour.
• They might link stomach pain to pancreatic cancer or a sore muscle to multiple sclerosis.
• Hypochondriacs often search online or see many doctors to find proof of their illness, sometimes going from one doctor to another.

 

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Therapy for Hypochondria

Although earlier hypochondria was seen as untreatable. However, presently, science understands it better: believing in an undiagnosed disease, being anxious about health, and focusing a lot on bodily sensations. Researchers and doctors now see the value of psychological treatments because misinterpreting normal body feelings and thinking negatively about them makes the problem worse.

However, doctors find hypochondria hard to treat. Patients with illness anxiety spend a lot of time seeking medical help, even when tests show they're not sick. They don't feel reassured by negative results and keep being anxious. It's challenging to guide them to the right treatment.

Is there any treatment for hypochondria? 

• A 2024 research by JAMA Psychiatry indicates that Cognitive Behavioral Therapy (CBT) effectively helps hypochondriacs recognise their triggers and learn coping skills. Before starting CBT, it's important to get a thorough physical exam to rule out any actual medical issues. The results of this exam should be reviewed and accepted as proof of good health. Patients who underwent CBT in six 90-minute sessions over six weeks experienced significant reductions in hypochondriacal thoughts, health anxiety, and sensitivity to body sensations. They were also better able to engage in daily activities. CBT doesn't necessarily make physical symptoms disappear, but it helps patients manage their fears and cope better with them. However, only about 30 per cent of patients offered psychosocial treatment accept it because many with hypochondria prefer physical solutions for their symptoms. CBT tackles various aspects of hypochondria simultaneously. 
• Exposure therapy is one of the methods that challenge mistaken beliefs of the person. Hypochondriasis, it means gradually facing situations and bodily sensations that are avoided due to fear of illness. During exposure, patients learn to handle uncertainty about whether a sensation is a symptom. Initially, they may feel anxious during exposure, but this anxiety lessens over time through habituation. This teaches them that they don't need to fear these situations or sensations because the distress doesn't last forever.
• Apart from this, it focuses on challenging distorted thoughts, like expecting the worst outcomes, and teaches patients to analyse and challenge these thoughts. They also learn coping techniques like diaphragmatic breathing and muscle relaxation to deal with physical symptoms.

 

Illness anxiety disorder is a long-term condition. There may be times when you have less anxiety about your health, but it can come back. You can take steps to manage the symptoms of illness anxiety disorder. Constant worry can affect your physical and mental health. It can also strain your relationships and life. You might avoid spending time with loved ones because of health concerns. In severe cases, it can lead to depression or even thoughts of suicide.

Providing support and understanding to someone with hypochondria can help reduce the severity of the disorder and provide coping mechanisms. If someone is experiencing acute anxiety, book a consultation with a psychiatrist at UR.Life for professional medical advice. Early intervention can prevent symptoms from worsening and impacting their quality of life.

 

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