What is it?
- Hypochondria is a chronic mental illness in which you fear having an undiagnosed serious or life-threatening disease. Hypochondria is currently considered a psychosomatic disorder, which means it's a psychological disorder with physical symptoms. However, some researchers believe hypochondria is a form of obsessive-compulsive disorder, and its designation may eventually change.
- With hypochondria, you believe that normal bodily sensations or vague symptoms mean that you have an underlying disease. For instance, you may believe that your body's occasional twinges mean you have cancer. Or that forgetting where you placed your car keys means you have Alzheimer's disease. You become so convinced that you seek doctor after doctor in search of a diagnosis.
Signs and symptoms of hypochondria include:
- Excessive fear or anxiety about having a particular disease or condition
- Worry that minor symptoms mean you have a serious illness
- Seeking repeated medical exams or consultations"Doctor shopping," or frequently switching doctors
- Frustration with doctors or medical care
- Strained social relationships
- Obsessive health research
- Emotional distress
- Frequent checking of your body for problems, such as lumps or sores
- Frequent checking of vital signs, such as pulse or blood pressure
- Inability to be reassured by medical exams
- Thinking you have a disease after reading or hearing about it
- Avoidance of situations that make you feel anxious, such as being in a hospital
Different intensities of hypochondria
Hypochondria can vary in intensity. When you have hypochondria, you may be absolutely sure that you have a certain disease, and getting a diagnosis becomes your primary focus in life. You visit numerous doctors and specialists. If one doctor tells you that you aren't sick, you don't believe it and seek out other opinions. You may seek numerous tests, such as magnetic resonance imaging (MRI), echocardiograms or even exploratory surgery. You may think that the lack of a diagnosis means you're getting poor medical care. You may relentlessly talk about your symptoms or suspected diseases with family and friends.
On the flip side, you may be so fearful that something's wrong that you can't bear to go to the doctor because you believe you'll get bad news.
Or you may have a less intense form of hypochondria. Your worry may always be at the back of your mind even if it doesn't compel you to make frequent medical appointments to find a diagnosis.
The normal human body constantly produces a variety of sensations and symptoms — a random pain here, a twitch there. Most people never notice these, just ignore them or treat them as the common, everyday sensations that they usually are. But when you have hypochondria, every sensation or symptom, no matter how minor, is evidence to you that you have a serious or life-threatening disease. A headache, for example, signals a brain tumor. A shaky hand signals Parkinson's disease. A cough, lung cancer.
Why one person is able to ignore common bodily sensations while another winds up with hypochondria isn't known — hypochondria has no specific known cause. Some experts now believe that hypochondria is a type of obsessive-compulsive disorder, and further research may help shed light on that connection and possible causes.
In addition, some research suggests that the body's natural fight-or-flight response may be partly responsible for causing hypochondria. People with hypochondria often feel anxiety. Anxiety can cause a physiological arousal in the body that includes an increased heart rate, shortness of breath, sweating, nausea, dizziness and other sensations. When you have hypochondria, you mistakenly interpret these signs and symptoms as further evidence of illness, which increases your anxiety, and in turn, intensifies your symptoms, creating a vicious cycle.
Factors that may increase the risk of developing or triggering hypochondria include:
- Having a serious illness during childhood
- Knowing family members or others with a serious disease
- The death of a loved one
- Having an anxiety disorder
- A rigid belief that being in good health means that you are free of all physical symptoms or sensations
- Having close family members with hypochondria
- Feeling especially vulnerable to illness or disease
Hypochondria occurs about equally in men and women. It can develop at any age, even in children, but it most often begins in early adulthood. Current estimates suggest that 1 to 5 percent of the population has hypochondria.
Complications that hypochondria may cause or be associated with include:
- Health risks associated with unnecessary medical procedures
- Work or school problems
- Relationship difficulties
- Anxiety disorders
- Substance abuse
- Excessive anger and frustration
- Strained relationships with your health providers
- Financial problems related to medical costs
Hypochondria can be overwhelming and disabling. You may become so obsessed with finding a cause for your physical symptoms that it affects your daily functioning. You may frequently miss work or school. Your health may be all that you can think about or talk about, which can alienate family and friends.
Unfortunately, some people with hypochondria may indeed have a physical condition, and it may be overlooked by health care professionals. They may have grown so frustrated with your frequent appointments that they dismiss you without realizing that something truly is wrong this time.
If your doctor or mental health provider believes you may have hypochondria or another mental illness, he or she typically orders a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms, and check for any related complications. Your doctor also wants to make sure that you aren't indeed physically ill.
These exams and tests generally include:
- Physical exam. This may include measuring height and weight, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.
- Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
- Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past.
Diagnostic criteria for hypochondria
To be diagnosed with hypochondria, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
Symptom criteria required for a diagnosis of hypochondria include:
- A preoccupation, lasting for at least six months, that you have a serious illness based on your bodily symptoms
- Distress about this preoccupation
- Impairment in your social life, work or other daily routines