by Lucas Myers
You are patiently explaining to the third doctor that the bruising on your arm is a sure sign of leukemia. Once again, she tells you that the tests all came back negative. You’ve heard it all before. She explains that much like the parasites causing intense stomach pain were just some gas, and the terrible headache in June was not a brain tumor but most likely a sign of dehydration, this is just a normal bruise and should clear up in a few days. You attempt to cap your seething frustration as you push your doctor to try another test. As soon as you get home you make an appointment with another doctor - perhaps this one will help. Welcome to the challenging world of someone coping with Hypochondriasis, sometimes referred to as Health Anxiety or Illness Anxiety.
Hypochondriasis, estimated to be affecting 1-7% of the population, causes a person to dread that she has, or is going to have, a terrible disease or physical ailment. This person may constantly monitor her vital signs, and see minor changes in her body as “symptoms” of something far more ominous. She may “hop” from doctor to doctor, reading obsessively online about disease and seeking validation and treatment by demanding unneeded tests. Negative tests may bring some temporary reassurance, but this typically wears off quickly, only to be replaced by more illness fears.
Those suffering from Hypochondriasis may believe that their excessive worrying is protecting them. They may believe that any discomfort or imperfection of body functioning is a sign of serious illness. Perhaps they sense that any doubt or uncertainty demands thorough investigation. Often they may scour the Internet until they find “proof” that the symptom they are concerned about is associated with a debilitating or deadly disease, such as cancer.
While hypochondriasis might seem funny or eccentric at first, those who have had or known someone with hypochondriasis tell a different story. The obsessive check-ups, monitoring, research, and fear can demand an enormous time investment and stress academic, professional and social relationships to the breaking point. Hypochondriasis can cause a person to become so obsessive that it appears to share similarities with Obsessive Compulsive Disorder (OCD). In particular both diseases share the feature that the more an individual attempts to address their fears (by checking, washing, doctor hopping, etc.), the more intense those fears tend to become. An important difference that distinguishes the two is that while someone with OCD may live in terror of getting a disease, someone with Hypochondriasis lives with the fear that they already have it.
Recommendations to those with Hypochondriasis include sticking to one doctor, avoiding Internet searches about illnesses, keeping active, and stopping self-checks. Of course making these changes is often very difficult to do without help, especially because the very nature of Hypochondriasis is the lurking sense that diagnosis of disease is just one doctor away. The nightly news often offers headlines that read as confirmation of a new health threat and a bombardment of well-meaning public health messages could leave anyone on high alert. However, WebMD is not the answer so where else can someone turn who is struggling with hypochondriasis?
The first step is education about the condition. Understanding hypochondriasis is crucial to gaining the power to change and sticking with a treatment plan. Make sure that a licensed or supervised psychologist is part of the healthcare team. Not only do they have the expertise to diagnose Hypochondriasis, but research has equipped them to to treat it. Due to the many similarities between OCD and Hypochondriasis, strategies developed to treat OCD have been found to be highly effective when adapted to the treatment of Hypochondriasis. According to recent studies by Harvard University and the Mayo Clinic, the most effective treatment is Cognitive Behavioral Therapy (CBT).
CBT is designed to help identify and change the behaviors that maintain and worsen anxiety and other symptoms of hypochondriasis. Sometimes it may include exposure therapy-- confronting fears little by little until they lose their power. For example, if someone is terrified that they have cancer, they may visit a cancer hospital. Another technique, cognitive restructuring, teaches clients to challenge the validity of their health related fears. An approach that borrows from Mindfulness-Based CBT, is to learn non-judgmental acceptance of unpleasant thoughts. From a mindfulness perspective this discomfort is normal, and distress arises from the persistent attempts to control or escape discomfort.
Over the course of therapy, which is often as short as 16-20 sessions, clients learn to use these tools to challenge their health related anxiety as well as the behaviors that they have been using to cope with those fears. If you would like more information on Hypochondriasis or Cognitive Behavioral Therapy, click here to contact us.
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