Some hypochondriacs go to the doctor every week, others flee from white coats. Both burden a constant and unfounded fear of illness, which often increases without therapy.Marian Grosser, Doctor ArticlesHypochondria
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
The term hypochondria covers a whole range of diseases. It ranges from pronounced health awareness and health-oriented behavior to hypochondriacal delusion - the full picture of hypochondria. The most important characteristic of hypochondria is the fear of illness or illness, which is exacerbated by the misinterpretation of one's own physical perceptions (such as the heartbeat).
Due to this morbid anxiety, which usually severely limits the quality of life of those affected, hypochondria often resembles a panic or anxiety disorder. In fact, however, it is counted among the so-called somatoform disorders. This group includes diseases in which emotional discomfort and stress are reflected in physical symptoms. However, this is not the main criterion of hypochondria, which is why their association with somatoform disorders is controversial.
A number of well-known people are or were said to suffer from hypochondria. These include Charlie Chaplin, Frederick the Great, Woody Allen or Thomas Mann. Overall, probably around one percent of Germans are affected by hypochondria. The full picture of the disease, the hypochondriacal delusion, can be found in about 0.05 percent of Germans - that is, five out of every 10,000 people. Mild health-related fears show six percent of the population. At university, psychotherapeutic ambulances, hypochondriacs make up a quarter of the patients. Worldwide, between two and seven percent of GPs are affected. Men and women are equally affected.
The unreported number of hypochondriacs is probably much higher, as there are also those who are not noticeable in the health system. This may be due to the fact that these hypochondriacs show a pronounced avoidance behavior or use alternative medicine. In general, hypochondriacs use the healthcare system unusually frequently and thus cause high costs.
So far, there is no reliable data regarding the age at which hypochondria break out. One third of patients claim to have had excessive anxiety about childhood illnesses as early as childhood. In principle, hypochondria can affect all age groups as well as men and women alike. Statistically, people of lower education are especially affected. A genetic predisposition plays in hypochondria from today's perspective, only a minor role.
Some people sometimes develop hypochondriacal seizures after actual serious illnesses or experiences. But even after acquiring new information about health and illness, it can lead to hypochondriacal phases - such as with medical students.
Especially in the context of schizophrenic disorders and anxiety disorders, hypochondriacal symptoms can also occur as a non-independent clinical picture. In this case, the doctor speaks of a secondary hypochondria, which is primarily (first) triggered by another disease.To the table of contents
People with hypochondria are very afraid of disease. This fear of being sick can severely curtail life. It includes the concern of pain, disability, suffering and death. The fear is usually not unconscious, but stiffening on certain diseases. Hypochondriors also do extensive research and gather information about the dreaded diseases. Conversations and activities of everyday life are dominated by the fear of illness and disturb the social interaction.
In addition, in hypochondria there is the difficulty of enduring insecurity and the urgent need to clarify symptoms. And symptoms of any kind are perceived in an increased way: hypochondriacs pay attention to signals of the body very deliberately and exaggerated, so that they are already perceived in low intensity. Hypochondriacs are absolutely convinced that they have or will soon contract a disease. Catastrophic thoughts about one's own state of health circle uninterruptedly in the head of the hypochondriac. This leads to insecurity and anxiety to severe panic attacks. The sufferers are more and more taken by the suffering.
Permanent guest in the waiting room or escape from doctors
To fight their excessive fear, hypochondriacs are increasingly looking for reinsurance - over and over again and more often. Many sufferers often examine themselves, run from one doctor to another and ask friends and family again and again for their opinion on the supposed disease symptoms. The purpose of this communication is to confirm that the suspected illness actually exists. Since this is usually denied, hypochondriac usually causes frustration and dissatisfaction.
On the other hand, there are also hypochondriacs who consciously avoid the health system in order to prevent a confrontation. For example, these people bypass hospitals and cemeteries.
The increased search for confirmation of one's own health or illness is a central feature of hypochondria. Symptoms and fears can be alleviated successfully only in the short term, so that the cycle soon starts again at the faulty disease views.
Conscientious health care
In addition, hypochondriacs are increasingly trying to protect themselves from a disease: they conscientiously change their diet, do a lot of sports and develop a lifestyle that is as healthy as possible.
Focus on specific organs and diseases
For the most part, the anxiety associated with hypochondria affects the gastrointestinal tract, muscles and skeleton, as well as the nervous system. Often, the focus is on diseases such as skin or breast cancer. Those affected very often examine the skin or the breast for signs of cancer. Oftentimes, hypochondriacs are very well informed about the disease and see all the descriptions met with them. It is important that hypochondriacs actually have the described symptoms, they do not simulate.
Depressed and narcissistic features
In addition, hypochondriacs are often depressive-melancholic and may show narcissistic behavior. Narcissism is conspicuous in this context, above all because of overestimation and desire for attention. Some specialists in hypochondria assume an association with a neurotic personality. This is characterized by a disturbed mental development.
Therapy can help or hurt
If a hypochondriac is offered help in the form of a therapy for his supposed illness, it often has a contradictory effect. Instead of improving the condition, there are often more complications, side effects and an intensification of existing symptoms. In addition, the hypochondriac can discover symptoms of a new kind in itself.
Diverse clinical picture
Overall, the clinical picture of hypochondria is very heterogeneous, so that different subtypes are characterized according to the dominance of individual symptoms. As the disease progresses, health concerns can affect all areas of life, resulting in a significant reduction in quality of life. This can lead to conflicts, especially at work and in relationships.To the table of contents
Hypochondria: causes and risk factors
There are several theories for the development of hypochondria, but so far the cause has not been conclusively resolved. In addition, it is often unclear whether hypochondria is a completely independent disease or, more importantly, a symptom of another disease, such as depression.
The usually exaggerated disease views, which are mainly due to the overestimation of the probability and severity of a disease, are considered to be an important basis for the development of hypochondria. The over- and misinterpretation of body signals is a crucial step on the way to severe hypochondriacal phases.
Often, hypochondriacs have lower self-esteem than other people, with a sense of vulnerability. You feel that you have an increased risk of illness.
Hypochondria is also characterized by the desire for attention and help. Often sufferers have the experience that as a sick person can draw a high attention to themselves.
In particular, the deep-psychological explanation assumes an experience in childhood as a trigger of hypochondria. The diseases a hypochondriac is particularly afraid of are often related to previous experiences. For example, in cases of increased skin cancer anxiety, it may be the case that a close relative or the person affected earlier had a skin cancer. Even an earlier confrontation with death can shape the patterns of thinking and behavior so that hypochondria develop later.
Overall, hypochondria can be interpreted as a coping and self-healing strategy for other problems.To the table of contents
Hypochondria: examinations and diagnosis
Get first aid hypochondriac with your family doctor. This usually has the best overview of real illness concerns and the health of the patient. So he is usually best able to distinguish between exaggerated fears and actual health risks.
After a detailed conversation, the family doctor can refer the patient to a psychiatrist or psychologist. The patient must agree, because his willingness is a fundamental condition for the initiation of a therapy of hypochondria.
However, it is safe to rule out that there is no organic disease that could explain the symptoms described before starting a psychotherapeutic treatment for hypochondria. These are in particular multiple sclerosis, the severe morbid muscle weakness myasthenia gravis, hormonal disorders, thyroid disorders and tumors.
Investigations with the psychiatrist or psychologist
The examination by the psychiatrist or psychologist consists of an intensive conversation in which various points are discussed. To ensure a reliable diagnosis, modern tests are used. These objectify the suspected diagnosis of hypochondria. Test means questionnaire in this sense. It includes specific questions about the symptoms of hypochondria, such as:
- Does the thought of illness scare you?
- Do you go to the doctor often?
- Are you worried about your health?
- Do you have physical complaints?
- How do you react to the fear of illness?
Such a "hypochondriac test" can also be found on the Internet, for example the "Illness Attitude Scales" (IAS). With the help of such tests it can generally be investigated whether there is hypochondria, which elements of hypochondria are present and how severe these are.