Hypochondriasis: Is it real or is it just in your head?

A few months ago, if one were to say the world would come to a standstill, he or she would have been ridiculed and even laughed at for suggesting something as impossible as this. Lockdown, social distancing was thought of as fictional terms, until recently, when one virus crept in our lives and brought the whole world on its knees. Lockdown and the subsequent changes that followed have become a new normal for human beings until at least the coronavirus pandemic is brought under control.

Feelings of anxiety, panic and unease have become a part of our lives just the way work-from-home and staying indoors has. But, what has also gone up is the rise in health anxiety, or to put it scientifically, hypochondriasis. “There has been an increase in anxiety-related to medical conditions rather than medical anxiety. What we are seeing currently is the fear of the unknown, which normally helps keep us away from danger. In this situation, the invisible enemy that could be hiding anywhere, coupled with the fact that there is no known vaccine/ treatment, increases that fear of the unknown. This is an expected and natural reaction,” says Ritika Aggarwal Mehta, Consultant Psychologist, Jaslok Hospital and Research Centre.

What is hypochondriasis?

Shedding light on the term, Dr Anjali Chhabria, Consulting Psychiatrist says, “In hypochondriasis, patients come to believe, or at least to very strongly suspect, that they are sick with a serious, perhaps life-threatening disease. It is the irrational, obsessive fear that a person has or will have a serious medical issue. Minor symptoms can also trigger their concern. Their concerns persist despite the reassurances of their physicians. Doctors now also use the term illness anxiety disorder when referring to hypochondria.”

To give a few examples, a person might have a normal cough, but his/her mind will think the worse and feel it is pneumonia or lung cancer, or rare fast heart rate and the person feels he/she has heart problems. So much so that a person might repeatedly check for sign of health problem even where there is none. In the current situation, Dr Chhabria says the anxiety might be related to “fear of contact with others, travelling on public transport or going into public spaces”.

Diagnosis & treatment

Dr Mehta says the diagnosis is based on the criteria “it has been causing persistent disruption in the client’s daily life for a minimum period of six months”. This extreme fear related to one health can disrupt an individual’s social and professional lives as well. “They could sometimes feel exhausted, have a heaviness in their chest (as a result of the anxiety), negative thoughts, and feelings of helplessness or hopelessness,” Dr Mehta adds.

Once the diagnosis is established, it can be treated with therapies such as cognitive behaviour therapy (CBT) and certain psychiatric medication, informs Dr Mehta. While Dr Anjali adds Repetitive transcranial magnetic stimulation (rTMS), a form of brain stimulation therapy used to treat depression and anxiety can also be a part of the treatment.

Can medical anxiety cause physical problems?

An extreme fear related to health can disrupt an individual’s social and professional lives as well. “They could sometimes feel exhausted, have a heaviness in their chest (as a result of the anxiety), negative thoughts, and feelings of helplessness or hopelessness,” Dr Mehta says.

Adding to this, Dr Chhabria says, “Pre-occupation with illness may become all-consuming; some patients become invalids, bed-bound not so much by their symptoms, but by their fear of having a disabling illness.The stress, anxiety, sleeplessness or excessive sleep, over or under eating as a defence mechanism, overworking to avoid facing continuous dilapidating fear—all of these and more can contribute to physical and mental health problems.”

Life ahead

For someone suffering from medical anxiety, seeking treatment is of utmost importance if they feel their daily life is getting disrupted and are unable to handle the anxiety by themselves. Unfortunately, this kind of anxiety can persist for life, even though it responds well to treatment. “Hypochondriasis has lifetime prevalence somewhere between 1 and 5% and appears to be equally common in males and females. Once established, hypochondriasis can tend to be a chronic and lifelong for some but not in all the cases, with symptoms waxing and waning over time, Patients may have between partial to complete remission. The good part is that with the treatments available today we can help sustain, constructively deal with and/or treat Hypochondriasis,” Dr Chhabria adds.

Dr Anjali Chhabria shares some easy tips by which you can tackle this medical anxiety:

1. Keep a diary of how obsessions present themselves, for example, frequency of checking symptoms and calling doctors for reassurance and reduce how often these occur every week.

2. Limiting the time spent watching the news or checking social media can also reduce feelings of anxiety, especially during the COVID-19 outbreak Top of Form Bottom of Form. Make sure to get information from credible news sources, such as the World Health Organization (WHO).

3. Follow healthy daily routines. Get plenty of exercises, such as walking, stretching, or yoga. Practice relaxation exercises, and mindfulness.

4. Keep busy with other activities. Do something meaningful and enjoyable, such as reading, cooking, or jigsaw puzzling.

5. Connect with family and friends to discuss concerns and feelings. Join an online mental health group to share feelings. Contact helplines, for support.

6. People with pre-existing mental health conditions should continue any treatment they are receiving from their doctors. They should also be aware of any new or worsening symptoms and report them to their health provider.

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