If you have acquaintances who are overly concerned with physical health, afraid of getting sick and terrorizing everyone around them, then they are most likely hypochondriacs. How does a hypochondriac differ from a simulant? And why should hypochondria be treated? Let's try to figure it out right now.
Hypochondria, daughter of Hippocrates
The morbid obsession of some people with health, like many other phenomena of the surrounding world, was first noticed and studied by the ancient Greeks. The physician Hippocrates believed that this obsession was caused by a disease of a special internal organ, which he called hypochondria (the area of the body under the ribs). Hence the modern term "hypochondria" originated.
According to the current International Classification of Diseases of the 10th revision, hypochondria belongs to the class of mental (somatoform) disorders. It has somatic (bodily) manifestations in the absence of gross morphological changes (physical damage to organs, tissues) in the body, which could explain the origin of somatic complaints. In this way, somatoform disorders differ for the better from psychosomatic disorders, in which the pathology of certain organs is revealed.
Usually hypochondriacs are confident that they have a serious, life-threatening illness! And therefore, even ordinary states of the body - for example, rapid breathing after running, discomfort in the stomach - are interpreted as painful. That is, hypochondria is not just concentration on some of its actual disease, but concentration of thoughts and feelings on what is objectively not a disease. Often such a patient assumes that in addition to the underlying disease, there are additional ones. In 90% of cases, complaints of hypochondriacs relate to diseases of the cardiovascular system, gastrointestinal tract or genitourinary system, that is, those organs whose pathology can threaten life. The certainty of certain death due to illness is accompanied by anxiety and fear,and all attempts to dissuade a person are in vain and do not relieve anxiety. Excessive concern also sometimes causes palpitations, sweating, every minute check of breathing, and any slight deviation from the norm, the disease "confirms".
Shot from the movie & quot; Love from all diseases & quot; / medbooking.
Hypochondriacs are very active. They are not only afraid of undiagnosed diseases, but also look for them: they go to doctors, collect extensive documentation with test results, clippings from popular newspapers and magazines, information about the latest alternative methods of treatment. At the same time, patients with hypochondriacal disorder deny the emotional reasons for their concern and perceive it as a reaction to a serious illness. Negative test results (CT, MRI, hormonal studies, blood tests, etc.) do not calm hypochondriacs. Discerning hypochondriacs realize that unqualified hospital staff make mistakes in their analyzes and insist on more specialized research.
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Do not think that hypochondriacs are simulators and invent problems themselves, drawing attention to their person. Hypochondria is a disorder and hypochondriacs need help, most often psychotherapy.
Society of Anonymous Hypochondriacs
In medical practice, hypochondria occurs in 3–13% of hospital patients, and equally in men and women. More often it affects people aged 40-50 years, the elderly and adolescents. In the latter, hormonal changes in the body take place, and the state of hypochondria is associated with somatosensory amplification - a tendency towards a strong experience of somatic experience, in which a person pays attention to new phenomena (albeit completely usual for any person) occurring in the body. The sensations intensify, and "slight tingling sensations" turn into pain syndrome.
The condition of hypochondria is often susceptible to medical students. However, as soon as the training ends, the hypochondria recedes.
Often, hypochondria is inherent in emotional and light-hearted individuals who are influenced by the media. The factors that develop hypochondria include the general availability of medical information, sensational programs about new diseases, and intrusive advertising of medications. Today, most of the fears of hypochondriacs are associated with diseases that are currently being publicly discussed: oncology, myocardial infarction, AIDS.
Total anxiety
The causes of hypochondriacal disorder are still debated. There are various hypotheses. At the beginning of the 20th century, French psychiatrists Dupre and Camus suggested that the development of full-fledged hypochondria is impossible without disturbing the so-called "general feeling of the body." Receptors located throughout the body constantly monitor the activity of our organs, as soon as one of them fails, this immediately begins to affect the general sense of calm. Another hypothesis postulates that hypochondriacal thoughts indicate a distorted perception by the cerebral cortex of impulses coming from internal organs. Some hypochondriacs have a very low pain threshold, which explains their violent response to minor pain. According to another hypothesis, hypochondria is psychodynamic in nature. Finally, there is onewhich claims: the nature of hypochondria has a socio-cultural origin.
Hypochondria often develops in the presence of anxiety disorders. Anxiety disorders are the scourge of the 21st century. Anxiety disorders have become the most common mental illness in the world, according to a WHO study covering 18 countries. According to various sources, from 15 to 20% of the population suffer from one or another anxiety disorder during their life. Generalized anxiety disorder (GAD) is a mental disorder that is characterized by generalized anxiety that is not associated with certain objects or situations. That is, a person “worries in general,” for him the state of anxiety is permanent. At the psychological level, anxiety manifests itself in anxiety, tension, nervousness, at the physiological level - as shaking, muscle tension, sweating, heart palpitations, dizziness and discomfort, chest pain.
In September 2016, scientists at the University of Cambridge found that men with anxiety disorder are twice as likely to get cancer than those who do not face this psychological ailment, since a generalized disorder leads to a weakening of the body as a whole and the immune system in particular. The study involved about 16 thousand men over the age of 15. The study also took into account other factors that increase the risk of cancer, including smoking, alcohol consumption and physical inactivity. Interestingly, scientists have not found a link between GAD and cancer in women.
Some experts believe that hypochondria is a form of GAD. Generally, all hypochondriacs are anxious people, but not all anxious people are hypochondriacs. For the first time, anxiety as a personal construct began to be studied by psychologist Janet Taylor in the middle of the 20th century. She created a tool for measuring anxiety, a clinical scale for measuring chronic anxiety, ranging from 0 to 50. In hypochondriacs, the level of personal anxiety is usually on a scale above 25.
In addition to general anxiety, the development of hypochondria can be facilitated by genetic and constitutional predispositions, intrapersonal mental properties and microsocial environment.
When hypochondria is dangerous
Hypochondriasis can be an independent disorder, or it can be a symptom, a "plot" of various syndromes as part of a mental illness. Hypochondria does not cause diseases of internal organs, it has a mental nature and is expressed in a somatic form. Therefore, hypochondriacs have nothing to worry about: because of the disorder, cancer, HIV infection or myocardial infarction will not occur.
The hypochondriac thinks that he is breathing too often, concentrates his attention on it, and his blood pressure begins to rise and his heart rate really increases. If at the same time he has health problems, regardless of hypochondria, excessive emotionality can lead to an aggravation of the painful condition.
In another case, hypochondria can be a symptom in the composition of various syndromes of "big" and "small" psychiatry. Big psychiatry is a branch of psychiatry that studies mental illnesses in which there are severe mental disorders, such as delusions or hallucinations, impaired consciousness. So, hypochondria can be a separate manifestation of paranoid syndrome or Kandinsky-Clerambo syndrome. Small psychiatry, however, concerns mental disorders that are, as it were, on the border of mental norm and pathology. Here, hypochondria, for example, can be a pathocharacterological manifestation as part of a personality disorder (paranoid personality disorder, neurotic hypochondria, etc.). These are disorders whose etiopathogenesis is based on a constitutional predisposition at the level of personality disorder.
Hypochondria is also characterized by a high level of comorbidity (coexistence) with other disorders of the affective spectrum, such as depression or anxiety disorders.
There is no medicine, but the disease is
There are no special psychopharmacological agents for hypochondria. Some drugs can help reduce tension and anxiety and improve mood, but they can only be taken as directed by a doctor if, for example, hypochondria is comorbid with other disorders such as depression or GAD. To get rid of depression, patients are prescribed antidepressants, and for anxiety disorders, anxiolytics. These medications are addictive and should only be used under medical supervision.
The most effective method of treating hypochondria is psychotherapy, in particular, cognitive-behavioral therapy, the purpose of which is to change the cognitive attitudes of the hypochondriac. For successful treatment, the therapist must acknowledge the existence of the problem and the reality of the patient's physical symptoms and explain in an accessible way that the disorder is of a mental nature and does not affect the health of vital organs.
Charles Darwin.
Treatment for hypochondria may not be required at all. Charles Darwin, Edgar Poe, Charlotte Brontë, Marcel Proust, Hans Christian Andersen, Andy Warhol and many other famous personalities suffered from hypochondria, which did not prevent them from creating. Take a closer look at your fellow hypochondriacs - maybe they have the makings of a genius writer or artist?
Consultant: clinical psychologist Natalia Osipova
Daria Dobrynina