The Truth About Hypochondria

Hypochondriasis is actually a diagnosis in the DSM-IV-TR. Clinically here is the description and the requirements for diagnosis -

A- Preoccupation with fears of having. Or the idea that one has, a serious disease based on the misinterpretation of bodily symptoms.

B- The preoccupation persists despite appropriate medical evaluation and reassurance.

C- The beliefs in Criteria A are not delusional and are not restricted to concerns about bodily appearance.

D- The preoccupation causes clinically significant distress or impairment in social, occupational, and other important areas of functioning.

E- The duration lasts for at least 6 months.

F- The preoccupation is not better accounted for by

What does that really mean?

Less clinically stated it means you hurt and the doctor can't figure out why. After taking tests and doing evaluations they can't find anything wrong. So they believe it really isn't there. But it may be or it may not be.

Secondary Gain -

Certainly there are those who have something to gain by being ill. Usually it means getting more attention from loved ones, avoiding work, seeking sympathy or any other gain they may want and receive. Rarely is this a conscious thought. Usually they have found through experience that being ill is the only way to get attention and caring from those they love.

What is the patient's history?

Children who have seen their parents become ill or die often grow up fearing for their health and experiencing every feeling as possibly meaning they have the same illness. People who see ill friends or family may believe they have similar symptoms. Sometimes after reading about an illness they might believe they have that disease and no testing can dissuade them from that belief. Patients who have really had a serious illness in the past may fear its recurrence or believe they have a recurrence of the illness when testing does not reveal any recurrence.

A person can only be a hypochondriac if the illness is not real. Personally, as a psychotherapist as well as a patient, I have seen many doctors today who rely on standard tests and do not take reports from the patient seriously. The indifference of a physician can mean that an illness which is a little more unique and difficult to find goes without discovery. And the person is labeled a hypochondriac. It is this reason that many people doctor-shop seeking the one person who can find their problem.

Hypochondriacs are not liars. They are usually not conscious manipulators. They are people who are in pain and that pain doesn't seem to be diagnosable by a physician.

Seeing a therapist for a mental health evaluation may help to uncover the cause of the pain.

Since it is the job of the therapist to listen, and they spend far more time doing that than doctors, it is always possible that they may have some ideas regarding possible medical causes for the pain or they may concur with the doctor's findings and believe that therapy is the best solution.

Hypochondria can occur at any age but is most prevalent in the elderly as they experience changes in their body functions which concern and confuse. I've seen many elderly too sick to leave the house get well when their children come over. Getting old alone can be frightening and more family involvement might help ease that fear.

According to the DSM the prevalence of Hypochondria is about 1%-5% of the general population.

Source:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Washington DC, American Psychiatric Association, 2000.