Hypochondriasis: causes, symptoms and possible treatments

This disorder affects highly suggestible people who believe they are sick without proof.

A headache is seen as an obvious sign of the presence of a brain tumor. A conjunctivitis is probably indicating the incubation of a hemorrhagic fever. The appearance of a bruise clearly indicates internal injuries due to disease. A discomfort in the arm implies that we are certainly suffering a Heart attack.

Although in some cases the association between the symptoms and diseases I have mentioned is correct, a large part of the population is not alarmed when a particular symptom occurs: almost everyone has had a headache, bloodshot eyes, bruises or discomfort and in general it is not due to the aforementioned diseases.

However, there are people who experience a high level of anxiety when they notice alterations that are generally considered mild and are convinced that they are suffering from a serious illness. These are people who suffer from hypochondriasis..

What is hypochondria?

It is understood by hypochondria, currently denominated disorder of anxiety by disease in the DSM-5Hypochondriasis is a disorder characterized by the presence of a high level of fear, worry and anxiety due to the belief or conviction that one is suffering from a serious medical illness, or the possibility of contracting one.

This belief comes from the perception of small alterations or sensations that are interpreted as unequivocal signs of a serious medical illness. are interpreted as unequivocal signs of serious disorders.. Sometimes it appears after the person himself or someone of his environment has suffered a long, painful illness or that has concluded with the death of the sick person.

What happens in the hypochondriac's mind

In cases where there is a conviction of illness, in general people with this disorder seek medical help in order to locate and diagnose the alleged problem, and it is common that in the presence of tests that show their good health, the explanations do not satisfy them or do so only temporarily and they demand new tests or seek other professionals to confirm their fears. However, there are some people with this disorder who choose to avoid going to the doctor because of the fear of being diagnosed, even though they suffer from severe anxiety.despite suffering from very high anxiety and being convinced that they are ill.

The high level of anxiety about their health that these people suffer from makes them continuously focused on the existence of possible symptoms, as well as the fact that they perform or stop performing behaviors in order to check their state of health.

The diagnosis of hypochondriasis supposes that these symptoms occur over a period of at least six monthsalthough the disease that is believed to be present may vary. This concern should not be confused nor should it be due to the existence of another mental disorder such as OCD or somatic disorders (although in some cases the high anxiety can lead to a psychosomatic disorder). It is a disorder that can be very disabling and cause a high level of dysfunction in different vital domains (both personally and at work or academically).

Causes of the disorder

The anxiety disorder due to illness or hypochondriasis has been known since ancient times, with information about it even being found in classical Greece. Throughout history there have been attempts to establish different explanations regarding its etiology. At the psychological level we can find that several schools and schools of thought have been formulating their own explanations.

From the psychodynamic model, hypochondriasis has often been linked as an expression of internal conflicts. as an expression of internal conflicts originating in a distrust of one's own body born in childhood, with a transformation of hostility towards others that is redirected towards oneself or the need for dependence, or as an attempt of the psyche to respond and defend itself against guilt or low self-esteem. However, this explanation is not scientifically validated.

From a psychosocial approach it is seen as a learned behavioral pattern which is acquired by the observation that it can cause benefits. It is proposed that the hypochondriac may be an insecure person who uses the idea of being sick as an unconscious mechanism to attract the attention of his environment. It is important to emphasize the fact that it is unconscious and involuntary.

However, one of the explanatory models that has received the greatest consideration is that proposed by Warwick and Salkovskiswho considered that in the etiology of hypochondriasis, previous harmful experiences with respect to health and disease (such as the death of a loved one due to one) can be found in the first place, leading to the belief that the symptom always implies something very negative,

These beliefs are activated after a triggering event and cause automatic negative thoughts to appear, which in turn generate anxiety. Such anxiety will be enhanced by the performance of specific behaviors and increased activation at various levels.

Treatment of hypochondria

The treatment of the hypochondria can have certain complication because as a general rule the subject tends to maintain the belief that something physical happens to him. In order to treat hypochondria, it is necessary to first it is necessary to discard that there is no real pathology and, once discarded and once discarded it is necessary to establish a good rapport between therapist and patient.

Initially, anxious symptoms are usually treated first and then move on to the deeper aspects that originate and/or maintain the worry.

1. Psychotherapeutic intervention

In the treatment psychotherapy is employed with techniques generally of cognitive-behavioral type.. The treatment in question is based in the first place on helping the subject to detect the beliefs regarding his state of health and how these affect his life, to subsequently raise the alternative that he may be dealing with a problem related to anxiety and to teach him an explanatory model of the phenomenon (generally that of Warwick and Salkovskis).

After that, we start to work on the different activities that the subject performs as a verification of his state, and together we propose to carry out different experiments that contradict the individual's beliefs. A commitment is established with the patient in such a way that he commits himself not to carry out certain verifying activities, and then he is instructed to make a small record in which when the anxiety arises he will to write down data in favor and against his suspicions so that he can question them..

Subsequently, the patient is helped to make an imaginative presentation or even a flooding of the idea of being ill or suffering from the disease in question. Self-focusing should also be worked on, showing the importance that this has in the exacerbation of their discomfort and proposing activities that allow them to vary their attentional focus.

Cognitive restructuring is also very useful to combat dysfunctional beliefs. to combat dysfunctional beliefs. It is important to incorporate in any program applied against hypochondriasis elements that take relapse prevention into account. It is also useful to train the environment so that they do not potentiate the symptomatology.

2. Pharmacological treatment

There is no specific pharmacological treatment for this type of problem, although sometimes anxiolytics and antidepressants are used to alleviate the subject's discomfort.

Bibliographical references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Avia, M.D. (1993). Hypochondria. Ediciones Martínez Roca S.A., Barcelona.
• Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J. ; de los Ríos, P. ; Izquierdo, S. ; Román, P. ; Hernangómez, L. ; Navas, E. ; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Psicología Clínica. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.