Hypochondria: causes, symptoms and possible treatments

A headache is seen as an obvious sign of the presence of a brain tumor. Conjunctivitis is probably indicating the incubation of a hemorrhagic fever. The appearance of a bruise clearly indicates that there is internal injury due to illness. A discomfort in the arm implies that we are surely suffering a heart attack.

Although in some cases the association between symptoms and diseases that I have named is correct, a large part of the population is not alarmed when a specific symptom occurs: a almost people have ever had a headache, bloodshot eyes, bruises or discomfort and in general it is not due to the previous condition diseases.

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

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What is hypochondria?

It is understood by hypochondria,

currently referred to as illness anxiety disorder in DSM-5, that disorder characterized by the presence of a high level of fear, worry and anxiety before the belief or belief that you are suffering from a serious medical illness, or the possibility of being contracting it.

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

What happens in the mind of the hypochondriac

In cases where there is a conviction of illness, people with this disorder generally seek medical help in order to locate and diagnose the alleged problem, and it is frequent that in the presence of tests that show their good health, explanations do not satisfy or do so only temporarily and 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 fear of being diagnosed, despite suffering from very high anxiety and being convinced that they are sick.

The high level of anxiety regarding their health that these people suffer makes them continually focus on the existence of possible symptoms, as well as that they carry out or stop carrying out behaviors in order to check their state of Health.

The diagnosis of hypochondria assumes that these symptoms last for at least six months, although the disease that is believed to have can vary. This concern should not be confused nor should it be due to the existence of another mental disorder such as the TOC or somatic disorders (although in some cases 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 personal, work or academic).

Causes of the disorder

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

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

From a psychosocial approach looks like a learned behavior pattern that is acquired from the observation that it can bring 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 attention from his surroundings. It is important to highlight the fact that it is unconscious and involuntary.

However, one of the explanatory models that has received the most consideration is the one proposed by Warwick and Salkovskis, who considered that in the etiology of hypochondria, harmful previous experiences with regard to health can be found in the first place and illness (such as the death of a loved one due to one) that cause the belief to appear that the symptom always involves something very negative,

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

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Treatment of hypochondria

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

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

1. Psychotherapeutic intervention

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

After that, work begins on the different activities that the subject performs as a check on their state, and it is proposed jointly to carry out different experiments that contradict the beliefs of the individual. A commitment is established with the patient so that the patient agrees not to carry out certain activities verification, to later tell you to make a small record in which when anxiety arises write down data for and against his suspicions so that he can question them.

Later he is helped to make an exhibition in imagination or even a flood regarding the idea of ​​becoming ill or suffering from the disease in question. Self-targeting should also be worked on, showing the importance it has in exacerbating their discomfort and proposing activities that allow varying the focus of attention.

Cognitive restructuring is also very useful to combat dysfunctional beliefs. It is important to incorporate into any program applied against hypochondria elements that take into account the prevention of relapses. It is also useful to train the environment so that they do not enhance the symptoms.

2. Pharmacotherapy

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

Bibliographic 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.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE PIR Preparation Manual, 02. CEDE. Madrid.