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Most people can relate to the experience of assuming they have a medical condition, mental health illness, or a disease – regardless of their being medically diagnosed with it.
It may stem from looking up something like stomach pain causes on the internet (then obsessing over what you find!) or hearing about a sickness spreading among a group of friends or family members that you now suspect you have as well. It’s especially common with disorders that people don’t understand well such as diagnosing oneself with obsessive compulsive disorder (OCD) merely out of liking things clean and tidy, or someone assuming they have ADHD just because they have a hard time focusing under certain circumstances.
While it’s normal to have fears or anxiety associated with a suspected health problem or condition, says Dr. Neha Pathak, chief physician editor at WebMD and a former primary care doctor at the Department of Veterans Affairs, excessively or obsessively worrying – especially absent an official diagnosis – “can be very disruptive to day-to-day joy and wellbeing.”
Someone who does this often is commonly referred to as a hypochondriac.
A hypochondriac is someone who overly worries about having an illness or condition, “despite medical evaluations indicating otherwise,” says Dr. Jason Nagata, an adolescent medicine specialist at UCSF Benioff Children’s Hospital in San Francisco. He says the condition used to officially be called hypochondriasis, but that in 2013 it was split into two recognized conditions and defined as either “illness anxiety disorder” or “somatic symptom disorder” with each diagnosis determined by unique factors. “Both disorders are characterized by high levels of health anxiety, but an important distinction is that somatic symptom disorder involves significant physical symptoms, while physical symptoms are absent or mild in illness anxiety disorder,” he explains.
In either case, someone experiencing feelings of hypochondria can become so convinced they have a serious medical condition that few things are able to convince them otherwise. “They may even repeatedly switch doctors as they seek any confirmation that they are ill,” says Juanita Guerra, PhD, a clinical psychologist in New Rochelle, New York.
In the meantime, such individuals often experience persistent and intrusive anxiety, and their preoccupations often “lead to significant impairments in daily functioning,” says Nagata.
Left untreated, the condition can even lead to adverse physical health outcomes. “Research indicates that chronic anxiety associated with hypochondria can increase the risk of conditions like heart disease, making it a significant issue both psychologically and physically,” he adds.
Making matters even more complicated, hypochondria or illness anxiety disorder affect some 8% of the population, says Aron Tendler, a board-certified psychiatrist and chief medical officer of BrainsWay, which he says not only impacts each affected individual, “but also causes a significant burden on the healthcare system.”
Despite the condition being so common, “we don’t know exactly what causes hypochondria,” says Pathak, “but it can be linked to things like a family history of severe illness, extreme levels of stress and anxiety, personal health scares, or trauma stemming from child abuse, neglect, rape, or other forms of emotional or physical abuse.”
Guerra adds that the condition can also be the result of excessive internet use related to health searches or to following social media accounts that traffic in fear mongering. It can also be as simple as frequently experiencing intrusive thoughts or having personality traits such as being a worrier or an overthinker.
Tendler says the condition is also often “a disease of comorbidity” – meaning people who struggle with it frequently have other psychiatric diagnoses such as OCD, depression, personality disorders, anxiety or post-traumatic stress disorder (PTSD).
No matter what’s behind the condition, it’s usually treatable – so long as the person affected is willing to get help “by speaking with a medical or mental health professional,” says Nagata.
Guerra advises starting with one’s primary care doctor, as they can first rule out the presence of any other condition. “Once the doctor determines there is no actual physical illness, they can then refer you to a specialist or mental health professional for treatment,” she says.
Pathak explains that popular therapies for illness anxiety disorder or somatic symptom disorder include talk therapy or cognitive-behavioral therapy, “which can help people change their thinking patterns.” She adds that sometimes medicines such as antidepressants can also be helpful and that healthcare professionals are able to provide individually-tailored treatment plans for each patient. “The goal of treatment,” she says, “is to reduce symptoms and improve day-to-day life.”