tag:theconversation.com,2011:/fr/topics/hypochondria-11054/articlesHypochondria – The Conversation2023-12-19T10:55:22Ztag:theconversation.com,2011:article/2199862023-12-19T10:55:22Z2023-12-19T10:55:22ZHypochondriacs die earlier than those who worry less about their health – what might explain this paradox?<figure><img src="https://images.theconversation.com/files/566295/original/file-20231218-17-biar6k.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5592%2C3756&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-model-blonde-woman-white-shirt-1279482784">HBRH/Shutterstock</a></span></figcaption></figure><p>People who worry excessively about their health tend to die earlier than those who don’t, a <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2812786">recent study</a> from Sweden has found. It seems strange that hypochondriacs who, by definition, worry yet have nothing wrong with them, should enjoy shorter lifespans than the rest of us. Let’s find out more.</p>
<p>First, a word about terminology. The term “hypochondriac” is fast becoming pejorative. Instead, we medical professionals are encouraged to use the term <a href="https://www.ncbi.nlm.nih.gov/books/NBK554399/">illness anxiety disorder</a> (IAD). So, to avoid triggering our more sensitive readership, we ought to use this term.</p>
<p>We can define IAD as a mental health condition characterised by <a href="https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t32/">excessive worry about health</a>, often with an unfounded belief that a serious medical condition is present. It may be associated with frequent visits to a doctor, or it may involve avoiding them altogether on the grounds that a real and quite possibly fatal condition might be diagnosed. </p>
<p>The latter variant strikes me as quite rational. A hospital is a <a href="https://www.who.int/news-room/fact-sheets/detail/patient-safety">dangerous place</a> and you can die in a place like that.</p>
<p>IAD can be quite debilitating. A person with the condition will spend a lot of time worrying and visiting clinics and hospitals. It is <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17159-5">costly to health systems</a> because of time and diagnostic resources used and is quite stigmatising. </p>
<p>Busy healthcare professionals would much rather spend time treating people with “real conditions” and can often be quite <a href="https://www.webmd.com/mental-health/news/20230120/medical-gaslighting-what-to-know">dismissive</a>. So can the <a href="https://www.theguardian.com/commentisfree/2013/mar/24/placebos-great-for-hypochondriacs">public</a>.</p>
<h2>Now, about that study</h2>
<p>The Swedish researchers tracked around 42,000 people (of whom 1,000 had IAD) <a href="https://www.jstage.jst.go.jp/article/ace/4/2/4_22005/_html/-char/en">over two decades</a>. During that period, people with the disorder had an increased risk of death. (On average, worriers died five years younger than those who worried less.) Furthermore, the risk of death was increased from both natural and unnatural causes. Perhaps people with IAD have something wrong with them after all.</p>
<p>People with IAD dying of natural causes had increased mortality from cardiovascular causes, respiratory causes and unknown causes. Interestingly, they did not have an increased mortality from cancer. This seems odd because <a href="https://www.treatmyocd.com/blog/constantly-worried-cancer-ocd">cancer anxiety is rife</a> in this population.
The principal cause of unnatural death in the IAD cohort was from suicide, with at least a fourfold increase over those without IAD.</p>
<p>So how do we explain these curious findings?</p>
<p>IAD is known to have a strong association with psychiatric disorders. As suicide risk is increased by <a href="https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr229-self-harm-and-suicide.pdf?sfvrsn=b6fdf395_10">psychiatric illness</a>, then this finding seems quite reasonable. If we add in the fact that people with IAD may feel stigmatised and dismissed, then it follows that this may contribute to anxiety and depression, leading ultimately to suicide in some cases.</p>
<p>The increased risk of death from natural causes seems less easy to explain. There may be lifestyle factors. Alcohol, smoking and drug use are <a href="https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm#:%7E:text=Roughly%2050%20percent%20of%20individuals,percent%20abuse%20alcohol%20or%20drugs.">more common</a> in anxious people and those with a psychiatric disorder. It is known that such vices can limit one’s longevity and so they may contribute to the increased mortality from IAD.</p>
<p>IAD is known to be more common in those who have had a family member with a serious illness. Since many serious illnesses have a genetic component, there may be good constitutional causes for this increase in mortality: lifespan is shortened by “faulty” genes.</p>
<figure class="align-center ">
<img alt="Man sitting on a sofa pouring hard liquor from a bottle." src="https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/566307/original/file-20231218-21-1wwzug.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Anxious people are more likely to drink alcohol.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/handsome-depressed-man-drinking-whisky-home-585761300">Africa Studio/Shutterstock</a></span>
</figcaption>
</figure>
<h2>What can we learn?</h2>
<p>Doctors need to be alert to the underlying health problems of patients and must listen with greater care. When we are dismissive of our patients, we can often be badly caught out. People with IAD may well have a hidden underlying disorder – an unpopular conclusion, I accept. </p>
<p>Perhaps we can illustrate this point with the case of the French novelist, <a href="https://en.wikipedia.org/wiki/Marcel_Proust">Marcel Proust</a>. Proust is often described by his biographers as a hypochondriac, yet he died in 1922 at the age of 51 at a time when the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844828/#:%7E:text=In%201922%2C%20a%2020%2Dyear,38%2Dyear%2Dold%20man.">life expectancy of a Frenchman was 63</a>. </p>
<p>During his life, he complained of numerous gastrointestinal <a href="https://www.rsm.ac.uk/media/2060/marcel-proust-exhibition-booklet.pdf">symptoms</a> such as fullness, bloating and vomiting, yet his medical attendants could find little wrong. In fact, what he described is consistent with <a href="https://my.clevelandclinic.org/health/diseases/15522-gastroparesis">gastroparesis</a>. </p>
<p>This is a condition in which motility of the stomach is reduced and it empties more slowly than it should, causing it to overfill. This can lead to vomiting and with that comes a risk of inhaling vomit, leading to aspiration pneumonia and Proust is known to have died of complications of pneumonia.</p>
<p>Finally, a word of caution: writing about IAD can be quite risky. The French playwright Molière wrote <a href="https://www.encyclopedia.com/arts/educational-magazines/imaginary-invalid">Le Malade Imaginaire</a> (The Imaginary Invalid), a play about a hypochondriac called Argan who tries to get his daughter to marry a doctor in order to reduce his medical bills. As for Molière, he died at the <a href="https://www.britannica.com/question/How-did-Moliere-die">fourth performance of his work</a>. Mock hypochondriacs at your peril.</p><img src="https://counter.theconversation.com/content/219986/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Hughes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Hypochondriacs live, on average, five years less than those who don’t have the condition.Stephen Hughes, Senior Lecturer in Medicine, Anglia Ruskin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/837622017-09-14T11:29:38Z2017-09-14T11:29:38ZDear worried well, the internet is not your friend<figure><img src="https://images.theconversation.com/files/185859/original/file-20170913-23117-sc2sdm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/629889977?src=DtJDXo1YCfVjp9K7wXDKdw-1-9&size=medium_jpg">pathdoc/Shutterstock</a></span></figcaption></figure><p>The worried well could be costing the NHS £56m in unnecessary tests and appointments, according to a <a href="http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_7-9-2017-12-37-49">recent estimate</a> by Imperial College London. Many of these worried well are probably “cyberchondriacs” – people who’ve googled their symptoms and ended up in front of their GP, clutching a ream of internet evidence that they have a life-threatening disease. </p>
<p>If your skin is itchy (“pruritus”, in medicalspeak), it could be a sign that you have blood cancer. More likely, though, your skin is just a bit dry or that fancy new soap you bought doesn’t agree with you. Feeling a bit tired? Maybe you have anaemia or clinical depression. Or maybe you’ve just been working or partying too hard – or both. </p>
<p>If you have trouble sleeping, abdominal discomfort, dizziness or other common symptoms that can be interpreted in a variety of ways, you must decide whether to visit your doctor, change an aspect of your lifestyle (such as eating healthier or getting a better night’s sleep) or ignore your symptoms – at least for now. </p>
<p>You might fire up your laptop to see if there’s any information in the ether to help you decide on the best course of action. In all likelihood, though, it will only make your decision more difficult.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/186012/original/file-20170914-8971-1qv82z4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Best not to google it.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/596816120?src=th-9ed6Yke6e2F3ia4UDbA-1-1&size=medium_jpg">Africa Studio/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Well intentioned but misleading</h2>
<p>A lot of online health information is well intentioned and informative, but some of it can be misleading. For example, some websites pair the early experience of fairly minor symptoms to potentially deadly chronic illnesses. A twitching eyelid is usually a sign that you’ve had too much caffeine, or not enough sleep; however, some websites will also tell you that it’s an early sign of multiple sclerosis. </p>
<p>While some people find it easy to compartmentalise this type of information and prevent it from becoming a cause for concern, for others worrying thoughts can be difficult to control, leading to increasing levels of anxiety. </p>
<p>Online sources of health information are broad and varied. They range from symptom checkers to charity websites, supporting those with selected chronic illnesses, to the personal blogs of people with various disorders. A number of commercial websites also provide free health information, alongside a recommended treatment. </p>
<p>If you’re worried about new symptoms, it’s important that you only access websites where the information has been written or reviewed by medical professionals, such as NHS Choices. These websites attempt to provide an unbiased and balanced view of symptoms that is informed by evidence-based medicine and clinical practice. But it’s worth bearing in mind that the information on these websites is often for information purposes only, and is not intended for diagnostic use. </p>
<p>But trustworthy medical websites are not what you will always get when you use a search engine, so it’s easy to be led to astray. Misinformation can lead to <a href="https://psychcentral.com/lib/what-is-catastrophizing/">catastrophising</a> (thinking the worst), rumination (dwelling on a troubling thought) and increased attention directed toward the area of discomfort, which can increase the experience of pain in the affected area. This leads to a downward spiral.</p>
<h2>Alternative sources of medical advice</h2>
<p>GPs are often the first port of call for people who are worried about their symptoms. But health services have a limited capacity and doctors often <a href="http://www.tandfonline.com/doi/full/10.3109/02813432.2014.900239">struggle to meet the demands of patients</a> seeking diagnostic tests, referrals or reassurance for new symptoms. </p>
<p>Fortunately, alternative sources of healthcare are promoted to ensure that the worried can seek help without increasing the impact on primary care, these include pharmacies, walk-in-centres and telephone helplines. This range of alternative places to seek more formal medical advice means that if you are worried about your symptoms, you don’t need to turn to the internet to find out if your symptom is serious and whether you need further medical help.</p><img src="https://counter.theconversation.com/content/83762/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebecca Stack does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are better places to go for health advice than cyberspace.Rebecca Stack, Senior Lecturer in Psychology, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/700482017-01-23T01:53:03Z2017-01-23T01:53:03ZHealth Check: how do you know if you’re obsessed with your health?<figure><img src="https://images.theconversation.com/files/150895/original/image-20161220-9515-11mi309.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Illness anxiety disorder is a serious mental health condition. But it can be treated.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/535279507?src=9wT7XBMTIYBm4xFmhohvTA-3-5&id=535279507&size=medium_jpg">from www.shutterstock.com/jevelin</a></span></figcaption></figure><p>Most of us worry about our health at some point. You may notice a new symptom or change in your body and become convinced it’s a sign of a horrible illness; a loved one might become ill and you might worry it may also happen to you.</p>
<p>In fact, it can be helpful to be concerned about your health. This is the type of concern that might motivate you to visit your doctor to check a sore back, apply sunscreen to prevent skin cancer, eat well, exercise or drink enough water.</p>
<p>Usually, worries about your health are short-lived and disappear after symptoms go away or after you receive the all clear from your doctor.</p>
<p>But for some people, what starts as a normal health concern can tip over into a serious mental health problem you might know as hypochondria, health anxiety or to give it its official title, illness anxiety disorder.</p>
<p>So how can you tell if your health concerns are helpful or harmful? And where can you go for help?</p>
<h2>What is illness anxiety disorder?</h2>
<p>Illness anxiety disorder involves an overwhelming, disabling and crippling fear of illness and is a new psychiatric disorder listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, known as <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">DSM-5</a>. </p>
<p>Illness anxiety disorder replaced the <a href="https://www.ncbi.nlm.nih.gov/pubmed/15337660">contentious diagnosis</a> of hypochondriasis in <a href="http://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420249.dsm-iv-tr">previous versions of the DSM</a>. The new label, which is also sometimes referred to as severe health anxiety or health anxiety for short, is less stigmatising, and better reflects the fact anxiety about illness is at the heart of this condition.</p>
<h2>How do you know if you have it?</h2>
<p>Like any mental health condition, answer the following questions to see if your anxiety has become a problem:</p>
<ol>
<li> Is it lasting too long, occurring too often and difficult to control?</li>
<li> Is it out of proportion to the actual danger or seriousness of the physical symptoms?</li>
<li> Is it distressing or affecting your quality of life, well-being and relationships?</li>
</ol>
<p>Do you ever Google your symptoms or check your body a lot for illness signs and symptoms? Are you very careful about what and where you eat because you are afraid you might get sick? Do you seek a lot of reassurance from friends, loved ones or health professionals about your health, or go straight to the doctor as soon as you notice a change in your body? Or do you simply spend a lot of time thinking about your health, dreading the idea you may become sick? </p>
<p>These things aren’t necessarily a sign of anything unusual, but if they happen too often or start affecting your quality of life, they might be a signal you need to seek help and support.</p>
<h2>Illness anxiety is common</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/22500013">We published data</a> from an Australian population survey that found illness anxiety affects 5.7% of Australians at some point in their lives. That’s over one million people.</p>
<p>As well as placing a burden on the individual, it places a burden on society due to excessive <a href="http://journals.lww.com/psychosomaticmedicine/Abstract/2016/01000/Health_Anxiety_and_Its_Relationship_to_Disability.4.aspx">health care use</a>.</p>
<p>There is also little community awareness it exists. And it is often misdiagnosed as a “personality trait” rather than a treatable condition.</p>
<h2>Illness anxiety comes in many shapes and sizes</h2>
<p>The illnesses people fear are vast and varied. While the creative ways the mind interprets what is going on the body can be fascinating, it’s also troubling how debilitating this condition can be.</p>
<p>Some people are terrified of having cancer, heart defects, HIV or other STIs, despite repeated reassurance and negative test results. Others are anxious they have neurological conditions and dementia despite all evidence pointing to the contrary. Some are convinced they have parasites, mental illnesses and even Ebola.</p>
<p>Most people with illness anxiety frequently seek health care, with <a href="http://journals.lww.com/psychosomaticmedicine/Abstract/2016/01000/Health_Anxiety_and_Its_Relationship_to_Disability.4.aspx">higher overall rates of health service use</a> in people with illness anxiety compared to the general population. But people may also <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">avoid health care</a> because they are terrified of finding out they are sick.</p>
<h2>Where you can find help?</h2>
<p>Illness anxiety <a href="https://www.ncbi.nlm.nih.gov/pubmed/24954212">can be successfully treated</a> using <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behavioural therapy</a> or CBT, a kind of therapy that teaches new ways of thinking and behaving. In CBT, we teach people how to recognise the symptoms of illness anxiety, and practical strategies to overcome the thoughts, worries and unhelpful behaviours (like excessive counterproductive body checking) that make illness anxiety worse in the long term. </p>
<p>The aim of CBT is not to take away all anxiety but to help people live a normal, healthy life without the dread of illness hanging over them.</p>
<p>If you are considering CBT, the first step is to see a doctor you trust for a general health check, and to rule out serious illnesses. </p>
<p>You can receive CBT in face-to-face sessions at <a href="https://adc.crufad.org/">specialist anxiety clinics</a> or with experienced psychologists. Recent research shows <a href="https://www.ncbi.nlm.nih.gov/pubmed/27491531">self-help</a> and <a href="http://www.sciencedirect.com/science/article/pii/S2214782916300379">online treatment</a> also have excellent results. <a href="http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=53">Self-help resources</a> and <a href="https://thiswayup.org.au/how-we-can-help/courses/health-anxiety-course/">comprehensive online CBT programs</a> are now available in Australia.</p><img src="https://counter.theconversation.com/content/70048/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jill Newby receives funding from the Australian National Health and Medical Research Council (NHMRC) in the form of an Early Career Fellowship (1037787). </span></em></p>When does a healthy concern about your health tip over into illness anxiety?Jill Newby, Lecturer and NHMRC Early Career Research Fellow, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/271242014-06-22T20:25:45Z2014-06-22T20:25:45ZListen up hypochondriacs, how do you want to be remembered?<figure><img src="https://images.theconversation.com/files/51600/original/zxrpw75h-1403146157.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People who worry excessively about catastrophic consequences of seemingly benign symptoms are known as hypochondriacs.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/karrienodalo/5484585874">Karrie Nodalo/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>We all worry about our health from time to time, at least to some degree, but some people worry excessively about catastrophic consequences of seemingly benign symptoms. They’re known as hypochondriacs.</p>
<p>This is the sort of process hypochondriacs go through: what’s that? A benign lump or malignant bump on your face, breast or rump? Adrenaline rush, heart pumping, sweating, and light-headedness follow, confirming the gravity of the terminal self-diagnosis. </p>
<p>Thoughts racing and images of a foreshortened future, orphaned children, and opportunities missed. Overwhelming distress. Must plan the epitaph – see, I told you I was sick!</p>
<p>Our future and physical health are inherently uncertain. But people with hypochondriasis (or, since the latest edition of the <a href="https://theconversation.com/explainer-what-is-the-dsm-14127">Diagnostic and Statistical Manual of Mental Disorders</a>, somatic symptom disorder) immediately resolve any uncertainty about novel physical sensations and symptoms on the side of catastrophe.</p>
<h2>Seeking symptoms</h2>
<p>The body is constantly in a state of flux. The heart pumps, blood flows, muscles twitch, lungs inflate, and bowels contract. Strange symptoms come and go. And most pass without conscious awareness as we focus on daily tasks.</p>
<p>But try this. Hold your hand upwards, so that your palm and fingertips face the sky. Focus all your attention on the tips of your fingers and wait …and wait …until you notice some sensations. Tingling, temperature changes, or just an awareness of the sensations on your skin. </p>
<p>Here’s an even simpler task. As you read this, shift your attention on to the sensations of the ground or chair pushing up against your body. Chances are you were unaware of all these sensations just moments ago.</p>
<p>Attention, you see, is the microscope of the mind. It can filter in or out any of your internal or external experiences. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=447&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=447&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=447&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=562&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=562&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51602/original/n48tjdh4-1403146416.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=562&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Focus all your attention on the tips of your fingers and you will start to notice sensations.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/jessandcolin/2247446957">Jess Liotta and Collin Liotta/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>Now imagine becoming hypervigilant to all the physical changes naturally occurring in your body. Try it. Just focus on all the sensations in your body for a minute. Amazing, isn’t it? Itchy toes, tense jaw, mild headache, numbness, and so on. All the normal workings of a healthy body.</p>
<p>People with somatic symptom disorder are experts at searching for and noticing normal bodily changes. They’re also experts at interpreting these in potentially catastrophic ways – fatigue is leukemia; a lump on the arm is cancer.</p>
<p>The number one enemy of someone with the disorder is Dr Google (“cyberchondria”). Indeed, the only thing more catastrophically creative than a hypochondriac’s mind is Google’s 2.42 million webpages on the causes of cancer. Every possible symptom can be linked to every possible diagnosis, by at least one disreputable source or another. </p>
<p>The hypochondriac is searching not for information, but for confirmation of their imminent demise. If they’re unlucky, they might come across contradictory information or additional ailments they hadn’t yet considered.</p>
<p>Their intense worry and anxiety feel intolerable and must be neutralised. Seeking out a sympathetic doctor or other source of reassurance, or avoiding the health section of the newspaper all provide temporary relief until the next physical symptom is perceived.</p>
<h2>Moving forward from health anxiety</h2>
<p>So what are some things that keep hypochondriacs worrying?</p>
<p>Belief: worrying will help me catch something early.</p>
<p>No, it won’t. Worrying will just keep you miserable until you’re old enough to find out how you will shuffle off this mortal coil (unless, of course, your demise is a blissfully brief surprise). Worry itself will not get you any closer to predicting, preventing, or planning for your death.</p>
<p>Belief: I can get certainty about my health.</p>
<p>Nope, can’t get that either. No amount of checking, doctor visits, Googling, reassurance-seeking will guarantee with 100% certainty that you’re well. I can, however, guarantee that the unrelenting pursuit of certainty will make you miserable.</p>
<p>So, how can you manage health anxiety?</p>
<p>First, develop some healthy guidelines for monitoring your health and stick to them.</p>
<p>Based on your past experience, how long do benign symptoms typically last? One day, two days, one week? Decide how long you will wait before seeking any form of certainty or reassurance (from the internet, friends, family, or medical practitioners) the next time you notice a symptom, especially ones you’ve worried about in the past. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/51604/original/37nrn69j-1403146539.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Hypochondriacs need to learn to sit with uncertainty about their health.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/seandreilinger/2194655714">Sean Dreilinger/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>Once this time expires (no pun intended), make a decision about whether you need to get the symptom checked or whether you can wait another little while before doing so. Follow guidelines from reputable sources about the recommended frequency of body checking.</p>
<p>And, be willing to sit with uncertainty about your health. None of us ever have certainty about our health. I could have a brain tumour as I write these words. I am willing to accept this possibility and shift my attention onto the next paragraph.</p>
<p>Think about it this way: if I offered you a $2 million insurance policy for your house, even if I promised to build you a gold-plated replacement if it were destroyed, you would likely consider it far too expensive.</p>
<p>So, how much are you willing to pay to prevent any possibility of illness? Are you willing to give up your capacity to work, time you would otherwise spend with friends and family, and ultimately your happiness? This is a very high price to pay.</p>
<p>Spend energy on things you truly value, rather than wasting it on a false insurance policy. Learn to accept uncertainty about your health. Revel in not knowing when or how the end will come. Focus instead on the time between now and then.</p>
<p>Ultimately, what you have to decide is which epitaph you would prefer when your inevitable end arrives: “lived decades in misery and fear of death”, or “didn’t see that coming but my life was far richer for it.”</p>
<p><br>
For more information about how to manage health anxiety, see the <a href="http://www.cci.health.wa.gov.au/">Helping Health Anxiety modules here</a>.</p><img src="https://counter.theconversation.com/content/27124/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter McEvoy does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We all worry about our health from time to time, at least to some degree, but some people worry excessively about catastrophic consequences of seemingly benign symptoms. They’re known as hypochondriacs…Peter McEvoy, Associate Professor of Clinical Psychology, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.