Understanding Hypochondria

At 65, Madam Lara, retired from civil service as a grade I principal in the Secondary School system. An erstwhile vibrant and vivacious lady, she now leads a quiet life. One of the consequences of her retirement is that she has developed an attitude of unbridled complain about various ailments. In spite of overwhelming and clear-cut proofs of sound health, Lara is obsessed with the idea of being constantly sickly. Last week, she complained of arthritis. This week, it is ulcer and next week, either it would be arthritis again or liver cihorsis.

Another case is Tonye, a civil war veteran who at 70 is so obsessed about his health that, he no longer shakes hands with people in order to avoid being contaminated. Also, Tonye visits every new Ear, Nose and Throat (ENT) doctor in town because he is constantly complaining of one organic disease or the other.

Hypochondriasis or hypochondria is the psychological/psychiatric condition in which an individual becomes excessively anxious or concerned about one’s health status. It is obsession with the idea of sickness particularly the serious type. The 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) refers to Hypochondriasis as Somatic Symptom Disorder or Illness Anxiety Disorder (IAD). To qualify as a diagnosis of hypochondriasis, the symptom should persist for at least six months.

The symptoms of IAD include, somatic (bodily) sensations such as muscle twitching or fatigue, preoccupation and magnification of minor health symptoms. Others include, refusing professional medical advice and results of tests, excessive worry about an illness basically because it has a family hereditary connection, avoiding certain people or places because one thinks that they are channels of a particular disease. In the same vein, IAD can manifest as compulsive checking of one’s body for symptoms of an illness, obsessive search for information about a particular disease or always expressing fear of possible contamination, infection or affliction of a particular ailment.

As one can see, these symptoms are heavy and actually cause terrible damages to the mental and emotional health of the individual. Consequently, an unhealthy psyche will produce a sick body.

A major cause of IAD is wrong belief system, which is actually the product of a wrong mindset. As we all know, mindsets develop over a certain time frame. Like spade loads of concrete, a particular pattern (in this case sickness) continues to be released in a predetermined content (the mind) until both merge and the former becomes solidified. For instance a symptom like fast breathing occasioned by climbing a high-rise building can be associated with heart attack. When repeated on several occasions, the individual may conclude that he is a victim of cardiac arrest.

Ignorance serves as a causative factor of hypochondriasis. This form of ignorance can be provocative because, the victim rejects scientific proofs and all rational evidence of sound health while on the other hand clinging to spurious and uninvestigated symptoms of a particular ailment. Sometimes, this form of hypochondriasis is based on superstition. The patient claims to have access to medical or psychological knowledge, which the professional lacks. Meanwhile the veneer of ignorance has overshadowed the mind of the patient.

Some other times, ageing or actually inability to adjust to the demands of ageing can cause hypochondriasis. Normally as one approaches middle age, the organs begin to grow weak. For men two, basic signs of monumental organic changes are greying of hairs and protruding of the stomach while for women, menopause as well as greying of the hair may set in. Positive ways of adjusting to these ageing changes in physiology include, changing to appropriate diets, engaging in appropriate physical exercise regime, and rest or relaxation. Ageing individuals who neglect or refuse to adjust to the current physiological clock of their bodies may likely end up as victims of hypochondriasis.

Personal or other people’s negative experience can predispose an individual to hypochondriasis. For instance, someone lost his life through ruptured appendicitis because of inability to obtain immediate medical attention. In another occasion, a woman had a stillbirth because of late arrival in the maternity ward. Tonye, the civil war veteran mentioned at the beginning of this discourse belongs to this group too.

Consequently such previous negative experiences of delay or carelessness in the area of health can (and does) predispose some people to become obsessed with health matters. Such people tend to complain excessively about any symptoms of diseases.

At other times, hypochondriasis is the product of association with victims of the disorder. Truly, no mortal is totally free from influence. Continuous association or relationship with victims of hypochondriasis may likely create an enabling environment for the associates to manifest the symptoms.

During my childhood days, one of the best occasions to attract parental love and care is the period of sickness. It was so effective that some children feigned sickness and yet attracted empathy and care. In the same vein, some people engage in hypochondriasis because of the emotional gain and extra care such a disorder attracts. The elderly is a significant cohort of patients who fit perfectly into this group of hypochondriacs majorly because in most instances, there is scarcity in terms of available time and other resources allocated to them. In our globe today, the challenge of parenting, coupled with the pursuit of career mobility and the desire to improve the standard of living among young and middle aged parents places the elderly in a more disadvantageous position. The result is that their adult children who are faced with those maturity tasks may be guilty of total negligence or of providing inadequate attention for the former. For such elderly folks, hypochondriasis becomes an attention getting behaviour. The disorder becomes a channel to satisfy the need for compensation.

The list of the causes of Illness Anxiety Disorder (IAD) is not exhaustive but suffices for now. We all detest illness or sickness. Therefore, let us aim at obtaining healing through excellent hound methods. Let us avoid compounding the disease condition through consulting quacks or engaging in self-medication. While it is an excellent practice to show concern for one’s health, one should avoid becoming excessively anxious or worried about it. In the second part, I will consider appropriate therapies for Illness Anxiety Disorder (IAD).

• Dr. Amaraegbu, a clinical psychologist and author lives in Lagos. He can be contacted at drpassy@yahoo.com.