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Important:  Always check first with a doctor any symptoms that concern you.

Has anyone noticed how prevalent hypochondria is as a co morbid condition amongst people who suffer with anxiety disorders? Hypochondria of course can exist as a distinct anxiety disorder but it also often presents with other anxiety disorders. In fact hypochondria heralded the beginnings of the emergence of my OCD, at least its full blow presentation as of course OCD presented in a relatively mild form in very early childhood. Hypochondria plagued the life of my sister and I right through childhood into adolescence and adult life, varying in degrees of intensity depending upon circumstance and the presence of other conditions. During the time when my sister suffered with agoraphobia so severe that she could not even stand on the doorstep, her hypochondria seemed a more aggressive torment perhaps due to having less distraction as a result of her need to be confined to her home.

During childhood, fear of illness would present its ugly head for both my sister and I. I recall how once having stayed up late to watch a film, a privilege in those days when children went to bed when they were told to do so, how I suddenly became aware of a noise in my ears, it sounded rather like the wind blowing through telegraph wires, a shrill and consistent noise which went right through my head from ear to ear. I recall the incident even now after so much time has passed, the panic, the fear, the crying and my mother’s lack of understanding and irritation: it was not so much the noise that caused the distress, which by morning had gone, but rather the fear that I had leukaemia. Why should a noise in my head make me fear that I had leukaemia, this as far as I know is not a symptom of leukaemia and as a child I really had no idea what the symptoms of leukaemia where, all I knew was that leukaemia and other cancers bought about death and these unexplained symptoms may well be leukaemia.

I recall many times when my sister’s hypochondria was severe, indeed this anxiety was more of a problem for her than myself. Because there were so many times that my sister cried wolf so to speak that when she was genuinely suffering from appendicitis my father hesitated to take her to see a doctor. In those days doctors appeared unaware of or had no real understanding for those who suffered with hypochondria or indeed any other anxiety disorder; my sister had presented at the doctors so many times that consequent hesitancy on my parents part was understandable but it could have been disastrous. Fortunately he relented. Many of the symptoms which bought the fear of death to my sister where strange and obscure ailments, most of which she imagined where cancer. Once a doctor was called out on a Saturday morning, my sister was crying and anxious, she had a tingling sensation . The doctor was annoyed but nothing was ever done to find out what could be done about the real illness from which my sister suffered : hypochondria.

So precisely what is hypochondria? Well I am sure that if you are a visitor to my website you are most likely a suffer of an anxiety disorder and you will no doubt know only too well what hypochondria is. You may however be a mental health professional, a student, a long suffering carer, or just someone who is interested in mental health issues, whoever you are you too have most likely experienced some kind of hypochondriacal fear even if only temporarily and momentarily. But for many people it takes over their lives, haunts their every thought, causes enormous fear and depression, reduces motivation and generally destroys the quality of the sufferers' life. Hypochondria is classified as an anxiety disorder. It is in a way very similar to OCD inasmuch as it involves unwanted and intrusive thoughts i.e. thoughts that one is ill, usually with a life threatening disease such as AIDS, cancer, bacterial or viral infection and ... well any of the umpteen thousand diseases of which is it is possible to suffer. Sufferers may also obsess over bodily functions of which he or she has previously been unaware, for instance heart beat, and breathing. Body sensations previously ignored now seem more ominous such as minor aches and pains, headaches, noises in the ears, tingling sensations and so on. Ironically such symptoms may arise as a result of the anxiety bought about by such fears and they than in turn perpetuate and increase the anxiety of the hypochondria sufferer still further. So now the sufferer really feels pain and discomfort, he of course begins to become more convinced that he is suffering from some dreadful disease.

When my hypochondria became manifest in its persistent full blown form as a result of a morbid conversation with a colleague at work I gradually began to feel as though I did have symptoms, genuine symptoms not merely anxieties that I had this or that disease. The symptoms were usually very mild: fears of lung cancer bought about the sensation of awkwardness in breathing as though I was conscious of my breathing. This sensation was most likely the result of anxiety, experiencing difficulty in breathing is a common symptom of anxiety which unfortunately validated my fear that I had lung cancer. An alarming increase in fatigue and falling asleep anywhere and everywhere including a session at my brother and sister-in-law's family film show accentuated my fear that I had leukaemia. Now fatigue and the tendency to fall asleep was again another symptom of anxiety or in this case outright fear, for indeed fear was the prominent emotion so great was my belief that I suffered with these illnesses. In recent years I became aware of difficulty swallowing and a sensation as though there was a lump in my throat. At times it was so bad that I could hardly speak. I feared oesophageal cancer or throat cancer. I searched on the internet, the more I read the more fearful I became. I had a barium swallow test which revealed that everything was okay, yet doubt remained and yet again the anxiety brought about by my fears produced a symptom quite common for people with anxiety but which in itself again validated my fears or in this case precipitated a whole new fear. It was rather like a catch twenty two situation; years of fear as a result of OCD and indeed hypochondria produced the lump in the throat feeling which in turn increased my anxiety still further by precipitating a bout of hypochondria.

Hypochondria also like OCD is characterised by compulsions i.e. checking spots should they become cancerous, visiting the doctors for reassurance, checking medical dictionaries, the internet. In extreme cases sufferers may constantly monitor their blood pressure and heart rate and so on.  The sufferer begins to have increasing concern about illnesses which may present in the future; as a result excessive avoidance of situations or lifestyles may be the consequence in order to avoid the possibility of contracting such disease. For instance an obsessive concern over healthy eating may arise as a result of ones fears concerning bowel cancer or indeed any disease or health problem which may be effected by diet.

Although sufferers constantly seek reassurance from friends and family and of course their doctor in order to quell the mounting fear and agonising torment, often any reassurance given is short lived. Yes, of course you should check with your doctor immediately when any symptoms arise which cause you concern however the problem then occurs when having had ones fears addressed by a medical professional the sufferer then continues to worry.

Often such reassurances from the doctor are not believed or only believed for a time and then doubts creep in and further reassurances are needed, perhaps a second opinion or requests for tests. Often sufferers of hypochondria will undergo many distressing tests and still remain unconvinced finding further evidence that they suffer from this or that disease. The saddest aspect of this disorder is that when the poor anguished sufferer finally accepts that he or she does not have the illness which has haunted his or her life for weeks even months the initial elation is only very short lived, for often within days even hours another fear will present itself and the sufferer is than tortured by fears of a new health threat, which despite the similarity of circumstances will again feel just too real despite the fact that previous fears have been unfounded. The sufferer’s mind will present new valid reasons why he or she is now most definitely suffering from the new illnesses. The sufferer cannot compare this new situation with the last and find relief, for the new worry about a different illness will present its argumentative persuasions in an entirely different way and convince the poor exhausted mind of the hypochondriac that this time he or she is correct. In extreme cases the distraught individual may not even accept the fact that he or she is an hypochondriac and needs help for what is effectively most likely the only real illnesses the person has. The term hypochondriac is often used in a derogatory sense as an insult and often this can hinder the individuals ability to accept that he or she has a valid condition but psychological rather than a physical but for which he or she nonetheless needs help.

Hypochondriacs often become anxious if they hear of a friend or relative or indeed anyone they know having a disease and they than begin to think that either they also have this disease or that they may do so in the future. I recall this happening at work when a colleague mentioned that a friend of hers was dying of hardening of the arteries and that this person had only a couple of weeks to live. Now this the kind of morbid conversation which does nothing for anyone who hears it but which has the power to seriously disturb those of us who are hypersensitive to such issues. This person who seemed a rather insensitive individual was perhaps very anxious herself not only because of the plight of her friend but because this situation bought to the fore her own anxieties about illness and dying. After this very depressing conversation I had the notion that I had hardening of the arteries: I was at that time only twenty-two. Yes, I began to develop symptoms but really bizarre symptoms: I imagined that veins in my wrist had disappeared! Can you believe it ... this was no neurotic thought it was more psychotic in nature inasmuch as I had no insight, I really thought that the veins in my wrists had disappeared. Quite what this had to do with hardening of the arteries I have no idea. In retrospect it now seems ludicrous but at the time this notion was horrifyingly real. I did not know what the symptoms where. There was no internet in those days and it was not easy for me to check such matters out in the library or elsewhere. After weeks of torment which no amount of rationalising could dispel - the obvious argument against my having hardening of the arteries of course being my age - I went to the doctors. In retrospect I was amazed that he could keep a straight face, he checked my blood pressure, all was well but I continued to think that the veins in my wrists had disappeared. Incidentally this tendency to imagine some rather unusual symptoms occurred with my sister. Once when returning from holiday we decided to visit with my sister in Leicester however she barely knew we were there preoccupied as she was, frightened by her fear that she had cancer she told me that her skin was silvery in appearance. This of course was entirely in her imagination, I tried to tell her that her skin appeared quite normal but such reassurance was to no avail, she like me couldn't see past such an idea no matter how bizarre it appeared to others. Perhaps these less logical manifestations of hypochondriacal symptoms result from our both having obsessive-compulsive illnesses for the imagining of unrelated impossible symptoms is not usually manifest in hypochondria - at least according to my understanding.

Hypochondria was often accentuated for my sister and I by such things as TV programmes and careless morbid talk amongst adults who where seemingly quite oblivious to the effect that such gloomy conversations had upon sensitive children such as my sister and I. Furthermore lessons at school could also bring about worry of this nature to both my sister and I. One afternoon my sister arrived home in quite a state of anxiety. The science lesson had centred upon a real life case of a school child of similar age to my sister who had died of leukaemia, the lesson went on to discuss the symptoms. My sister was sick with fear as was I when she shared this with me. Now when I say sick with fear this is no exaggeration, I can recall both the incident quite clearly in my memory and the sick anxiety that arose as a result. It is my opinion that it is quite unnecessary for such matters to be discussed so explicitly in schools or elsewhere to young children. Yes of course children need to be aware of such matters but until adulthood there is often little they can do to take appropriate steps to prevent the possibility of this kind of illness arising. The discussion in my sons class concerning bowel cancer I would image was of little use to anyone and most probably caused anxiety. Often it is not possible for children to make changes in diet as such is out of their control. Just my opinion of course; perhaps due to my own fears I am more sensitive to such issues. Also many of the 'soaps' these days aimed at young people such as Home and Away and Neighbours are far too preoccupied with cancer and are too explicit in their portrayal of the effects of this frightening disease. Of course death is a reality and it would be impossible not have death as a part of any drama series particularly an on going series but need these scenarios be so long drawn out, so explicit and morbid as was the case in Home and Away recently when one of the characters died as a result of skin cancer. This depressing scenario really began to get to me after a while. I had thought to stop watching the series for a time but lets face it I am fairly addicted to these programs despite the fact that they are really very superficial, irritating, and at this time unnecessarily morbidly gloomy. Sometimes I think that someone is trying to get a message across but there are more appropriate ways, such programs are about entertainment not education or an opportunity to make a point however worthy; information concerning the dangers of skin cancer and any other health issues can be relayed in less depressing ways. The character concerned died a long and protracted death, this scenario was carried over several weeks and after a while of this it was beginning to prey on my mind bringing to the fore disturbing anxieties and an increase in existential ruminations. This week I accidentally got mild sunburn the sun was not even shining. This is something that has never happened before which I find worrying and I wonder if there is more of a problem with the ozone layer than we are led to believe. But the most worrying aspect was the fear of skin cancer mostly accentuated by this TV programme. I should have been wearing sun block, I had a bottle with me having rushed out and bought some... indeed, as a result of this TV programme but I had forgotten to apply it. The public should be informed about skin cancer and any other disease and the precautions that should be taken to prevent such an occurrence, however, as the saying goes there is a time and a place.

Because of the effect that certain situations have had upon my life I would now make it a point never to discuss such matters in front of children or young people or indeed to anyone whom I do not know well enough to know that such conversations would not bring about worries or anxiety. My husband for example seems unaffected by such issues and I do off load my concerns to him, but there are few others with whom I can safely share my trepidation. Why discuss such worries anyway: I guess the need to talk about ones fears in this regard arises from the persons own fears, it is an attempt to alleviate their anxieties by sharing their fears with another. But please; if you are tempted to do this be very careful whom you choose as you could make someone depressed or anxious maybe only for a time but such conversations can have a long term effect upon susceptible people. As I have already mentioned, it was one such conversation, many years ago that precipitated my full blown OCD or at least paved the way for such. A colleague engaged me in a morbid conversation about death and illness, this account can be read in my memoir. The conversation was so explicit in detail that I never fully covered from it and thereafter I was beset by the most profound and awful dread of death that has never left me. Moreover from that day on and for months and months hypochondria was my torment until it was superseded by OCD which due to this conversation centred its obsessive-compulsive concerns mostly around my fear of death. Hypochondria remained but became less of a problem however it then became what I call 'vicarious hypochondria' inasmuch as I then began to worry that other people had a life threatening disease, a far more serious problem as of course it is not always easy to get other people to see a doctor.

The sick pervasive fear that is brought about as a result of hypochondria cannot be related to you by words as none seem adequate. Unless you have personally been effected in this way you may not understand the profound horror and the resulting fear and dread which arises from the notion that you may have a serious and life threatening illness.

The only positive outcome of hypochondria is that sufferers live longer as of course they are always at the doctors. Conversely however there is a possibility that a real disease may be overlooked in people with hypochondria because their previous symptoms were unsubstantiated. Therefore all new symptoms need to be checked out in the first instance and it is advisable to find a doctor who is understanding and aware of the situation concerning his or her patient.

One needs help in coping with this very debilitating disorder which I know from my own personal experience can take all the joy out of life and fill your mind, your whole being with a pervasive and misery inducing fear.

So what help is available?

I am not going to tell you to ignore whatever it is that is worrying you. Any symptoms need to be carefully checked out by your GP.

But sufferers of hypochondria would certainly benefit from cognitive behavioural therapy CBT and medication in order to control their anxieties and to learn to cope with the awful fear which arises from imaging that one has a serious life threatening illness before there is any evidence to substantiate such concerns. The sufferer needs to be aware of the possibility of impending illness but not absorbed by such worries to such a degree that life is nothing but a fearful misery and one becomes unable to function. These fears can be that overwhelming that you can barely concentrate or think of anything else! In my opinion of all the anxiety disorders hypochondria is one where you really need the help of a mental health professional in order to acquire a more normal approach to illness, to know when it is appropriate to visit a doctor and so on. Often sufferers of hypochondria lose any rational perspective and need guidance to retain a more normal approach.  For instance I delayed seeing my doctor for a year with my irritable bladder which although turned out not to be life threatening my doctor seemed rather concerned that I delayed consulting her for so long as of course an urgency to urinate may mean ovarian cancer. Yet recently a tiny purple mark on my breast had me scurrying down to the doctors' surgery the same day!  Yes it was a bruise and in retrospect I could tell that was all it was and I felt silly but I was just too scared to ignore it. It is not easy for the hypochondriac to know if he or she should consult a doctor: It's difficult for the sufferer of hypochondria  to treat or cope with this complex condition alone as you do need the more rational perspective of another. I would never tell anyone to ignore any symptoms and you should always see a doctor in the first instance but once you have received a diagnosis you do need help in order to leave behind your fears.

Useful Links:

I am not a health professional merely a sufferer. I was very anxious indeed to include this article fearful of giving the incorrect advice. I have of course always checked any worrying symptoms with a doctor and would not advise anyone to do other wise. I have never recovered from hypochondria and therefore can offer no advice concerning recovery, except as I have already mentioned above. I think it is best to seek help from a mental health  professional rather than to attempt to cope or recover alone. For a more authoritative information check out the following

MedlinePlus Medical Encyclopedia: Hypochondria

The Hypochondria Webpage

The Hypochondriac.com

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