People who are repeatedly afraid of being sick often receive little empathy from those close to them, who brand them as malingerers, obsessives, storytellers or hypochondriacs. However, it turns out that while that person doesn't have the disease she fears so much, she isn't healthy either.
Hypochondrism, which is the way that permanent fear of being sick is called, is a psychic disorder that greatly affects daily life.
Calling a person a hypochondriac today seems to be almost an insult, says psychologist Timo Slotta, who works as a psychotherapist at a specialist clinic in the German city of Cologne. And it seems to be enough that someone has the fear or concern of suffering from a disease that is not found when doing a medical analysis for everyone to tell him that he is a hypochondriac.
The body, under permanent observation
To be able to make the real diagnosis, it is necessary to go one step further. "Those affected are overly preoccupied with the terrible illnesses they might have," says Slotta. "Usually these are diseases that the person can suffer from for months or years and that will slowly kill them," he details.
People who have this disorder go to the doctor frequently, they turn the matter over in their heads, read a lot about it and do a kind of "bodychecking", that is, they scan their skin, for example, to see if they detect any type of suspicious spot, feel until it maybe hurts, do balance tests, have their blood pressure checked regularly, or keep an eye on their blood oxygen level.
Freaking out over certain symptoms from time to time isn't the problem, Slotta says. The sick thing is when the person feels that they must be seen yes or yes and her daily life is altered.
"Those affected develop preventive behavior: they stop going to work or playing sports," explains Sabine Köhler, psychiatrist and director of the German Association of Neurologists. Added to that is the temporal aspect. In order to make the diagnosis, those affected must be convinced that they have a serious illness for at least half a year. "Patients refuse to accept that they have nothing and constantly ask for more tests."
Possible causes of hypochondrism
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It has not yet been possible to determine the causes that lead a person to develop this type of disorder, but there are several hypotheses. On the one hand, there may be a certain genetic predisposition, that it has something to do with the style of education received or that it has been an impact of previous illnesses suffered. Having a weak bond with parents in the first year of life could also generate this type of alteration.
People who live in an environment where a lot of serious illnesses occur are often affected, Slotta observes. The way of thinking is also a factor to take into account, since hypochondriac people often fear causing or promoting the appearance of a disease through their behavior or their own thoughts.
A difficult diagnosis
Although there are very well defined criteria to establish the diagnosis, it is not so easy to do so. "It's a hidden disease," says Köhler, "because while those affected insist on receiving a diagnosis, what they are looking for is a diagnosis of a physical illness. They usually don't even want to hear about a psychic disorder."
The role of the GP is important here, according to Köhler. From her perspective, when a person has seen professionals from five different specialties in a quarter without having any clear health problems, she would do well to undergo some kind of psychiatric or psychosomatic analysis or psychological treatment.
"Hypochondrism can be treated," says Slotta, who claims that between two-thirds and four-fifths of those affected benefit from psychotherapy. Doing a drug treatment, this percentage is approximately half.
"Psychotherapy is hard work, no question about it," Slotta acknowledges. But medication treatments are only effective as long as one takes that medication. "In psychotherapy that's different."
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