What are the causes of hypochondriasis
Hypochondriasis Information | Mount Sinai
Signs and Symptoms
Signs and symptoms include:
- Preoccupation with a serious illness for at least 6 months
- Inability to control fears and worries
- Misinterpreting normal body sensations as symptoms of a disease
- Constant fear of illness despite reassurance of health status by health care providers
- Complaints mostly related to the head, neck, abdomen, and chest often in the form of pain
- Complaints of headache, indigestion, and constipation
What Causes It?
The exact cause of hypochondriasis is not known. Some of the causes include:
- Disturbance in perception such that normal sensations are magnified.
- Having learned apparent benefits of being sick, such as receiving attention. Hypochondriasis may occur in an individual who had a childhood illness or had a sibling with a childhood illness.
- May be related to another psychiatric disorder, such as anxiety or obsessive compulsive disorder. Hypochondriasis may develop from, or be a sign of, one of these other disorders.
Who's Most At Risk?
Risk factors may include:
- Age between 20 and 30 years
- Serious childhood illness or trauma
- Mental disorders, such as anxiety, obsessive-compulsive disorder, personality disorders, and depression
What to Expect at Your Provider's Office
Your health care provider may:
- Perform a physical examination.
- Other tests to determine whether a physical disease is responsible for your reported symptoms.
- Ask specific questions and use psychological tests to rule out anxiety or obsessive-compulsive disorder.
- Consult with a trained specialist, such as a psychologist or a psychiatrist, to aid in the diagnosis and treatment.
In addition to regular visits with a health care provider who will take physical symptoms seriously, people with hypochondriasis may also benefit from psychotherapy. Studies show group therapy, behavior modification, and cognitive therapy work particularly well.
People with hypochondriasis often have other mental health conditions, such as anxiety and depression. Treatment of these conditions is important in treating symptoms of hypochondriasis. Your provider may recommend limiting reading medical books and websites.
Doctors typically do notuse drugs to treat hypochondriasis. They may prescribe medication for associated mental health conditions. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or paroxetine may improve the anxiety and physical symptoms of hypochondriasis.
Several types of psychotherapy may help:
- Cognitive behavioral therapy (CBT), a type of talk therapy, can help you deal with symptoms. CBT helps identify thoughts that make the symptoms worse and develop methods of coping with symptoms.
- Behavioral stress management therapy is another kind of psychotherapy. It teaches stress management and relaxation techniques. These techniques help people avoid focusing on illness during stressful situations. Doctors may use it in conjunction with cognitive behavioral therapy.
Complementary and Alternative Therapies
Cognitive behavioral therapy and stress management are the main treatments for hypochondriasis. Participating in mindfulness techniques, such as meditation, may also help patients manage symptoms.
No scientific studies have examined the effect of nutrition on hypochondriasis. However, people with hypochondriasis who also have anxiety or depression may benefit from avoiding alcohol and caffeine.
Following these general nutritional tips may also help reduce risks and symptoms:
- Eliminate all suspected food allergens, preservatives, and chemical food additives.
- Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).
- Avoid refined foods, such as white breads, pastas, and sugar.
- Reduce significantly or eliminate trans-fatty acids.
- Avoid coffee and other stimulants, alcohol, and tobacco.
- Drink 6 to 8 glasses of filtered water daily.
- Exercise moderately, for 30 minutes daily, 5 days a week.
You may consider the following supplements:
- A daily multivitamin, containing the antioxidant vitamins A, C, E, D, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
- Omega-3 fatty acids, such as fish oil, may reduce inflammation and improve immunity. Omega-3 fatty acids interact with blood-thinning medications, such as warfarin (Coumadin) and aspirin. Speak with your provider.
- Melatonin may improve sleep. However, there are no studies on the safety of long-term therapy with melatonin. Ask your provider about potential prescription interactions which can be numerous and can even include birth control pills.
No herbs are specifically used to treat hypochondriasis and no studies show any effectiveness of herbs for hypochondriasis. Because many herbs interact with prescription antidepressants and anxiety medications, make sure your doctor is aware of all medications, herbs, and supplements you take.
- St. John's wort (Hypericum perforatum) may be helpful for some people with symptoms of depression. St. John's wort has several serious drug interactions, including, birth control pills, antidepressants, blood-thinning drugs, and others. Check with your provider if you are taking prescription medications.
- Kava kava (Piper methysticum) is used to relieve stress and anxiety. However, kava kava may have dangerous toxic effects, especially when combined with alcohol. The Food and Drug Administration has issued a warning concerning kava kava's effect on the liver. In rare cases, severe liver damage has been reported. If you take kava, do not use it for more than a few days, and tell your doctor before taking it.
- Bacopa (Bacopa monnieri) was studied for anxiety. Study results are mixed and there are concerns of dangerous side effects. Bacopa may increase the chances of a blockage in the intestines, slow down heart rate and increase fluid secretions in the lung. Speak with your physician.
No studies have examined the effectiveness of specific homeopathic remedies. Homeopaths may consider the following remedies for anxiety and other symptoms of hypochondriasis:
- Arsenicum album
Some studies indicate that acupuncture may be useful in treating some symptoms of hypochondriasis. Acupuncture may be useful for symptoms such as:
- Sleep disturbances
Massage therapy may help reduce symptoms of hypochondriasis in some people.
Stress and anxiety may make the symptoms of hypochondriasis worse. Many people may also struggle with costly medical tests and develop a dependency on certain medications. Hypochondriasis is a chronic illness (it persists for a long time), but getting early psychiatric treatment and having a strong motivation to change may increase the chances of getting better.
Keep up the regular appointments scheduled with your health care provider.
Bergquist PE. Therapeutic homeopathy. In: Rakel D, ed. Integrative Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 115.
Bongiorno PB, Murray MT. Hypericum perforatum (St. John's wort). In: Pizzorno JE, Murray MT, ed. Textbook of Natural Medicine. 4th ed. St Louis, MO: Elsevier Churchill Livingstone; 2013:chap 99.
Bongiorno PB, Murray MT. Affective disorders. In: Pizzorno JE, Murray MT, ed. Textbook of Natural Medicine. 4th ed. St Louis, MO: Elsevier Churchill Livingstone; 2013:chap 142.
Cooper K, Gregory JD, Walker I, Lambe S, Salkovskis PM. Cognitive behaviour therapy for health anxiety: a systematic review and meta-analysis. Behav Cogn Psychother. 2017;45(2):110-123. PMID: 28229805 www.ncbi.nlm.nih.gov/pubmed/28229805.
Evens A, Vendetta L, Krebs K, Herath P. Medically unexplained neurologic symptoms: a primer for physicians who make the initial encounter. Am J Med. 2015;128(10):1059-1064. PMID: 25910791 www.ncbi.nlm.nih.gov/pubmed/25910791.
Fallon BA, Ahern DK, Pavlicova M, et al. A randomized controlled trial of medication and cognitive-behavioral therapy for hypochondriasis. Am J Psychiatry. 2017;174(8):756-764. PMID: 28659038 www.ncbi.nlm.nih.gov/pubmed/28659038.
Kalanithi L. Hypochondriasis (illness anxiety disorder). In: Ferri FF, ed. Ferri's Clinical Advisor 2019. Philadelphia, PA: Elsevier; 2019: 744.e1-744.e2.
Murray MT. Piper methysticum (Kava). In: Pizzorno JE, Murray MT, ed. Textbook of Natural Medicine. 4th ed. St Louis, MO: Elsevier Churchill Livingstone; 2013:chap 114.
Pizzorno JE, Paul C, Schauss AG. Fish oils (omega-3 fatty acids, docosahexaenoic acid, eicosapentaenoic acid, dietary fish, and fish oils). In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 4th ed. St Louis, MO: Elsevier Churchill Livingstone; 2013:chap 91.
Reichert RG. Melatonin. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 4th ed. St Louis, MO: Elsevier Churchill Livingstone; 2013:chap 103.
Winter AO. Somatoform disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 103.
What are the Causes of Hypochondria
by Daniel Sher, MA, Clin Psychology and Micah Abraham, BSc
Micah Abraham, BSc
Last updated October 10, 2020
Hypochondria is a disorder marked by the persistent and misguided belief that you have serious health problems when no such problems are present. At times, the physical symptoms that are present are caused by your own mind - this is characteristic of a different but related disorder, called somatization. In either case, hypochondria is a complex disorder – one that has many causes – and we explore those causes in this article.
Note: the official name for this condition has changed from hypochondria to ‘Illness Anxiety Disorder’. Furthermore, this disorder is no longer technically classified as an anxiety disorder. Nonetheless, there is a fair amount of overlap between this condition and the symptoms of anxiety. Read on to learn more.
Causes of Hypochondria
Hypochondria can be serious for a lot of people. But what causes it isn't entirely known.
If someone with this condition also experiences frequent panic attacks, they might qualify for a diagnosis of panic disorder. At times, a person may receive both diagnoses - these disorders are closely interlinked (see the 2005 paper referenced below for more information). This condition is caused by an oversensitivity to the way a person feels, combined with serious panic attacks that mimic terrible diseases – all leading to the person feeling as though something must be wrong with their health. Even generalized anxiety disorder can cause these types of issues. Do panic attacks cause hypochondria? We don’t know this for sure, but the two phenomena are definitely closely interlinked.
Other potential causes for hypochondria are listed below.
- A History of Physical and/or Sexual Abuse Observing or experiencing physical and sexual abuse, particularly as a child, can result in a heightened sense of physical vulnerability. This may lead a person to suspect serious health issues when they are not present. A history of abuse can also lead a person to feel a sense of insecurity in their interpersonal attachments, which causes them to engage in compensatory care-seeking behavior.
- Google Syndrome Search engines may contribute to hypochondria. People Google weird feelings/experiences that they have, and find that they're linked to serious diseases. They then start to believe they may have a bad disease, and this type of behavior is reinforced.
- Serious Illnesses or Deaths of Family Members or Friends Seriously ill family members or friends can create an environment, for a child especially, where love and attention are directly linked to the illness. Observing this, the child may assume that they need to be ill to deserve love and attention, and continue to hold this belief unconsciously even into adulthood. When a close family member or friend dies, at any point in a person’s life, the shock and grief related to the death can easily trigger fear and obsessive concerns about one’s own health.
- Difficulty in Expressing Emotions Some people experience difficulties in expressing their emotions. This could be due to the way they were raised or to traumatic past experiences that caused them to distance themselves emotionally from others. Such people may find that the only way to connect emotionally with others is to provoke concern in them regarding potential health problems. A person who does this may not even realize they are doing it, apart from being aware on some level, perhaps even subconsciously, that being sick and having people worry about them makes them feel better.
- A Hypochondriacal or Overly Protective Parental Figure Learned behavior from a hypochondriacal caregiver is a potential cause of hypochondria. Behaviors taught to a person during childhood are likely to persist into adulthood by helping to form their beliefs about the world around them. A child with a hypochondriac as a caregiver is likely to believe that it is healthy to constantly question one’s health, and that a primary feature of the world around them is that it is a highly dangerous and unhealthy place. An overly protective caregiver instills many of the same principles into a person during childhood, while also teaching them the notion that people who care about them ought to worry constantly about their health and be highly receptive to their health complaints, even when they are minor.
Learning the specifics of the cause behind a person’s hypochondria is the first step towards addressing their core beliefs about why illness “needs” to be a part of their life and cultivating healthier beliefs to replace them, so that eventually they can be healthy, happy, and even happy to be healthy.
Was this article helpful?
- Hiller, Wolfgang, et al. Differentiating hypochondriasis from panic disorder. Journal of anxiety disorders 19.1 (2005): 29-49.
- Marshall, Tamsin, et al. Intergenerational transmission of health beliefs in somatoform disorders: exploratory study. The British Journal of Psychiatry 191.5 (2007): 449-450.
Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!
Ask Doctor a QuestionAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?– Anonymous patient
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice. Ask Doctor a Question
You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.– Timothy J. Legg, PhD, CRNP
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Causes of hypochondria. Symptoms of hypochondriacal disorder. Psychotherapeutic and drug treatments for hypochondria.
If a person develops an obsessive concern about his own health, he begins to look for (and finds!) various diseases in himself, although in reality there are no prerequisites for this, then doctors talk about hypochondria. Not only do such people convince themselves of the presence of some disease, they manage to make even the attending physician believe in it. This problem requires the unconditional intervention of a specialist.
Causes of hypochondria
Hypochondria disorder can be an independent disease, but often it is included in a complex of other mental disorders. Hypochondria can be a component of a depressive disorder, and, in this case, a negative psycho-emotional background, experiences and disorders really lead to a deterioration in health. The following predisposing factors are currently identified: feel;
Particular attention should be paid to actually present somatic diseases - if they occur in a severe form, then a person may experience fear, which is a provoking factor in the development of hypochondria in the future. Most often, hypochondriacal disorder is associated with difficult life situations, conflicts, but the patient himself denies such a relationship.
What a hypochondriac looks like
Symptoms of the disorder in question can vary in severity from mild to severe (sometimes reaching the scale of hypochondriacal delusions).
- Obsessive thoughts about their health, that some processes in the body may be defective, doubts about the correct interpretation of the results of the examination by doctors - such patients tensely "listen to themselves", sometimes examine their skin and mucous membranes, feel themselves etc., take repeated tests even with negative results of the previous ones, constantly read medical literature and compare descriptions of various diseases with their feelings.
- Unshakable certainty in the presence of severe physical illness. Moreover, neither the results of analyzes and instrumental examinations, nor consultations with leading specialists can convince the patient of the opposite. Confidence can concern not only pathology, but also a physical defect or deformity.
- A complete failure to understand that the signs/symptoms present are not evidence of a disease, but normal processes in the body.
- Sometimes a patient can calm down after a conversation with a doctor who intelligibly explained everything that happens from the standpoint of medical logic, but not for long - literally the next day (or even after a few hours) doubts flare up with renewed vigor and again take possession of the patient's mind.
But a hypochondriac can be detected much easier - it is enough just to talk to him several times:
- in the conversation there are only topics of health, treatment and well-being;
- the presence of symptoms is always emphasized;
- the conversation can be reduced to looking at the medical record and discussing the "inaction" of the doctors.
A person with a hypochondriacal disorder is not just afraid of getting sick - he is already "sick" and therefore checks his pulse, heartbeat, and blood pressure every hour. Any deviation from generally accepted norms is perceived as a tragedy and confirmation of an imaginary diagnosis, and such physiological processes as shortness of breath, palpitations become the reason for the next request for medical help.
People with hypochondriasis may be in perfect health, but they will still clearly feel cold fingers, rapid heartbeat, burning or tingling in certain places. When, after a thorough examination, doctors exclude any pathology, the hypochondriac is simply perplexed and begins to doubt the professionalism of doctors.
When visiting a doctor, a hypochondriac behaves very characteristically - he begins to list his complaints, to present a pile of documentation related to previous examinations. If the doctor tries to convince the patient that he is healthy, then this leads to an affective state of the hypochondriac - he begins to scream, fight in hysterics and even throw objects in order to attract attention to himself and his illnesses.
Another type of hypochondria is the so-called "health hypochondria". This is the name of the desire to preserve this health at all costs, without having any diseases. Hypochondriacs tend to run in the park, lead a healthy lifestyle and eat right. Sometimes, in the pursuit of health, such people give themselves extreme loads and, as a result, only worsen their condition.
Separately, it is worth mentioning the reverse syndrome - the denial of the disease. A person with such a disorder, being actually seriously ill, as evidenced by the results of examinations and examinations of doctors, categorically does not recognize any diagnoses and considers himself absolutely healthy. Such a disorder is dangerous for a person, because the time will be lost when the treatment of pathology can bring positive results.
Please note: individuals suffering from the disorder in question often self-medicate - they select some kind of inadequate diet, begin to exercise intensely, take dietary supplements and vitamins. Hypochondriac people are very easy to deceive, which is what scammers use, selling them ordinary “vitamins” for big money.
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Treatment of hypochondriacal disorder
If there is a person in your environment with obvious signs of hypochondria, and ordinary conversations / examinations do not bring him relief, then it is worth seeking qualified medical help. Hypochondria does not belong to the category of severe mental disorders, and a psychotherapist can provide a decent treatment for this condition.
It is the psychotherapist who will help the hypochondriac to understand the reasons that provoked the disorder, and this is already halfway to recovery. Further sessions will come down to the fact that the specialist will try to change the patient's emotional mood, support him in the fight against obsessive thoughts, and influence the behavior model. Often, psychotherapists use group sessions to treat the disorder in question - this helps the patient feel support from people, make sure that there are actually quite a lot of such hypochondriacs.
Often, hypochondria is treated with complex methods, that is, the patient must not only visit a psychotherapist, but also take certain medications. Most often, tranquilizers and antidepressants are prescribed (less often, atypical antipsychotics), which help stabilize the psycho-emotional background, get rid of obsessive thoughts.
If hypochondriacal disorder is one of the conditions inherent in schizophrenia, then doctors will put the patient in a hospital and prescribe him more serious drugs. The fact is that hypochondria within the framework of schizophrenia becomes delusional, and this already poses some danger to the patient himself and those around him.
Hypochondriacal disorder can develop in people of all ages. It is important to remember that hypochondria is a fairly serious condition that, in the absence of qualified medical care, can significantly reduce a person’s quality of life, up to the formation of disability. Psychotherapists and psychiatrists from CELT can accurately diagnose and fully cure hypochondria - seeking help in this case will be the most reasonable decision.
Hypochondria: signs, symptoms and treatment
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One of the most common somatoform diseases is hypochondria - excessive concern about one's own health, manifested in increased suspiciousness, the perception of any ordinary sensations as manifestations of a dangerous and serious illness. At the same time, a person focuses his attention on one or several organs, but hesitates in assessing his condition, constantly discovers symptoms of various additional diseases.
Hypochondria is naturally attributed to mental disorders, since in almost all cases the patient does not show objective symptoms that he ascribes to himself. Some medical studies claim that up to 14% of all patients visiting general clinics suffer from this disorder to some extent. There are three forms of the disease:
- obsessive - the easiest to treat, arising under the influence of a strong experience or a traumatic impression;
- overvalued - with a severe course of the disease, frequent medical examinations, attempts at self-treatment, which lead to a general deterioration in the condition;
- delusional - the most severe form of the disorder, which is characterized by pathological conclusions devoid of logic, and the patient may be dangerous to himself or others.
Patients with a delusional form immediately after diagnosis are placed in a hospital. Other forms of the disease are treated on an outpatient basis.
Why the disease develops
Psychiatrists identify several different causes of hypochondria.
- Character traits and personality traits. This includes high impressionability, anxiety, suspiciousness inherent in people with a certain type of character. Hypersensitivity to a variety of physiological manifestations and a low pain threshold can cause a person to misinterpret their own sensations. As a result, he begins to perceive normal bodily signals as signs of illness.
- Diseases suffered in childhood. People who had to be treated for a long time in early childhood are much more likely to show hypertrophied attention to their health and well-being. Parents' increased concern for the child's health leads to similar results, forming in him a belief in the weakness of his health and forcing him to look for signs of illness in himself.
- Stress, depression, traumatic experiences. In some cases, the disease occurs against the background of emotional and mental exhaustion, leading to mental vulnerability. A person fixes his attention on various physiological signals, which leads to a violation of the autonomy of body functions, minor somatic or vegetative disorders, which are perceived as signs of illness.
- Pathologically strong fear of death. The patient fixes his attention on the neutral signals of the body, but when a real disease is detected, he perceives it as insignificant and insignificant compared to a fictional disease.
- Schizophrenia. As a rule, delusional hypochondriacal disorders develop against the background of this mental illness and are the most severe manifestations of the disease, requiring immediate hospitalization of the patient.
For obvious reasons, the diagnosis of hypochondria is quite complicated and includes the study of the patient's complaints, his anamnesis, as well as examination data and the conclusions of specialized specialists. So, if a patient complains of constant pain in the heart, then it is necessary to refer him for a consultation with a cardiologist, appoint a number of relevant studies and make sure that there is no somatic disease.
How to recognize?
The main symptom of hypochondria is hypertrophied anxiety about the state of one's health. It is characteristic of all forms, but it can find different ways of expression - obsessive thoughts, ideas, and in severe cases it manifests itself in the form of delirium.
- Obsessions. As a rule, fear is not associated with any particular disease. A person is worried about his health and therefore stops going out or visiting crowded places so as not to get infected from a random passerby. He is actively interested in medicine, visits specialized websites, watches programs, reads relevant literature, participates in online surveys, etc.
- Overvalued ideas. Health concerns are concretized in the form of fear of a certain disease or concern for one of the organs. Most often, patients focus their attention on the heart, digestive tract, reproductive organs, and perceive headaches as symptoms of a brain tumor. Under the influence of their overvalued idea, they actively visit doctors, undergo examinations, adhere to a strict diet, and engage in health practices.
- Crazy ideas. The most severe symptom of hypochondria, which manifests itself in delusional, illogical conclusions. For example, a crack in the wall is perceived as a source of radioactive radiation, which should cause brain cancer in a patient. As a rule, he is sure that doctors cannot recognize his illness and treat him incorrectly. Therefore, he himself prescribes potent drugs for himself, attempts suicide, or decides to "punish" doctors who do not want to treat him.
- Senestopathy. Unpleasant sensations that are not related to certain diseases cause discomfort to the hypochondriac. In various parts of the body, the patient may experience burning, swelling, twisting, emptiness, hesitation, squelching, etc. He cannot accurately describe these sensations, but he suffers with each new attack.
- Visceral hallucinations. False sensations are clearly localized in a certain area of the body, the patient describes them clearly and accurately. Often they relate to the presence of a foreign object in the body.
Pessimism, an exaggerated assessment of one's condition, depression, a panic fear of death are also characteristic symptoms, and treatment of hypochondria should be carried out in accordance with severity.
How to get rid?
Treatment of hypochondria is carried out depending on the severity of the disease, in a hospital or on an outpatient basis. Most patients are prescribed sessions of psychotherapy: rational arguments, Gestalt therapy, psychoanalysis, family therapy, etc. Drugs, as a rule, only strengthen the patient in the validity of his anxieties, so drug therapy is usually not used for such patients. However, if the disease develops against the background of depression, then the patient may be prescribed antidepressants and tranquilizers, and in case of schizophrenia, neuroleptic drugs.
Frequently Asked Questions
How to deal with hypochondria on your own?
With a mild form of the disease, a person can try to restore health on their own. This is helped by regular physical activity, healthy long sleep, sunbathing, walking, chatting with friends. Yoga classes and meditation practices that help control negative emotions and thoughts give a good effect. But if all of the above does not bring relief, you should consult a doctor.
Which doctor treats hypochondria?
To investigate the symptoms and treatment of hypochondria, you should contact a professional psychologist or psychotherapist. It must be a qualified medical specialist with a specialized education.
How does the disease manifest itself in children?
As a rule, the child does not even talk about his concern about his health to his parents. You can suspect trouble by changing habits: the child begins to wash his hands more often if he is afraid of infection, refuses certain foods that, in his opinion, can be harmful to his health, etc.