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| Anxiety And Your Health
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| It starts out as a headache and rapidly becomes an inoperable brain tumor. A scratchy throat and you’re convinced you have SARS. Suffer a little shortness of breath and you're the fatally afflicted star of your own TV movie of the week. When you’re a hypochondriac, all symptoms point to an early grave.
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“There is often a tendency to catastrophize, that is to choose the least possible but most dangerous interpretation. Hypochondria, excessive health anxiety, is basically a psychological anxiety disorder. Some basic attitudes fuel the anxiety, like, ‘I must not die now,’ or ‘I must recognize disease as soon as it starts developing,’ and ‘I must be 100 per cent certain that I’m well,’ ” says Dr. Ingvard Wilhelmsen, a Norwegian gastroenterologist, psychiatrist and one of the world’s leading authorities on hypochondriasis.
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Some experts suggest that people whose anxiety meters have run amok constitute a large percentage of North Americans whose frequent trips to clinics and hospitals impose a strain on health care costs and resources.
Ironically, if you experience unreasonable anxiety about your health, including symptoms with no physical foundation, for at least six months, then according to Dr. Wilhelmsen, you may have a legitimate medical problem — it’s just not the one you imagine.
“Hypochondriasis has been an official diagnosis for ages and is a more or less well-defined disorder. Whether or not it’s a disease depends on the definition of disease. There are no specific organic malfunctions or somatic findings, but the patient may experience symptoms of anxiety, like palpitations, chest pain, dizziness, shortness of breath, fatigue or nausea. These symptoms are often misinterpreted as signs of serious disease.”
Hypochondriacs compulsively check themselves for symptoms, besiege their doctors —often having several whom they visit on a regular basis — demand multiple testing, reject favorable diagnoses and worry about contracting whatever disease is currently occupying world headlines.
“All symptoms are subjective and real. You can’t have an unreal pain or dizziness. These patients are honest and earnestly suffering, their fear of death and disease is very real. If you focus on a certain part of the body — the head, for example, if you fear stroke or brain tumor — you’ll notice more symptoms in that part of the body, which will amplify normal and common symptoms,” says Dr. Wilhelmsen, who opened the world’s first clinic for hypochondriacs in Norway in 1995. He says that hypochondriacs are quite capable of “…thinking themselves into feeling terrible. Anxiety is very energy consuming.”
In their zeal for treatment, hypochondriacs often wind up undergoing unnecessary and invasive procedures — tonsillectomies, appendectomies, hysterectomies — and excessive diagnostic testing in a vain attempt to ease their anxieties about invisible ailments.
Some experts, including Dr. Wilhelmsen, suspect that hypochondria may occur as a by-product of affluence. When basic needs are met, people have the luxury of time and a talent for inventing problems.
He has achieved remarkable results in treating hypochondriacs.
“ I offer patients five sessions of cognitive behavioral therapy and for around 85 per cent that’s enough for them to lower their health anxiety to a normal level. Hypochondriacs differ a lot but they are all preoccupied with life and death, being well, and some have a tendency to mistrust their own coping skills and ability to endure pain and suffering.”
Getting Control of Excessive Health Anxiety:
- Hypochondriacs must first accept that death is uncontrollable. They must learn to cope with the uncertainty of living, says Dr. Wilhelmsen.
- Through self-criticism, they’re able to differentiate between real and imagined cancer. It’s important to teach them how to accurately interpret physical signals in a reasonable, objective and informed way, rather than as worst-case scenario.
- Dr. Wilhelmsen suggests confronting the hypochondriac: “It doesn’t help to reassure —to say ‘you’re not sick’ — because the other person knows you really don’t know for sure and may just be offering false comfort. An honest and direct message such as, ‘Maybe you’re trying to control the uncontrollable? Death, disease, the future’ – is fine.”
- Once hypochondriacs reflect on their attitudes, feelings and behavior, they can more easily see where the problem is and change it.
“When people recover there is no tendency for syndrome shift, other anxieties also diminish. Being well and having well functioning attitudes is just as contagious as being afraid,” says Dr. Wilhelmsen. “Nobody wants to suffer, hypochondriacs just don't know how to get out of it on their own.”
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