Hypochondriasis

The term hypochondriasis is derived from the old medical term hypochondrium which means “below the ribs” because most people with this condition have abdominal complaints. When we think of a hypochondriac we tend to think of Woody Allen and characters he's played that are constantly in fear of having some terrible medical illness which, of course, never really exists.

Watch the segment from TODAY

Hypochondriasis is a person’s inaccurate interpretation of real physical sensations that have no actual medical cause. The preoccupation with having a serious disease causes a lot of distress and compromises a person’s ability to function in important areas of their life. About five percent of people have this condition. It affects men and women equally and it most often develops in a person’s 20s. It often comes along with depression and/or anxiety. Despite tests a doctor may give demonstrating that the person is well physically, she or he is convinced otherwise. Over time, the person may become convinced she has developed a new disease.

There are several theories as to the cause of hypochondriasis:

  1. A lower pain threshold which leads to a misinterpretation of any normal pain experienced.
  2. A wish to be sick so as to escape insurmountable stresses and be excused from difficult responsibilities.
  3. A defense against feelings of guilt and a belief of being a bad person. The pain becomes a "deserved" punishment for past real or imagined wrongdoings.
  4. A variation on symptoms of depression or anxiety.

Hypochondriasis often arises after a traumatic event like the death or serious illness of a loved one. This usually goes away with time. Children can also experience hypochondriasis; it usually goes away during the late teenage years.

Most hypochondriacs do not want to understand the psychological reason for their problem because they firmly believe the cause is physical, not psychological. A regular check up is helpful. This assures the patient that she is fine physically and gives her attention from the doctor which hypochondriacs often seek.

On the other hand, doing unnecessary tests or procedures is not a good idea and will only increase the concern that something is wrong. Attention to stress in the person's life and identifying any relationship problems with loved ones can be helpful — these are often the underlying source of the problem. However positive reinforcement to the person for playing the “sick role” is a very bad idea — it will only lock in the belief that they really do have an illness.

Group therapy is often helpful. Feedback from others going through the same thing provides a social support that reduces anxiety and tends to make the person less afraid of illness.

While it’s tough to live with a hypochondriac, it isn’t helpful to ignore them or tell them they don’t feel anything, because they do. The pain they feel is real. Reacting to their stress without buying into the illness is the best road to take. And, of course, encourage them to seek psychological treatment.

Have you or someone you know ever had hypochondriasis? What has been your experience with this? Share your thoughts below.

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36 Comments

Gsnap said:

I have struggled with hypochondriasis for many years. I was diagnosed with lupus in college. Ironically, I never worried about the lupus since it has always been mild and well-managed. But having been diagnosed at a young age, I felt vulnerable to other illnesses as well. It wasn't until I was in my 30s with a husband and a child that I became overwhelmed with my health and survivability. Suddenly the stakes for my life (and a good life at that) became much higher, and I began to obsess over my health--one doctor visit after another, chasing one illness after another. My life became a miserable existence day after day. I partly attribute my health anxiety and depression to an early surgical menopause secondary to a hysterectomy due to fibroids. It seemed that all my fears and anxieties compounded with the onset of menopause. During this period in my life, I was on a work sabbatical and unwisely spent the time focusing on myself. With a deepened spiritual walk and a return to my career, I feel like a new woman.

Joy said:

My mother has had this condition all of my life and I an 56 yrs old. But after the death of her husband and then my brother in 2002, it has taken over her life. She hastaken to her bed 24 hrs a day. She is 82 yrs old and getting so weak from being in bed that she is going to end up in a nursing home. I keep telling her to make herself get up so she can get strenght. But she is convinced she is in too much pain. The pain in he hips is from being in bed and I tell her that, but its like she doesn't hear me. What can I do to help her????

Doris said:

Give her a lot of love.

Jess said:

I'm like that. My mom died of cancer after 20 yrs battling the disease and I can't help but think I will get cancer too or, worse of all, that the people I love will. I'm afraid my partner will get sick and die, I'm afraid of all sicknesses and also of fatal accidents. It's crazy. I feel a lot anxiety, I bite my nails and can't seem to concentrate on anything. However, I'm a very successful women in almost every aspect. I'm aware of my problem and sometimes I even make fun of myself but I just can't help feeling afraid.

Jess said:

By the way, I forgot to say...How can you not be afraid of getting sick when everything you hear and read is about hidden symptoms, and fatal stories of people who died surprisingly after a very late diagnosis, or due to criminality, etc...The information is everywhere!!! How can you get rid of it?

Rachel said:

I say that my sister is a Hypochondric. Our Mother pasted away when we were 8 and 9, and since then she claims to have most of the syptoms she did. I think she has even found a dosctor to feed her what she wants to hear. I have a question--Can hypochodrism caused "REAL" illnesses? Such as, inability to get pregnant?

Christie said:

I wish that Dr. Saltz would have addressed psychosomatic, or somatization illness. The unconscious mind and emotions actually cause these symptoms as a distraction from emotional pain. This is different from hypochondriasis, but related. I have struggled with somatization for years and have gained control over it, most of the time.

Emotional stress can cause all kinds of real physical symptoms and it doesn't neccessarily mean the person has a low pain tolerance. I am not arguing that one can become a "hypochondriac" when this is happening. But the person may not have conscious control over their symptoms until the emotional component is addressed.Dismissing that as hypochondriasis is not helpful, especially to the patient.

Elisabeth Baker said:

I sometimes feel that I am a hypochondriac, but I have a constant pain in my left pelvic area. I have had two hernia repair surgeries since having two C-sections and a hysterectomy. I thought this pain was another hernia, but I've been told that it's probably my endometriosis. My doctor started me on Depo shots (I've had one and am ready for the second this coming week). The medication was supposed to kick in in a month or two. It has now been over 11 weeks, and the pain is just as constant and just as bad (like a sharp knife sticking in my side). I'm not comfortable with the Depo shots as my mother had breast cancer...believed to have been brought on by hormone medication. I am exhausted and so tired of the pain. It is totally keeping me from living my life, and my husband is very frustrated, though he denies that it is because of me. My doctor is trying to avoid any more surgeries until we are sure where the pain is coming from, but I don't want to live with this any more. Please help me!!

Lavina Mack said:

I missed some of your appearance on the Today show this morning, so you might have touched on this.
Anyway, for what it's worth, I find myself bordering on hypochondrism if I get depressed. With treatment for depression the hypochondrism, for the most part, vanishes and I'm happy, whatever is happening in my life.
I see you touch on this possibility in your possible causes list as #4.
In my case that's the cause.
I read the comment posted by Joy at 9:55am, on 1/26/07, about her 82 old mother. I am 67, and was 64 when my husband died. Some days I just couldn't get out of bed at all, I had so many ills. When I sought help and the diagnosis was depression.
I have no family here at all and I live alone. I have no children at all.
Since proper treatment (I'm on Prozac) I'm the happiest I've ever been and don't obsess about any of my aches and pains.
It sounds to me that Joy's mother is so deperessed she has to look up to see the belly of a snake.

Elisabeth Baker said:

Responding to "Jess": I feel the same way! I try to have my kids watch shows on important issues that could affect them, but I have always been somewhat overprotective; although not to the extreme that I have seen in others.

My anxiety is extremely high right now. I am on medication for it, but I am still biting the "heck" out of my fingernails. There's nothing left to bite! My fingers HURT, and so do my teeth! I am constantly worried about my kids. We moved recently to a whole new state...far away from what they have known. Things are very different here, and they are beginning new friendships and learning how different people are, and sometimes their feelings get very hurt. I immediately go on the defensive for them. Also, after the recent killing of a school student by another student, as well as the threats of one student to two younger students, I am considering home schooling. Unfortunately, it is necessary for me to work. What should I do??

Sheryl said:

I was called a hypochondriac for many years, as I was always in pain, horribly fatigued, and in and out of ERs for chest pain,among many other symptoms. Tons of tests came back normal, so there just couldn't be anything "real" wrong with me.
I was finally diagnosed with fibromyalgia several years ago, after having symptoms since I was a child.Many simply say I have a "low pain tolerance".I have had 5 children, all natural births, and the last two born at home.That is NOT a low pain tolerance.
Also, if you believe FMS is psychosomatic, you need to look into a test called an APA Assay.I had this test, and my antibody levels were through the roof.I dont know why the FDA will not allow this test to be used to test for FMS,as it appears to be proof positive that FMS is "real",and not the hypochondria many believe it to be.
But, please, do NOT assume that everyone who has tests come back normal yet insist there's something wrong,are hypochondriacs.It's a disservice to those who really are suffering.

Elisabeth Baker said:

Responding to "Sheryl": I am so glad to hear from you! It has been suggested that I could, possibly, be suffering from fibromyalgia, but I have never been tested. When a doctor suggested this diagnosis to me recently, I asked what exactly fibromyalgia is. The response was that it is a diagnosis when they can't find anything else wrong. I couldn't believe that a "doctor" would actually say that to me. I have also had many medical issues, including chest pain, which was diagnosed as the cartilege calcifying. (?) Have you heard of that diagnosis?

Cheryl said:

I have had issues with hypochondria since having a major depressive episode at age 30 (17 years ago). Following the San Francisco Earthquake in 1989, I developed Post Traumatic Stress Disorder and major depression. Somatic pain became a reality for me, causing me to think that the internal pelvic pain that I had was a deadly disease and that I was going to die. Luckily after almost a year of tests, GIs, ultrasound, etc. my doctor heard something that I said "I think I am going to die", and sent me to a psychiatrist. After being on anti-depressants for a few months, my symptoms went away. Now I am having these "feelings" again. After someone close to me died of ovarian cancer, I have focussed on these undiagnosable diseases (without surgery). I never know if what I feel inside is real or just another "somatic" pain. This is very difficult for me to live with. It rarely leaves my mind for more than a few hours. I wish I could find a way to let it go and know that I am healthy.

Elisabeth Baker said:

Responding to "Cheryl": Exactly!! I was diagnosed with Major Chronic Depression almost 10 years ago. I have been on meds since then, and they have definitely helped my outlook on life... for the most part. But this pain just will NOT go away, and I'm afraid that somebody has got to be missing something. I have often wondered if I'm imagining the pain or if it's a result of my depression, but seriously, this particular pain simply cannot be imaginary or somatic. My first hernia repair surgery helped almost completely, but then the pain came back. The right side got better, the left side did not. That's why I thought it was hernia pain, but now I have mesh in there that could possibly be covering any hernias that might remain, or it could be, as my new doctor has suggested, endometriosis, which is something I have dealt with for a long time as well. I haven't dealt with the type of post-traumatic stress that you have, but my father's plane disappeared when I was 14 years old. We never found him.

Lora Johnson said:

I don't know if I'm a hypochondriac or not. I have weird muscular sensations in my chest, back, stomach, & shoulder areas-but not really pain. I am 56 years old & was very active excercising and walking until 9 months ago. It was like I stretched my frontside to much and something came loose. I've heard that a person's diaphragm can come loose where it's fastened to the spine. But my Dr either doesn't know how to treat it or he doesn't believe me. Just wondering if anyone else has ever experienced this & what can be done. By the way,I'm also being treated for depression & anxiety. It has totally consumed my life.

Sheryl said:

Responding to Elisabeth Baker,yes, I've heard of calcifying cartilage.My last doctor told me the frequent chest pain I have may be from where the cartilage in my sternum has calcified and possibly even broken.
I've also had doctors tell me FMS was a "wastebasket" diagnosis-something they say when they can't figure out what's "really" wrong.When they say that, I ask them what cave they've been in since all the "experts" agree that it's very real.
Insist that your doctor refer you to a very good Rheumatologist.Many doctors, Social Security,and many others will not accept FMS as a diagnosis unless it comes from a Rheumatologist.Just hope that you get a Rheumy who "believes in" FMS-there are some who don't.But, if everything else has been ruled out, it is entirely possible that you may have it,and learning as much as possible about it will at least give you the advantage of knowing when a doctor is treating you well, or thinking you're a "malingerer".

Elizabeth said:

This is a very touchy subject to me. I was told by numerous doctors throughout the years that I was likely a hypochondriac and there was nothing wrong with me. After years of suffering from numerous real medical problems I was finally diagnosed with celiac disease. It makes me very angry that I was dismissed as having a psychological issue simply because the doctors weren't skilled enough to discover what was really wrong with me. I was nearly suicidal because of it, thankfully I finally know that I was not crazy. Now that I feel better, I often want to revisit all of them to show how wrong they were.

cami said:

Responding to Elizabeth, Can you describe the symptoms of celiac disease, thank you in advance and well wishes to you.

db said:

GAIL: Saw your show today on hypochondria. I wanted to add that promoting positive activiites, such as yoga and other mind/body pursuits is always a great way for those with a mental illness to ward off stress. In the February issue of FITNESS we also have a story on Getting Healthy:What Works, What Doesn't that helps women understand when they have been misdiagnosed. It's on newsstand's now :) db

Cara said:

Help. I have a hypochondriac daughter. Everytime her friend has (who is also a hypochondriac,) she has similar illnesses. She had surgery cause she swore something was wrong with her stomach and had endometriosis like her friend, nope, healthy as can be but did have bowel adhesion in the same area, so it could of been for real. She has been reaching for so many illnesses that I don't let her watch the Discovery Medical Channels anymore, and sometimes CSI. Am I crazy?
What do I do? I have another daughter who is 7 months pregnant. She has been violently ill, in and out of the hospital for severe hydration and false contractions, and I don't want to take sides with either one. But when I am helping the pregnant one, my youngest seems to be ailing somehow. I can't take it and am ready to move to a shelter! My youngest is 18 (19_in March) Old'st is 20. My young'st is also making me a wreck as a constant habitual worrier. She goes to "hotel" parties, "hangs"out all day at her friends house. They do drugs, Can yu help

Alan Gross said:

For several years, I found that I was not feeling well and grew fatigued easily. I went to my primary care doctor and he took blood and other tests and said that there was nothing wrong with me. I continued to complain and was sent to an infectious disease specialist. The doctor performed a few blood tests and diagnosed with me with Epstein-Barr virus.

I continued to grow weaker and the doctor felt that I was exaggerating my symptoms and treated me like a hypochondriac. A friend who was recovering from a stroke told me that I was showing some of the symptoms. I called the doctor and was very angry so he re-checked my chart and saw that for the past 2 years my blood levels were abnormal.

I was sent to a hematologist and was diagnosed with a rare blood cancer, Polycythemia Vera, and had to be phlebotomized immediately. I switched to a different set of medical care providers but the doctor's lack of knowledge about the rare blood condition almost killed me. I believe that this cancer is clustered in the U.S.

Ginny said:

Attention does seem to be the heart of the matter for many hypochondriacs. Some of them use symptoms of diseases as tactics, but others use many aspects of disease to keep the spotlight on themselves.

Some mothers exaggerate or fabricate symptoms for their children, taking them to various doctors, seeking sympathy for themselves. This is called Munchausen By Proxy Syndrome.

Some wives take on the causes of their husband's illness in order to gain notoriety in increasingly wider circles. They put much more time into being known as a crusader than in actually caring for their loved one.

It's as if all they can see is the vision of their names in the history books...linked to a cure. They care more about finding a cure for the sake of their own image than for the lives of patients with the disease. The husband's illness has become their avenue to the walk of fame. Fame may also be courted by calling on celebrities with the same disease or asking them for help w/funding. Is there a name for this phenomenon?

Cara said:

My comment to you ALAN GROSS (sorry for the bold letters, I just wanted to make sure if you checked, you'd see them clearly). I too had a similar instance as yours. I went 33 years of my life with nothing but the flu or colds, you know, the normal stuff minus appendicitis and removal of my gallbladder. But otherwise, a healthy, working, human being who was part of life. I went on a cruise (not saying this was the culprit) and a month after coming back, fell ill. First Fatigue, then loss of appetite and these lesions started appearing sparingly all over my skin. So, the Dr. told me I contracted a viral infection and that my lesions were just a mild case of "folliculitis" and that my picking them made them look worse than they were. I"M NOT A PICKER!
Went to another physician, said I had an infection, put me on antibiotics, sent me home. I fell asleep, for 3 days. Didn't get up to pee, eat, speak, drink, nothing. Cont'd on the next one down, their running me out of characters! Cont'd on......

Cara....again said:

Cont'd from before, anyway, my then 3 year boyfriend thought that this was ok, normal, didn't allow my two girls to come in and see me, nor did he call 911. I was in a diabetic coma while he was out running around on his motorcycle, picking up babes with his son, reliving life, whatever you call it. So my girls finally called my mother when he left and she flew down and took me to the hospital. This wasn't the end. Fast forward to today. I have Autoimmune Hepatitis from the damage to my liver (similar to lupus)and toxic Hashimotos disease which is basically, hypothyroidism at its worse. So, I wonder all these years did I make my children, who believe me, deserve the highest honor of taking care of me so well, as well as my mother, all these years did I make them one, my oldest, always looking for someone to care about her and fall in love over night, and two, my youngest, a hypochondriac? My oldest met a guy online, 4 mos engaged, broken up, now pregnant(due 4/29) and my other, always quitting school (cont'd...

Cara, again and again said:

Cont'd, again...make that, both my girls start and quit everything. From High School, to jobs. I don't know what to do. I am on Soc. Sec.Dis.Finally, 37 and ready to have my own life, even with my illness, I could have someone come in daily and help out as well as the great group of doctors I have right now. Except for the occassional flare up, I am not hospitalized and control the pain fairly well. But, we live with my mother, with whom I have now found myself buying a house with since she has given me so much help, I've paid off most of her bills but 3 ($6,000)and have both girls under the same roof (new house has apartment downstairs. But now I feel my mother is codependent on us. If she doesn't have us, she would just, well, I don't know, go off the deep end in a big way. The worst part is my kids (19 and 20) are disrespectful. The things they say such as "if you can't stand life then just kill yourself" "Your such a bitch I can't wait til' you die"..then they are angels. I don't know what todo (cont'd

Cara said:

Anyway, if anyone can help or if you have any ideas Alan, please let me know. I was told for years by 23 Doctors I was a hypochondriac and even a few fired me from their office..lol..I then wrote to them after a diagnosis was definite and received an apology letter by one (for fear of being sued) and nothing from the other. But, I have what I have and that is each day that I wake up. I'm glad you have that too. Thanks iVillage...

Alan Gross said:

TO CARA AND ALL...
Thank you for sharing your experience and it helps to illustrate the point I am trying to make. It is all about self-awareness, advocacy, and persistence. I am not a medical professional but I have learned a lot using the internet. Thank you Google.

I live alone and have no family but I do have a network of caring friends. I treasure my independence...usually. My 3 cats are a great comfort but the human element is missed. However, my health difficulties make it difficult to begin and sustain a relationship.

My advocacy and passion for certain causes stimulates me and gives me a reason to get up and do things. For example, I contacted the hematology of a local hospital recently and they told me that my allegedly rare blood cancer is not so rare in this area. I am waiting to hear back from one of the hematologists so that we can work together on determining if there is indeed a cancer cluster here in Queens County.

Most importantly, believe in yourself. It works for me!

Alan Gross said:

I just wanted to add that people in the medical profession should be better trained so that they can better distinguish patients with Hypochondriasis and those who may have a real medical condition that needs attention, diagnosis, and treatment.

As someone who has health issues for most of my life, I can understand why I might be considered a Hypochondriac as I always seem to have a health issue. However, all my complaints have always indicated true medical ailments and so you can just imagine how angry I was with my primary care doctor when once again a medical condition was diagnosed. The last medical problem he diagnosed for me was life threatening!!!

Dr. Saltz has done a wonderful job in presenting this subject to the general public, especially on national television. I would like to see more information and open dialogues about Hypochodriasis. There are obvious social, psychological, and fiscal benefits to bringing about a greater awareness. It could even save lives!
Alan

Elaine said:

Could it be that many "hypochondriacs" actually have an undiagnosed physical ailment that is the cause of their pain and suffering?

Sometimes I felt like my doctors thought I was a hypochondriac because they ran their run-of-the-mill blood tests, then patted me on the head and told me to run along. But I KNEW something was terribly wrong.

Too bad they didn't know which tests to run. Some knowledgable doctors I saw finally ran a battery of tests that show I have chronic Lyme disease. I now have permanent neurological damage that could have been reduced or avoided if it had been recognized early and treatment had begun sooner.

Yes, I have been called a hypochondriac, and it makes me angry. It's ignorant and dangerous to assume that people with symptoms that are unfamiliar to the doctor are all simply "looking for attention."

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Sherry J said:

Elaine,I don't remember where I read it(somewhere on an internet medical site),but some people think that as many as half of those diagnosed with hypochondria really have a medical illness, which is simply hard to diagnose.
I belong to several chromic pain forums, and the majority of members there went through years of being told there was nothing wrong with them,until they finally got a diagnosis.The average time it takes people to recive a diagnosis of Fibromyalgia alone is seven years-thats seven years fo almost constant doctor visits, ER visits, and running back and forth to specialists.Even AFTER I was diagnosed, the main doctor at the practice I went to told me that FMS was a "wastebasket diagnosis"-what they told patients when they had no idea what was "really wrong" with them.
There's no doubt in my mind that most people know when something is wrong.I believe that there are truly only a handful of true hypchondriacs out there.I know too many who were told that, then turned out to be very ill.

Cara said:

Alan,
Please tel me more, if you'd like, you could e-mail me directly @ bettyboop6069@aol.com, if not, that's fine too. But from someone who has the same limited capacities, maybe we can keep each other company once in a while and chat. Take care and thanks to all out there who are stepping up. That's the biggest step we can all take to help awareness become a factor in everyone's lives.
Anyone is welcome to e-mail me, except the ones that are not sincere and vulgar! Thanks!!

I have lupus, but thankfully the symptoms have always been quite mild - and I put this down to a fairly healthy vegetarian diet. WBR LeoP

It takes serious observation and psychological testing to diagnose any mental disease or conditions in children, much more so than adults, because kids have such limited experience for comparison and underdeveloped mental and verbal skills. WBR LeoP

Sally said:

I know a misdiagnosis is a real possibility, but living with a hypochondriac will tell you that what they're doing is not about a misdiagnosis. My boyfriends pains are always his stomach and for years he's had every test under the sun, nothing's wrong. BUT, it's not limited to that and it's absolutely ALWAYS something. That's the kicker for me. IF it's not his prostate, it's his arm, or his foot or a spot on his face and trust me, doctors will run tests and they will remove bumps on your face etc. All of which gets him the "proof" he needs to show me he's really sick. Doctors love to make a few thousand on an MRI and they almost have to to avoid a lawsuit I guess. My boyfriend has had 5 MRI in the past 2 weeks. For real. He's also had a "pre-cancerous" spot burned off his face, a procedure done to see if he's a canidate for a new prostate procedure, physical therapy 3 times a week at a chiropractor, he's also even got pictures of the inside of his stomach, pretty neat huh? And, there's nothing wrong.

Bruce said:

Just a guess on my part, but it seems to be isolated to people who eat the skin on the fish. The acronym I like to use is "IBS." Irritable bowel syndrome.

Bruce

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About Me

Psychiatrist, author and Today show contributor Gail Saltz shares what's on her mind and helps explain what's on yours.

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