Hypochondriasis is an older and more familiar term for IAD (Illness Anxiety Disorder). People with IAD are preoccupied with their health, though there is no objective reason for their concern. They will believe they have or will get a serious illness, though they have no actual symptoms of a serious illness. They may experience mild physical symptoms, such as a rapid or irregular heart rhythm, sweating, hyperventilating, tremors, headaches, or stomach upset, but all of these symptoms can be accounted of by anxiety. If the person has an actual, objectively verifiable condition, their concern will be far out of proportion to the actual severity of the condition. They will also make a very dramatic display over minor injuries. They may also project their preoccupation with illness on to others. Examples include calling a benign cyst cancer, or believing a moderately serious illness such as tonsillitis brought one to the brink of death, though the condition was discovered and corrected early. People with IAD will closely monitor their health, being very hypersensitive to benign day to day variations in their health, and may check their temperature or blood pressure several times a day. They may spend an inordinate amount of time on –line researching their symptoms, and becoming distressed when they read about ambiguous symptoms that could be attributed to multiple benign causes. They will catastrophize, jumping to the absolute worst conditions.
Ironically, such people may avoid medical care as they have too much anxiety about what they think a physician will discover. They may experience shifting source of anxiety, e.g., thinking they have cancer, then heart disease, then diabetes. Or alternately, they may visit their physician excessively, or ER’s, or insist on referrals to specialists and intrusive and unneeded testing to pursue reassurance that they do not have a serious disorder.
IAD is a disorder that can lead to reduced quality of life. People with IAD can drive others away. They may be perceived as whiney, dramatic, they feel sorry for themselves, complain, and may burden others with their complaints of their health. Parents with IAD may project their anxiety onto their children and insist on intrusive and unneeded testing or frequent pediatric visits, or inappropriate use of OTC medications, or supplements.
They may overreact to media reports of disease outbreaks and epidemics, such as the 2014 Ebola crisis, or swine flu or avian flu outbreaks. They also run the risk of fatiguing their health care providers and family to the point that an actual serious disorder is not attend to similar to the Boy who Cried Wolf. Others can become so weary of their complaints of their health, that they disregard a valid medical condition. They may over utilize health care, Ironically, they may develop actual medical conditions due to complications from invasive, repeated testing that they insist upon.
They may have rigid beliefs about illness that does not have scientific support. Such as the preponderance of people who have self-diagnosed with celiac disease, which is an actual disorder, but many people self-diagnose. There is an industry built on gluten free foods that is maximizing profits in response to people’s widespread science illiteracy.
Causes of IAD:
IAD can result from having a parent with IAD, and being exposed to constant concern about health. A personal or family history of severe or chronic illness without sufficient relief or resolution may cause one to lose confidence in the medical profession.
An episode of IAD can be triggered by a general stressor, symptoms of a serious disease that turn out to be benign. Child abuse or a childhood history of serious illness can leave one feeling fragile. It can be speculated that IAD is a form of OCD (Obsessive Compulsive Disorder) in which the obsessions are somatic, or focused on one’s body.
Treatment of IAD:
IAD can be serious and require professional help. MCBT (Mindful Cognitive Behavioral Therapy), or REBT (Rational Emotive Behavioral Therapy) are types of psychotherapy that can help someone with IAD by teaching them to respond reasonably to signals from their bodies, and challenge the validity of their beliefs. SSRI’s (Selective Serotonin Re-uptake Inhibitors) are a class of medications that may also be useful to manage IAD.
Commentary by Dr.
Carlo Carandang: Hypochondria is also known as health anxiety and illness anxiety disorder. It is a preoccupation in the belief that you are sick, despite multiple medical tests and doctor assessments revealing no illness exists. It is important for family physicians and general practitioners to refer patients to psychiatry who have persistent worries about being sick despite a normal physical exam and negative lab results.