No- a hypochondriac does not know that they are a hypochondriac. If you have hypochondria, then you have constant fears and worries that you may have a serious illness. Even if you go to your doctor, and the doctor does a full history, physical examination, and laboratory studies, and the doctor tells you that nothing is wrong, this does not reassure you. Alas, you may just go to other doctors and get more medical tests, as each time they say nothing is wrong, you are sure that they have missed something and you keep searching for doctor who can make the correct diagnosis.
When you have hypochondria, you are suffering and really believe you have a serious illness. But you are still able to see that you may be exaggerating the extent of your feared illness, and you also see the possibility that you may have no illness at all. However, there are some hypochondriacs who do not believe that their concerns about having a serious illness is unreasonable or excessive- these people have poor insight, and they definitely do not know that they are a hypochondriac. But for those hypochondriacs who can see that they may be exaggerating or that they may not have a serious illness after all, they still have conviction that they have a bonafide, serious illness, and therefore they also do not know that they are a hypochondriac.
Help is available for hypochondriacs, but the first step in treatment is to acknowledge that you indeed are a hypochondriac. Your doctor and your family members can help you gain insight into hypochondria. Reassurance from your doctors that you have no illness based on negative medical tests will not convince you that you do not have a serious illness. The only way for you to get better is to acknowledge that you are a hypochondriac.
Hypochondria is also known as health anxiety, or illness anxiety disorder. Click here for help and more information on hypochondria.