The digital age has made it easy to overanalyze every ache and pain. Self-diagnosis is only a few Google searches and mouse clicks away. One minute your shoulder hurts and after a few searches, you’re now convinced you need invasive surgery to remove a rare tumor.
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Once labeled as hypochondriasis, it’s now medically known as somatic symptom disorder. It can even be generally referred to as illness anxiety to avoid stigma.
“Somatic symptom disorder is when someone is excessively preoccupied and worried about their health far beyond what is reassured by medical experts,” explains psychiatrist and chronic pain specialist Xavier Jimenez, MD. “It’s a variation of an anxiety disorder.”
Symptoms can include:
To someone with hypochondriasis, a headache means a brain tumor, while coughing must signal lung cancer. He or she has lost sight of the difference between true symptoms and obsessing over developing an illness.
“Health anxiety looks different for every patient and it comes in varying degrees,” says Dr. Jimenez. “It becomes an issue when it crosses the threshold into excessive and dysfunctional. How much time and money is it going to take until the patient realizes they aren’t sick, or aren’t as sick as they think?”
Hypochondriasis is different from factitious disorder because the person truly believes that he or she is sick. In factitious disorder (formerly known as Munchhausen syndrome), a person is faking an illness and is aware it’s not real.
The thing is, most people who suffer from hypochondriasis don’t realize that they do. Dr. Jimenez describes it as a personal problem with insight. He says it’s similar to someone walking around with a piece of food on their face and they haven’t noticed it yet, but it’s obvious to others. Someone who is a hypochondriac might think it’s completely normal to go to 10 doctors and three emergency rooms because of a racing heart.
People with hypochondriasis take their thoughts to extreme levels, but that doesn’t always mean they had severe anxiety beforehand. They might have even had undiagnosed anxiety or a mild form. But now worrying about the illness has caused it to get out of control.
The disorder affects men and women equally and is seen across all age groups in adulthood, with the majority falling between 18 and 50. It’s not uncommon, though, to see health anxiety appear in the elderly.
One catch with hypochondriasis? It’s rarely diagnosed.
“It’s very stigmatized, so doctors often tend to spare the patient the name and instead might call it health anxiety or illness anxiety so they don’t feel ashamed,” says Dr. Jimenez. “Sometimes if a patient hears ‘hypochondriasis’ they’ll refuse to accept the diagnosis.”
“The internet mixes poorly with somatic symptom disorder,” says Dr. Jimenez. “It’s a free forum where people can describe symptoms and diseases without medical confirmation or insight. This reinforces the legitimacy or reality of a symptom for the patient and that a provider somewhere can somehow treat their concern.”
The internet gives patients the small possibility and chance that they will actually be diagnosed or cured with certain treatments. It reinforces the behavior and fear. Often patients return to the “what ifs” of their health. What if I have a rare disease? What if the doctors miss something?
Interacting with online accounts of others who were “finally diagnosed” after many years of being misunderstood could fuel this style of wondering.
“Every patient deserves a thorough medical evaluation first,” explains Dr. Jimenez. “After that’s done and we’ve established that this is illness anxiety, we’ll work with the patient and ensure them that we want to help increase their quality of life and function.”
Somatic symptom disorder, hypochondriasis, health anxiety, illness anxiety – whatever term it’s referred to – the main goal of treatment is to increase the patient’s quality of life. Often times, those who have the disorder have disrupted their lives with the time and money spent chasing a health concern.
Focusing on quality of life instead of feeding into the fear of illness is the first step in treatment, says Dr. Jimenez. We want to open up the focus so it’s not so narrowed on the disease.
Typical treatment for hypochondriasis includes therapy, support groups and medication. It’s also crucial for the physician and patient to form a trusting relationship.
“The patient needs to be assured that their overall medical concern is being addressed and not just being reduced to a psychiatric problem,” says Dr. Jimenez. “Even if they have severe anxiety, you have to ease into it. A lot of symptoms are presenting simply because the nervous system is under assault with stress and overload.”
It’s not uncommon to hear about a condition or read about the symptoms and BAM. Suddenly you get this strange and nagging feeling that you’ve developed said condition out of the blue.
Medical student syndrome is a condition where people perceive themselves to be experiencing the same symptoms of the disease that they’re studying, researching, reading and learning about.
“It’s a normal human phenomenon to read about things and think about things and then become vigilant of those symptoms,” explains Dr. Jimenez. “Our minds are designed to assess things like threats, so if you play the threat on loop, it can appear to get stronger and stronger.”
If you find yourself stressing about your health in an obsessive manner, Dr. Jimenez recommends an external jolt of reality. Not every bump, pain and rash is a sign of trouble. Talk to a friend or see a specialist if you’re truly concerned. Then, trust the medical evaluation. If you’ve identified with feeling anxious and tense already, seek additional help for managing those feelings.
And leave the internet alone for a while.
“You’ve done your part, not much more can come from continuing to search the internet,” he says. “Try to embrace other things in your life that bring you joy.”
