Is hypochondria a real thing?
Hypochondria, like obsessions and depression, is a term that is used one way in casual conversation but that has a different meaning in a clinical context. People typically use the term “hypochondriac” to describe people who are unusually or unnecessarily anxious and concerned about their health. And, in fact, hypochondriasis was an actual clinical diagnosis until the introduction of DSM-5 in 2013. In its casual use, one connotation of the term “hypochondriac” is a lack of reasonable grounds for thinking one has a medical illness. For example, if someone becomes convinced they have lung cancer because they coughed a couple of times last week, they might be called a hypochondriac. People often use the term dismissively, saying things like “she’s always worried about some illness, it’s crazy — if you ask me, it’s just hypochondria.”
DSM-5 eliminated the diagnosis of hypochondria and replaced it with two new categories: illness anxiety disorder and somatic symptom disorder. Illness anxiety disorder is the diagnosis that most closely maps onto the common conception of hypochondria. This disorder involves a preoccupation with having or getting a serious illness, along with an absence of related physical symptoms (or near absence). It also involves excessive health-related behaviors such as checking one’s body for symptoms, researching medical conditions, or avoiding medical appointments. Thanks to the advent of the internet, researching medical diagnoses and troublesome physical symptoms has never been easier. For most people this is a great convenience. But for people with illness anxiety disorder, it is a curse. Unlike scheduling medical appointments, “asking Dr. Google” can be done anonymously and without concern about negative feedback from doctors’ or their offices. This internet research, when done repetitively, can make the anxiety and distress of illness anxiety disorder much worse.
What does cognitive-behavioral therapy for hypochondria look like?
Treatment for hypochondria will often involve 1) education about the condition and the anxiety that fuels it, and 2) learning skills that will help handle this anxiety more effectively. These skills can vary a bit from person to person, but will often involve learning to tolerate the feeling that precedes a checking behavior (e.g., looking up medical information on the internet, calling your doctor, or checking your blood pressure). People with this kind of anxiety will often assume that acting out of anxiety is the best way to lower the anxiety, but the opposite is often true. Consult with a cognitive-behavioral therapist to find out of such an approach can be helpful for you or a loved one.