Mental Health Basics - Preoccupied With Pain: Hypochondria Explained

Medical Reviewer:

Vikram Tarugu, MD

Medically Reviewed On: July 24, 2003

Have you ever spent a sleepless night convinced that the inexplicable pain in your leg was due to rapidly growing tumor? In most cases, a visit to the doctor and tests, with negative results, will allay fears of serious illness. But for people with hypochondriasis, reassurance is almost never enough to ease their medical concerns.

Hypochondriasis is a bona fide psychiatric disorder with potentially serious consequences. Even if a medical problem has been reasonably ruled out, a person with hypochondriasis will continue to fervently seek healthcare, and support from friends and family. Contrary to old beliefs, people with this disorder are not always inventing their complaints, but may be less able to cope with aches and pains than others. This heightened awareness can, in some cases, be traced back early relationships with caregivers.

Below, Dr. Scott Stuart, an associate professor of psychiatry and psychology at the University of Iowa, discusses the challenges inherent in diagnosing hypochondriasis and how a solid doctor-patient relationship can help ease people's health anxieties.

What is hypochondriasis?
Hypochondriasis is simply an excessive concern about one’s health. Distinguishing between someone who has a normal concern for a medical issue or their health and someone who actually has this disorder has been debated for quite some time. “I think there is a difference in terms of the anxiety that's associated with the individual's health problems, or perceived health problems,” says Stuart.

For example, if someone has had a relative who had cancer, they may be a little bit more vigilant about making sure that they don't face the same diagnosis. But people with hypochondriasis worry so much about their health that their functioning is impaired. Their health worries prevent them from engaging in pleasurable activities and functioning as well as they might at work. Their health anxiety might affect their sleep and relationships with friends and family members.

Do people with this condition tend to focus on particular problems?
Most people complain pretty consistently, over a long period of time, about the same kinds of things. A classic hypochondriacal patient would have multiple complaints in different areas, so they might complain of persistent diarrhea, stomach problems, joint pain and aches all over their body. They might also have persistent headaches, and neurological symptoms such as numbness and tingling As a result, people go to a number of different doctors seeking a diagnosis, and wanting treatment as well.

How is hypochondriasis diagnosed?
The understanding of hypochondriasis has really changed over the last 20 to 30 years. Psychiatrists used to diagnose it primarily based on the number of physical complaints that people had. So it was required that people have a certain number of neurological complaints, or gastrointestinal complaints.