Hypochondriasis

Hypochondriasis (or hypochondria) is a condition involving a person's excessive or unjustifiable worry, fear, or alarm about having, or being at risk for, some serious illness, especially when the person's health concerns seems irrational to physicians.

Quotes

• Hypochondria seems to be a symptom (that is, a response to) so many different kinds of troubles that the disorder assumes dozens of different forms. Taken together the hypochondrias are so common, in fact, that some doctors believe that they are among the most common symptoms of emotional distress. ... Is this because among certain groups hypochondria is a more socially acceptable expression of distress than divorce, child abuse, alcoholism, and the like? Is it biologically or psychologically more efficient than other defenses?
  • Susan Baur, Hypochondria: Woeful Imaginings. University of California Press. 1988. p. 3. ISBN 9780520067516.  (252 pages)

• In 1909, Sigmund Freud told the Vienna Psychoanalytic Society that "the position of hypochondria is still suspended in darkness," and more than a hundred years later it does not feel as if there is much light on the subject. Even in the most widely used and up-to-date clinical literature, its definition is still shifting and changing. For instance, for the latest edition of the Diagnostic and Statistical Manual (DSM-5), which was published in 2013 by the American Psychiatric Association and is often referred to as "the bible of psychiatry," the diagnosis of hypochondria was entirely recategorized into two separate entities: somatic symptom disorder and illness anxiety disorder. Both describe patients with "extensive worries about health," but the former features so-called somatic or physical symptoms the patient feels in their body that medicine cannot detect or explain, whereas the latter is focused solely on "preoccupation with having or acquiring a serious illness" and "excessive health-related behaviors."
  • Caroline Crampton, "Introduction. The People Made of Glass". A Body Made of Glass: A Cultural History of Hypochondria. HarperCollins. 2024. ISBN 9780063273924.  (336 pages — In 2022 the American Psychiatric Association published The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).)

• A letter containing four pages or more, closely written and narrating the writer's own disorders, is a sure and certain sign of hypochondria.
  • Samuel Jones Gee, Medical Lectures and Aphorisms (4th ed.). Henry Frowde. p. 304.  (with recollections by J. Wickham Legg; 408 pages)

• ... my therapist tells me that to worry unceasingly about getting cancer is as irrational as worrying about getting hit by a bus on Flatbush Avenue. In fact, I am terrified of getting hit by a bus on Flatbush Avenue, and I think he is the madman for being so cavalier on the subject. Has he been out there recently? Belling says that hypochondria is “always ironic,” by which she means that, despite all its convolutions, hypochondria is always right. You will get sick and die. The question is only when and how. The bus is coming.
  • Alexander Nazaryan, (Aug 2, 2012) "Internal Affairs: On Hypochondria". The New Yorker.

• He who, in the study or the treatment of the human machinery, overlooks the intellectual part of it, cannot but entertain very incorrect notions of its nature, and fall into gross and sometimes fatal blunders in the means which he adopts for its regulation and repair. Whilst he is directing his purblind skill to remove or relieve some more obvious and superficial symptom, the worm of mental malady may be gnawing inwardly and undetected at the root of the constitution.
  • John Reid, "Essay I. The Influence of the Mind on the Body". Essays on Hypochondriasis and Other Nervous Affections (3rd ed.). London: Longman, Hurst, Reese, Orme, and Brown. 1823. pp. 1–6.  (440 pages: quote from p. 1; 1st edition, 1816; 272 pages)

• Are hypochondriacs born or made? Is illness anxiety the product of your particular roll of the genetic dice, or the result of something in your childhood or environment?
  These questions are worth asking, because people like me cost the healthcare system extra trouble and money. We're constantly making appointments for symptoms that feel real bur aren't. We doubt our clinicians, so we seek second and third and even fourth opinions asking for (or demanding) unnecessary medical tests, and running up insurance claims that help cause everyone's healthcare premiums to go up, too.
  • Hal Rosenbluth, "Chapter Two. The Making of a Hypochondriac by Hal Rosenbluth". Hypochondria: What's Behind the Hidden Costs of Healthcare in America. Rodin Books + ORM, 2024. ISBN 9781957588292.  (240 pages; co-authored by Hal Rosenbluth and Marnie Hall; with a foreword by Judith S. Beck)

• After King Charles V of France died in 1380, his 11-year-old son Charles VI was next in line to inherit the throne. However, for the next 8 years it would be his uncles who ruled in his stead, spending money from the royal treasury and extorting heavy taxes from the common people. Overthrowing these avaricious regents and replacing them with highly competent advisors earned young Charles VI the title of ‘the Beloved’.
  Just a few years later, this title would be replaced by one not so kind: ‘le fou’ or ‘the mad’. In 1392, Charles had what was thought to be the first psychotic episode of many. During a military expedition he became paranoid, and when a servant accidently dropped a lance, Charles turned around and began attacking his own knights, some of whom died.
  In another episode Charles came to believe that he was made of glass – the glass delusion, which would occur intermittently throughout his life. Pope Pius II noted that Charles even had iron rods sewn into his clothes as reinforcement to stop him from breaking.
  Although perhaps the most famous person to suffer from the glass delusion, Charles was by no means the only one – in the 15th to 16th centuries it was not uncommon for such delusions to be reported. Case numbers dropped after this period, and cases of the glass delusion are now rare.
  • Rachel Sinha, (January 2021) "Charles VI of France: the Glass King – psychiatry in history". The British Journal of Psychiatry 218 (1). DOI:10.1192/bjp.2020.207. (55 pp.)

• Hypochondriacs tend to have a specific preoccupation – cancer, infertility, an indwelling parasite – and scan their body for evidence to support this conviction, which sets off the “falling dominos of catastrophisation”. But hypochondria also overlaps with obsessive compulsive disorder and conversion disorder (when stress or emotion manifests as pain, weakness or similar symptoms that don’t fit a pattern that can be readily explained).
  • Kate Womersley, (31 March 2024) "A Body Made of Glass by Caroline Crampton review – an intelligent and engaging history of hypochondria. In this fascinating book, a survivor of a life-threatening illness chronicles the history of health anxiety and ponders whether it is a rational response to our flawed bodies". The Guardian.

External links

• Illness anxiety disorder - Symptoms and causes. Mayo Clinic.
• Somatic symptom disorder - Symptoms and causes. Mayo Clinic.