How to get help for hypochondria and health anxiety

No laughing matter

Being a hypochondriac is nothing to laugh at. Sometimes the worry of what might be wrong with you really is worse than what you're actually worried about. And it can ruin your life. For instance, some people are constantly paranoid they have something serious (like סרטן) lurking somewhere inside them and that the doctors are going to miss it.

Eventually they are reassured enough that they don't have that particular illness (be it throat cancer, a brain tumour or an impending שבץ). But usually at some point in the near future, be it a few weeks or months, they start again with a different illness.

It can result in people being unable to live a normal life; they're always at the doctors, or sometimes they spend their hard-earned cash on private doctors, going round and round until someone, somewhere does the scan or the test that they're certain will reveal them to have some kind of widespread illness which will surely result in imminent death.

It's no joke: some people lose their jobs over it and their relationships break down.

There are a number of validated questionnaires that can assess how worried you are about your health. The three main ones are the Health Anxiety Inventory, the Illness Attitude Scales and the Whiteley Index. But these are usually given to you by a professional. For a simple DIY test, try these questions which have been put together by Anxiety UK:

During the last six months:

• Have you experienced a preoccupation with having a serious illness due to bodily symptoms that has been ongoing for at least six months?

• Have you felt distressed due to this preoccupation?

• Have you found that this preoccupation impacts negatively on all areas of life, including family life, social life and work?

• Have you felt that you have needed to carry out constant self-examination and self-diagnosis?

• Have you experienced disbelief over a diagnosis from a doctor or felt that you are unconvinced by your doctor's reassurances that you are fine?

• Do you constantly need reassurance from doctors, family and friends that you are fine, even if you don't really believe what you are being told?

If you answer 'yes' to most of these questions, it's likely that you suffer from health anxiety.

We can't necessarily point the finger at modern life for the prevalence of hypochondria. People were writing about the condition hundreds of years ago. In 1798 German philosopher Immanuel Kant wrote in his book Anthropology:

"The disease of the hypochondriac consists in this: that certain bodily sensations do not so much indicate a really existing disease in the body as rather merely excite apprehensions of its existence ..."

What I think he was saying was: just existing as a human being on earth is so mind-blowing that we can't fathom it. We focus on it all the time and wonder if something will go wrong. But when we're distracted (like being busy at work or being in a new, exciting relationship) we lose those fears altogether.

The more modern philosopher Alain de Botton agrees. He wrote:

"Hypochondria: an above-average imagination applied to the deeply improbable nature of being alive."

Cyberchondria

However, the internet might be to blame. That little ache around your ear lobe? The ever-so-slight tingling sensation around your eyelid that lasted ten seconds last week? The internet has an answer, and it's usually bad news. This is the new phenomenon called 'cyberchondria'.

The chief executive of Anxiety UK, Nicky Lidbetter, explains: "Anxiety UK receives many enquiries every year from those experiencing health anxiety and indeed the number of people affected seems to be on the rise. 'Dr Google' may in part be responsible for this along with a general increased awareness in society of mental health issues and of חרדה ו רגשי."

The internet has no doubt made health information more widely available. Medical knowledge is no longer the preserve of the medical profession alone. But a qualified doctor can put your symptoms in context and, crucially, can examine you.

Lidbetter agrees: "Whilst the internet can be of help in terms of connecting people that would previously have been isolated, 'googling' symptoms does not usually result in an accurate diagnosis and is most definitely not a replacement for seeing your GP."

No, not at all. When people make things up just to waste their doctor's time, that's called malingering. True malingering is actually pretty rare. Most people don't wake up in the morning and plot lies to tell to their doctor. With hypochondria, the symptoms seem real to you and you truly are worried: although it's psychological, it doesn't mean it's deliberate.

Worrying is generally quite a lonely existence. And it can sometimes seem like you're the only one preoccupied with your health. It's easy to feel isolated when you have health anxiety, but it's more common than you think.

In fact, a study from 2011 found that as many as 1 in 5 people in hospital clinics met the criteria for 'health anxiety' and a review article in the British Medical Journal in 2016 called it 'remarkably common' and 'reaching epidemic proportions'.

You are not alone.

Well firstly, you may have to accept that, like all humans, you will eventually die of something. Sorry, can't help you with that one. But until that day comes (and remember, average life expectancy in the developed world is over 75 years), you can start with a few pointers:

Talk it out

Tell your friends, tell your partner, tell your family. Firstly, you'll probably find they have a bit of hypochondria too. We all do, to some degree. A trial where people were put into groups and had weekly meetings to discuss health anxiety, showed that it really helped: it's called 'Acceptance and Commitment Group Therapy' and it's hopefully going to take off.

Try meditating

Mindfulness has been shown in studies to reduce health anxiety.

Tell your doctor

If you're worried about a health condition, don't put off going to the doctor. Try saying: "I'm a bit of a hypochondriac, but would you mind checking ...". It breaks the ice and it puts your concerns into context. Similarly, if your worries about your health are preventing you from leading a normal life, do tell your GP. There are several options that could work for you: from anti-anxiety medication to טיפול קוגניטיבי התנהגותי which has been shown to significantly improve hypochondria in trials.

Keep busy

If you feel worried about something try to keep yourself busy. If the symptoms disappear when you're distracted, it's probably nothing.