Studying Health While Having Hypochondriasis

 

Written by Angela Dong

 

I have a confession to make.

I used to be a hypochondriac.

I used to pore through WebMD, coming up with the most obscure and serious medical conditions imaginable. That mole on my neck after a day in the blazing summer sun? I fretted over that for a week. Got a slight rash on my arm after walking in the woods? It isn’t poison ivy, of course — it has to be Lyme disease!

I used to blow symptoms out of proportion, endlessly fixating on one small discomfort until that small discomfort became all-encompassing, an ever-repetitive cycle of anxiety, fear and impeding sense of doom. Although I gained a valued awareness of my own mortality, which compelled me to make the most of my life in every moment, this endless tide of anxiety interfered greatly with my day-to-day life.

I wasn’t alone. Around 1 to 5% of the general population is affected by hypochondriasis, a somatoform disorder characterized by a prolonged period of hyper-vigilance to one’s own health and excessive anxiety that one is or may be seriously ill, despite lacking any notable physical symptoms.1,2 Some hypochondriacs require constant assurance of health, visiting clinics time after time as “checks.” Others may avoid all medical assistance — much to the detriment of their long-term health — fearing for the diagnosis they might receive.

The ready accessibility of information (and misinformation) on various diseases and conditions, such as television dramas where generic symptoms are dramatized as harbingers of death, only exacerbates fears. Furthermore, as most people often lack a real-life point of comparison for the actual manifestation of the disease, it is rather a surprise that hypochondriasis is not more common than it is.

For individuals studying medicine and immersed daily in a maelstrom of symptom knowledge, 2 to 7% — more than the 1 to 5% of the general populace — have hypochondriasis, otherwise known as the “medical student syndrome”.3 They have the facts of a disease, but in the first years of medical training before clinical rotations, many may lack practical professional exposure to a patient displaying that condition.4 Thus, without a benchmark case study for a particular ailment, students might mistake and exaggerate their own symptoms as hallmarks of a disease that they learned about theoretically in lectures.

However, that is not to say that once a medical student hypochondriac, forever a medical student hypochondriac. Upon entering clinical rotations and gaining first-hand experience of diagnosing patients and comparing cases, medical students gain a valuable benchmark for comparison, thus minimizing their own perceived symptoms.1 As a result, by the time one becomes a full-fledged medical personnel, one tends to become almost immune to hypochondriasis. In fact, medical professionals tend to seek medical care less compared to the general population.5 Although that can be accredited to busy schedules and the fact that doctors tend to be healthier than the general populace, a greater contributing factor to this newfound peace of mind may be the more rational approach used for self-diagnosis.1

In fact, it is this rational approach that forms the basis for cognitive behavioural therapy (CBT), a psychologically therapeutic method for quelling the irrational fears of hypochondriasis.6 By developing personal coping methods that target one’s anxieties and change stress-inducing cognitive patterns of thinking, CBT helps to regulate one’s emotions, encourages adapting new information-processing skills, and prevents hypochondriasis from interfering with day-to-day life.

I’ve since gotten over my hypochondriasis, although, like almost everyone, I am occasionally hit by bouts of “what-ifs,” only to dismiss exaggerated fears with the techniques of CBT. As counter-intuitive as it seems, for me, learning more about biology and pathology actually reduces hypochondriasis, almost akin to exposure therapy in minimizing phobias. The old adage — “What doesn’t kill you, makes you stronger” — seems true after all.

 

References

  1. Waldman, K. (2016). What Doctors Could Learn From People With Hypochondria … er, Illness Anxiety DisorderSlate Magazine. Retrieved 1 December 2016, from http://www.slate.com/articles/health_and_science/medical_examiner/2014/07/hypochondria_in_medical_students_and_doctors_when_to_worry_about_health.html
  2. Illness anxiety disorder – Mayo Clinic. (2016). Mayoclinic.org. Retrieved 1 December 2016, from http://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/basics/definition/con-20124064
  3. Collier, R. (2008). Imagined illnesses can cause real problems for medical students. Canadian Medical Association Journal, 178(7), 820-820. http://dx.doi.org/10.1503/cmaj.080316
  4. Fix, M. (2011). How Should I Schedule My Third-Year Clerkships? Medscape. Retrieved 25 December 2016, from http://www.medscape.com/viewarticle/738498
  5. Frank, E. & Segura, C. (2009). Health Practices of Canadian Physicians. Can Fam Physician, 8(55), 810-811. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19675268
  6. Warwick, H., Clark, D., Cobb, A., & Salkovskis, P. (1996). A controlled trial of cognitive-behavioural treatment of hypochondriasis. The British Journal Of Psychiatry, 169(2), 189-195. http://dx.doi.org/10.1192/bjp.169.2.189

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