“I had five blood counts.” The ordeal of people suffering from “hypochondria”
“I have a constant fear of dying.” It is one of the messages Josephine A., 24-year-old student, frequently posts in a Facebook support group chat called “hypochondria”. Triggers can range from having a fever of 38° to the appearance of an eye injury. The answers of the doctors do not manage to calm her and those of the rest of the members of the group, of course, neither.
Leila Vigna, team manager Cognitive Behavioral Psychologists Psycho, indicates that the term hypochondria is not used today in the area of mental health, although it does appear in the previous version of the Mental Health Diagnostic Manual (DSM 4). The concept is illness anxiety disorder and describes excessive worry about the possibility of having a health problem. “It is characterized by hypervigilance of the symptoms that confirm the disease and interferes with the patient’s quality of life,” he explains.
There are very few studies about this disorder, since it presents difficulty when it comes to concluding the statistical data. From Psicoc, they point out that this condition is suffered by between 1 and 5% of the population in the American continent and that its chronicity can persist in up to 50% of cases if it is not treated properly. According to American Psychiatric Association (APA), during the pandemic cases of anxiety multiplied by four.
Experts agree that the outbreak of Covid-19 intensified fear and symptoms. “The virus brought with it uncertainty and ignorance, which results in these patients beginning to experience all the information they receive in catastrophic terms. Anxiety clouds them and makes them stiff. The pandemic increased the predisposition and intensity in this way they have to read reality”, he explains. Daniela Tolettini, coordinator of Psicoc.
Josefina was going through quiet days, but the positive result of Covid-19 made her go back. “I had some symptoms and couldn’t sleep. That caused me tachycardia and arrhythmia… my heart felt strange and a ringing in my ears. I felt like I had high blood pressure I was afraid to sleep in case I died”, he tells LA NACION.
“It’s terrible and very emotionally draining. I think all day that I have a disease. I research the symptoms of cancer on the internet, the causes of a rash or pain and I associate it with the most terrible”
Google is the worst enemy. “I got vaccinated with AstraZeneca and I regret looking for information on the internet. I read that there were people who died from a thrombosis, a stroke or heart disease, ”reveals Josefina. And he added: “Hypochondria is an altered, irrational state, in which the person believes that for the slightest thing they can be sick or even die. The nervous system is altered when it feels that it is in danger and the sense of reality disappears”, says the student.
“Stress situations or going through a difficult time, be it personal, work or economic, influence this state, which the pandemic worsened. There are patients who refuse to go to a meeting of four people in the open air, even though the contagion curve is low and all attendees have three doses of the vaccine. They are excessive reactions, behaviors and ideas”, adds Tolettini.
“I think I have leukemia. I have all the symptoms. Already I did five blood counts and they came out negative, but something has to be wrong, because I get little red spots on my skin. I checked on Google and they are symptoms compatible with leukemia. I don’t know what to think anymore.” Francisca Y., 30 years old, in the same group of the social network.
“It’s terrible and very emotionally draining. I think all day that I have a disease. I research the symptoms of cancer on the internet, the causes of a rash or a pain and associate it with the most terrible. What’s more, As soon as I feel discomfort, I start with tachycardia and I think if the tests did me well. I even doubt the doctors because of this insecurity and I begin to self-diagnose”, confesses to THE NATION.
“From psychology, we work on the excessive symptomatology, which is subjective. But don’t confuse health anxiety disorder with episodes of anxiety or distress. This condition is characterized by the chronicity over time of this interpretation that the person makes of their symptoms and their discomfort. The focus is always negative and generalizes”, planted Vigna.
In addition, this fear of illness and death often leads to avoiding medical consultation or, on the contrary, to going excessively. “For the least thing I feel like I have to go to the hospital and see a doctor. I have to constantly confirm that everything is going well. When I got over the coronavirus, and it was without serious symptoms, I still believed that I could die from the virus,” says Josefina.
“Most people with this disorder tend to have constant intrusive thoughts and searching for information on the internet reinforces their anxiety. What’s more make diagnostic hypotheses because they need an answer to their doubts. The fear of contracting Covid-19 has been one of the main reasons for consultation in the last two years,” says psychologist Andrés Davidson.
And he adds: “The context did not collaborate: a lot of uncertainty, too much information that is not always correct, new variants, scenarios and changing prevention measures… Not having a context that provides security is a factor that reinforces anxiety.”
Josefina A. finds no understanding among her family members and this increases her discomfort. They treat me like I’m crazy and that makes me feel worse. I just need a little empathy. It goes very badly, I spent three days crying because I had blood in my urine and I thought I might have cancer, “he recalls.
Specialists affirm that fear is constant and that when an objective symptom appears, patients seem to confirm the most tragic thoughts. The confusion of those around them is also a factor that is repeated. “They cannot be calm and they feel fear all the time. This affects them in their social ties. Illness anxiety disorder carries a high social stigma. You have to understand that there is no dualism between body and mind and that these patients are not looking for attention”, Vigna asserts.
In some cases, misunderstanding also appears on the part of professionals. “Doctors should be prepared for these cases and know how to show empathy and understanding towards the patient, who at that time is in a highly anxious state,” says Josefina.
“A doctor should not dismiss these patients. They should suggest therapy to reduce stress, but always after having ruled out any physical ailment”
Davidson brings a different perspective: “Sometimes people with illness anxiety are treated differently. exaggerated or dramatic. Fortunately, more and more doctors tend to consider mental health as a factor to take into account and, after making their diagnosis and rule out organic etiologies, referral to psychology. Many patients consult for therapy referred by primary care physicians”.
And he concludes: “A doctor should not dismiss these patients. I do suggest that they do therapy to reduce stress, but always after having ruled out any physical ailment.”
APA highlights in the first line the therapy of cognitive behavioral psychology within their recommended treatments. “It’s an evidence-based treatment about avoidance. Patients are recommended to go to a medical consultation and, if the physical is ruled out, cognitive help is given to rediscover interpretations and provide behavioral strategies”, explains Tolettini.
Much of the work points to readjust interpretations and to tolerate the fear of the unknown. “We try to get the patient to validate other vital tasks, in a healthy and positive way. No one is in control of what is going to happen. You ask the patient to put himself in the worst case scenario and ask him: ‘What would you do then?’ This reduces uncertainty and works with a scenario that they can deal with,” adds Vigna.
And he warns that it should not be thought that because a patient suffers from illness anxiety disorder they do not have any physical ailment. “Both circumstances can coexist. The professional must be alert if the patient goes to many specialists and nothing appears, offer him a mental health consultation, to work in an interdisciplinary way”, he details.