AS COVID-19 continues its onslaught, it has been filling the general public with fear and anxiety from the perceived threat of danger. The constant text message alerts, news updates, and rising number of infected individuals make it difficult for anyone not to be distressed by the possibility of contamination. People are responding by avoiding high risk areas, searching for health information, and stockpiling food, face masks, and disinfectants. However, for those with a fear of illness, these types of concerns and behaviors during a health crisis characterize the norm of their daily lives. The global health emergency and the looming threat of uncertainty is simply a factor exacerbating their existing psychological concerns and fears. 

What is hypochondria? 

According to the National University Health System, hypochondria is when a person has a “persistent fear of having a serious medical illness, and tends to interpret normal sensations, bodily functions, and mild symptoms as signs of a serious disease.” Despite reassurance from medical professionals, hypochondriacs fear developing a serious illness and insist on believing that they have an undiagnosed disease. Since 2013, hypochondria has no longer been included in the Diagnostic and Statistical Manual of Mental Disorders, and has been identified as an illness anxiety disorder, or a somatic symptom disorder. Affecting approximately 2-5% of the population, the condition is characterized by a focus on physical symptoms and excessive worrying, which causes distress and difficulty coping with everyday life*. 

Many hypochondriacs repetitively check themselves for signs of illness, talk excessively about health, fear any slight sign of abnormality, and spend significant periods of time researching their symptoms**. Hypochondriacs also frequently visit doctors for medical tests but are unconvinced by negative results and see multiple doctors despite getting the same results. This may add to the stress hypochondriacs receive, as they may fear that they will never be successfully diagnosed and treated. On the other hand, some hypochondriacs may also refuse to visit the hospital fearing that they will be diagnosed with a severe illness, and avoid places, people, and activities that may pose a risk to their health.

Although the exact cause of hypochondria is unknown, it is often accompanied or caused by other mental disorders such as depression, anxiety, or obsessive-compulsive disorders (OCD). It can also be caused by a history of illness or abuse, significant stress, sudden deaths of relatives due to disease, or severe symptoms believed to threaten one’s health such as chest pain. 

Effects of hypochondria

During times such as the current COVID-19 outbreak, many individuals experience fear and anxiety regarding symptoms of the common cold that resemble early signs of COVID-19 infection. People who are concerned about their health may react in similar ways expected of a hypochondriac, such as wearing masks, refusing to leave the house, constantly washing their hands, avoiding friends or family, or having a sudden fear of infection from a single cough. However, those with hypochondria are more severely impacted by the COVID-19 health emergency than the average person. In an anonymous interview with The Yonsei Annals, a Yonsei University student who was diagnosed with hypochondria two years ago said, “I visited China right before the Coronavirus outbreak happened, so when I returned home I checked my kidney, got a full body x-ray, and checked my fever for the next 20 days because I have a weak immune system.” In addition to her worries, she also decided to take a gap semester from Yonsei University and stay in her home country to avoid high risk areas. 

In comparison to those simply concerned about their health, those with hypochondria worry to the point it disrupts their lifestyle and will react severely to mild symptoms on a regular basis. The anonymous interviewee confided, “I had a pimple on my thigh last semester, but I thought it was a sign of a bigger illness and couldn’t sleep for three nights. So, I made an appointment at Severance Hospital and Seoul National University Hospital. Both told me that it was only a simple epidermal cyst, but I didn’t feel reassured until I went to the hospital in my home country because I don’t trust Korean medicine and doctors.” 

In addition to excessive worry, stress, and inability to be reassured, hypochondria can affect an individual’s lifestyle in various ways. For example, constantly visiting hospitals and doctors can result in burdensome medical fees—$2000 a year in the interviewee’s experience—and disrupt one’s normal schedule, such as missing class or work. Also, hypochondriacs’ fixation over illnesses may result in physical symptoms such as sweating, muscle twitching, and fatigue***. Generally, hypochondriacs self-diagnose themselves with diseases prior to visiting doctors, which can result in an escalation of anxiety and physical symptoms. For example, the anonymous interviewee mentioned, “I once had a lung cancer scare, and my doctor wasn’t sure about the results. After researching and making a list of common symptoms, I started to feel the symptoms the next day. But once it was confirmed that I wasn’t sick and that my doctor made a mistake, all of the symptoms went away, and I automatically got better.” 

Treatment

   As a treatment for hypochondria, many patients are prescribed antidepressants such as Prozac and Luvox to reduce anxiety levels and relieve the symptoms****. Other suggested treatments include regular therapy or counseling sessions, which are often used to treat associated mental disorders such as depression or anxiety, and to encourage healthy lifestyles to maintain low levels of stress. However, the interviewee said, “Before being diagnosed with hypochondria I was already taking Prozac, and after being diagnosed I started taking more anti-anxiety medication. But I’ve been taking medication for so long I don’t feel like it helps.” 

Although there is no cure or fixed treatment for hypochondriacs, cognitive-behavioral therapy (CBT) is also a type of psychotherapy frequently used to help patients rationalize their fears*****. In CBT you work closely with a therapist to recognize negative patterns of thinking and behavior, identify negative beliefs, and find less harmful ways of how to think and act. In an interview with the Annals, Dr. Jang Suh-kyung from the Yonsei University Center for Counseling and Coaching Services stated, “There are a variety of ways to treat hypochondria, but CBT is commonly used amongst therapists because it is evidence-based therapy. It has shown to be effective in short term treatment and is very manualized.” 

According to Dr. Jang, to aid individuals with health anxiety, one must begin by helping the patient understand that “these are not physical symptoms, but they are psychosomatic symptoms.” If a loved one is struggling with this disorder, people must recognize that their fear is real. “Since hypochondria is a symptom of underlying mental conflict, such as depression or anxiety, one can help them relax and reduce their stress by briefly reassuring them and distracting them from their health concerns,” said Dr. Jang. Moreover, she expressed that it is best to seek professional help before the symptoms become too severe to fully recover from. 

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Similar to helping a friend with a fear of illness, those who feel anxiety about the COVID-19 outbreak should remind themselves to not panic. Unease and concern about one’s health amidst this crisis is a rational reaction to these uncertain circumstances but worrying will not change anything. The best method to prevent excessive worry and overestimating the threat of danger is to acquire medical information from reliable sources, take preventative measures such as wearing masks and staying home, maintain good hygiene, and look at the probability instead of the possibility of infection.

*Everyday Health

**Medical News Today

***News-Medical

****WebMD