To all my friends who pointed out my own fashion mistakes when I posted my last blog choc-full of essential fashion tips, I just want to give this reasonable feedback: dress as I say you should dress, not as I do dress. I'll admit- I take a special pleasure in occasionally wearing hideous or outdated clothes, just to elicit reactions. That doesn't mean you should, unless you enjoy people laughing at you.
READER QUESTION: WHAT IS HYPOCHONDRIASIS?
Or more specifically, "what causes someone to be a hypochondriac?"
This was a tough question for me to answer. In fact, it took me weeks to find information that I felt was reliable. Essentially, being a hypochondriac means that you have an "exxagerated concern or worry about having a health problem or health problems, despite evidence to the contrary." This actually used to be classified in the psychiatric literature as a form of a "personality disorder," in other words a mental illness all its own. That was probably both innaccurate and unhelpful, since personality disorders are not often treatable. Currently, hypochondriasis is generally seen as a symptom of a treatable mental illness, the most common illnesses being depression, anxiety disorders, and post-traumatic stress disorder (PTSD). Hypochondriasis can also be seen in other mental illnesses such as obsessive-compulsive disorder (OCD), and psychotic syndromes.
By far the most common underlying illness in someone who is a hypochondriac is depression. Part of that is because we are recognizing, with increasing frequency, that major depression can cause physical symptoms, which are often ill defined. Another factor is that a majority of depressed patients are very resistant to being diagnosed as having depression, and depressed patients are often hard to convince that their physical symptoms are coming from a psychological rather than a physical source. Hypochondriacs who are depressed and are treated for depression do very well, and are able to overcome their hypochondriasis is most cases.
This is also true for patients who have hypochondriasis in the context of an anxiety disorder, PTSD, or other mental illnesses.
MORE QUESTIONS AND ANSWERS ABOUT HYPOCHONDRIASIS
1. DOES EVERYONE WITH HYPOCHONDRIASIS HAVE A MENTAL ILLNESS?
No. Honestly, I think many hypochondriacs just have too much time on their hands, or they're too focused on their own needs. In these folks, it tends to be a temporary problem. After a few doctor's visits and normal tests, and hopefully some encouragement from a doctor, they realize that they are wasting their time- and that rather than worrying about non-existent health problems, they should use their mental energy to work, have fun, and pursue more productive hobbies.
There are also hypochondriacs who are justified in their hypochondria, in my opinion. For example, cancer survivors often become hypochondriacs, and for good reason. The last time they thought they had a serious illness, they did! I don't even think it's fair to call cancer survivors hypochondriacs. It's better just to offer them the tests they want, whenever they want, to help reassure them that they don't have cancer again. At least, that's what I do.
2. WHAT'S WRONG WITH BEING A HYPOCHONDRIAC?
I think the biggest problem for hypochondriacs is that they are unhappy, and their hypochondria keeps them that way. It's really no fun to think you have an undiscovered illness. Not only does the hypochondriac worry about his or her health, but he or she wastes a lot of time- time in doctor's appointments, getting tests, searching for health information on the internet, and seeing various health practitioners. Hypochondriacs put a big time and financial burden on themselves, and they also can make their loved ones and family members unhappy or frustrated with them.
3. WHAT IF OTHER PEOPLE THINK I'M A HYPOCHONDRIAC, BUT I REALLY HAVE A SERIOUS HEALTH PROBLEM?
See a doctor. If your doctor treats you with annoyance or insults you, get another doctor. If there are tests that are reasonable to do, ask your doctor to run them. But you should trust your doctor's judgement to some degree- demanding complex tests that your doctor doesn't think you need will generally get you nowhere. And keep in mind the most important fact here: there are very few health conditions out there that "no one can detect" or "multiple doctors can't diagnose." A recent book on the subject reviewed a number of studies of patients with "hard to diagnose, undiscovered health problems." The studies revealed that only a tiny fraction of these patients turned out to have a real physical ailment; most had either stress-related conditions or depression. So if you've been to a few doctors, had a number of tests, and "no one can figure out what's wrong with you," the painful truth is this: there probably is nothing wrong with you, physically. You might do yourself a favor and seek a therapist.
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