Differences in how Patients with Hypochondria Interpret and Regulate Stimuli - Research Paper Example

Hypochondriasis Affiliation Hypochondriasis Resent research has shown that there are differences in the ways in which patients with hypochondria interpret and regulate stimuli. Hypochondriacs cannot differentiate between relevant and irrelevant symptoms hence treating them with equal concerns. The patients can experience normal bodily functions such as peristalsis and end up attaching pathologic fears. The occurrence of a minor inhibition of the sensory input leads to the amplification of the patient’s awareness and exaggerates their response. Hypochondria is found in 10% to 20% of first degree relatives of people with similar disorder. The statistics are similar to those of patients with conversion, pain, and depressive disorders (Starcevic & Noyes, 2014). Hypochondria psychodynamics are often complex. Patients displaying this disorder are usually found to have grown up in environments where illnesses and physical complains are focused on. Research show hypochondriac patients spend over ten million dollars in doctor fees because of their frequent visits to the doctor’s office. Introduction. Hypochondriasis also known as hypochondria can be defined as a condition where an individual has overwhelming fear that he or she is suffering from a serious disease although medical checkups by health care providers do not find any evidence of the disease. In the past, hypochondria was defined as a somatoform disorder. However, recent researches have classified hypochondriasis as an anxiety disorder. It is a form of abnormal health anxiety which instead of being mild it is severe and disabling. Individuals with this disorder often misinterpret normal body conditions and mild symptoms as symptoms of serious diseases. Normal people are usually concerned that they may have a certain disease but with hypochondriacs, they are abnormally consumed with fear and anxiety. The hypochondriac’s fear is consuming and consistent and it ends up affecting their work and social relationships (Barlow, 2013). People with hypochondria may have concerns about a particular part of the body such as the cardiac system or the digestive system. Often, a doctor’s reassurance that the patient is in good health conditions or even a full medical evaluation do not help in calming the individual’s fears. In the case where the doctor manages to calm their fears, they come up with other worries a few days later. Majority of hypochondriacs do not develop somatic delusions. Somatic delusions are ideas about health that are dispatched from reality. A popular belief is that hypochondriac’s health fears are so severe that reassurances only serve to temporarily calm them. In some situations, the patients may admit that their concerns are farfetched but will not accept the fact that there is nothing wrong with them. Research done on hypochondriasis and hypochondriacs is much less thorough than those done on other mental disorders. Estimates show approximately 4% of patients in the health care systems have symptoms of the disorder. Another 10% of the patients have hypochondriasis symptoms without having the full disorder (Starcevic & Noyes, 2014). Patients with severe form of the disorder tend to go from doctor to doctor in search for the one who will confirm their perceived symptoms. In the process, the doctors and the patients alike may become frustrated and angry. The obsessive search for a disease that cannot be found may lead to the patient developing a real medical symptom caused by the interference of proper health care. To some extent hypochondriasis is the same as obsessive- compulsive disorder. A number of researchers have actually categorized it as a form of obsessive-compulsive disorder (Starcevic & Noyes, 2014). Hypochondriacs are obsessively preoccupied by notions of illness and are compelled to take actions in order to quell their anxieties. Researches have also found that most patients have had an experience of a serious disease especially when they were children. Normally, hypochondriasis symptoms start to manifest themselves when the patient is a young adult. These symptoms can occur in both males and females at the same age. In the beginning the symptoms are mild and may be aggravated by the experience of stressful or traumatic events such as the death of a family member. In most cases, medical illnesses are associated with discomfort, but can also result to relief. The relief is a result of the care that patients receive from doctors, nurses, friends, and family members (Basavanthappa, 2007). Although hypochondriacs are often oblivious to this, their symptoms are sometimes motivated by these advantages. In some cases, an individual may fake illness in order to receive obvious gains like drugs, financial benefits, avoid legal responsibilities, or even work. In instances where an individual is consciously faking illness to gain some privileges, the condition is known as malingering. Note that, hypochondriasis is not the same as hypochondria. Hypochondriacs do not fake illnesses. The patients truly believe that the symptoms they are experiencing are real and they are sick. Symptoms There are various symptoms that are manifested by hypochondriac patients. Patients with this disorder are usually obsessed with their physical health. They have unusual fear of developing or having a serious disease. Hypochondria occurs equally to both men and women. The patients constantly think about their physical conditions which leads them to believe that they have certain symptoms. They think and worry about normal bodily sensations, which result to the development of a cycle of symptoms and worry that cannot be easily stopped. It is important to note that hypochondriacs do not intentionally or falsely develop these symptoms. It is a fact that it is impossible for them to control these symptoms. Individuals with a historical experience of sexual or physical abuse often develop this disorder. However, this does not mean that every hypochondriac patient has a history of abuse, but a significant number of them have a history of serious childhood illnesses. Physical symptoms can first be noticed at the age of thirty for majority of the patients. Few cases of hypochondriasis occur during childhood. Most patients have one major symptom, which is pain. The symptoms may be vague in nature such as general fatigue or they can be specific like pain in the neck. The patients worrying about the symptoms can lead to other serious consequences. It becomes very distressing for them and can cause depression and disruption of their lives. Hypochondriacs become dependent, demanding help and emotional care, and may react with anger if they feel their needs are not taken seriously. There are case where they attempt or threat to commit suicide. When doctors attempt to reassure them, they believe that the doctor is not taking their concerns seriously. Because of the lack of satisfaction, they typically visit different doctors at the same time. In most cases, the symptoms worsen due to lack of response to medication and others become abnormally susceptible to the medication’s side effects. The persistence and intensity of the symptoms reflect a desire to be cared for. The hypochondriac symptoms can be an excuse for individuals to avoid responsibilities but they can also be a punishment as they prevent them from participating in some social activities. It may also cause a latent feeling of guilt and low self-esteem. Hypochondriac symptoms may worsen or lessen but they cannot be completely relieved (Barlow, 2013). Causes The real cause for hypochondria is not yet known. However, there are several theories which attempt to reveal the redisposing factors of the disorder. They include psychodynamic theory, cognitive theory, social learning theory, past experience, and genetic influence (Weck, Neng, & Satngier, 2012). The psychodynamic perspective argues that, hypochondria is an ego vindication mechanism. Hypochondriacs find it easier to feel something is wrong with their physical body than to feel that there is something wrong with the self. The psychodynamic theory also views hypochondria as a transformation of hostile and aggressive wishes on others in form of physical complains. Repressed anger resulting from past disappointments is expressed by soliciting other people for care and help then rejecting and thwarting them as ineffective. Other psychodynamists view the disorder as cover for guilt. They argue that hypochondriacs feel guilty about past events and therefore view pain as a deserved punishment. The cognitive theorists argue that, hypochondriasis is as a result of cognitive and perceptual abnormalities. Research shows that the cognitive screening process that involves clarification and assessment can reduce or amplify sensations. The perspective proposes that hypochondriacs have an amplified bodily sensations. Emotional arousals are incorrectly interpreted and given negative cognitive meanings when they precipitate somatic symptoms. Therefore, all future perceptions are interspersed to match the established cognitive scheme (Hedman, Anderson, & Anderson, 2011). The social learning theory argues that, hypochondriac complains are reinforced by them being a relief from the individual’s stressful situation either in the family or the society as a whole. Hypochondriacs are encouraged when they are excused from stressful situations, unwelcomed challenges, or receive a lot of attention because of their illness. The presence of these factors encourages repetition of the response. Past physical illness theory argues that if a person had a childhood experience where a family member suffered or died from a serious disease, there is a high possibility of them suffering from hypochondriasis in future. People develop fear of reoccurrence of biological threats to them when they are exposed to such situations. The individuals become alert to physical changes and their bodily sensitivity increases. The fear for disease reoccurrence increases, and leads to exaggerated response hence hypochondriacal behavior. Genetic influence theory argues that, hypochondria is genetically transmitted. They argue that although there is little known about the genetic inheritance of hypochondriasis, there is significant proof that it has an increased prevalence among first degree relatives and identical twins (Weck, et al, 2012). Diagnosis The diagnosis of hypochondria is normally done by a primary physician but it can be confirmed by a psychiatrist or a mental health professional. However, hypochondriac patients often refuse to see mental health doctors. The common nurses and doctors’ diagnosis includes fear of being infected by a serious disease based on past experience and chronic low self-esteem caused by childhood disappointments. Other diagnosis can include the patient being too anxious about their symptoms, and spending a lot of time and resources on the symptoms. Doctors are advised to do a thorough examination so as to determine whether the symptoms are caused by physical abnormalities. It is important to note that some symptoms might be missed in the case of old people. Symptoms such as fatigue, and pain are frequently considered as understandable for old people. Additionally, old people usually have many medical problems and they take a lot of medication. Hence, doctors should be very observant when it comes to them so as to give a correct diagnosis. Recently there has been several developments in detecting hypochondria. The developments are in the form of the recently approved and adopted Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Xiong, 2013). DSM-5 has several changes in mental health care and a few touch on the hypochondria disorder. The criteria of diagnosing hypochondriacs is that the patient must display one or several chronic hypochondriasis symptoms, which they are obsessively concerned, preoccupied and fearful. There should be significant dysfunctions and distress caused by the patients behavior. Although the patients frequently visit health care facilities, they feel that the medical care is inadequate. Hypochondriac individuals might have a medical condition, but they have increased bodily sensation. They also display excessive anxiety about undiagnosed diseases, and spend a lot of time energy, and resources researching them. Like individuals with somatic conditions, hypochondriacs are not easily reassured. Treatment There are several treatment plans that can be adopted to treat hypochondriasis. Psychotherapy where group therapy, cognitive therapy, and behavior modification have been applied has proved significantly effective. Hypochondriacs frequently have other mental health issue such as depression, and anxiety disorders. The treatment of these other disorders is important for the treatment of hypochondria. Doctors may advise refrain from reading medical books and visiting medical websites. Doctors do not usually use drugs to treat hypochondriasis but there are drugs which can be prescribed to treat latent mental health conditions. Drugs such as fluoxetine, sertraline, paroxetine, and fluvoxamine can be administered. Recent researches showed that, fluoxetine was much tolerated and significantly effective in treating hypochondriasis. Stress management and cognitive behavioral therapies are the cornerstones for the treatment of hypochondriasis. Also, the participation in mindful activities like meditation can help in managing the symptoms. Acupuncture has also been known to be effective. Apart from these, a number of studies have been done to determine other alternative and complimentary treatments for this disorder. Regular visits to CAM health care providers can be helpful in dealing with physical health fears. Hypochondriacs are advised to work with professional reputable doctors to develop a health and self-care program (Xiong, 2013). There are no scientific researches done to prove the role nutrition plays in the treatment of hypochondriasis. However, avoiding caffeine and alcohol can help in the treatment of anxiety and depression. Also, hypochondriacs are advised to maintain a healthy diet in order to keep their bodies well-nourished and healthy. Strengthening and toning of the body by using herbs has been proved to be a safe method. Hypochondriacs can use herbs such as glycerites, and tinctures. However, as for any therapy, patients are supposed to get a diagnosis from a health care provider before starting the treatment. No particular herb can be used to specifically treat hypochondria, but they can be used to treat anxiety and stress. The results will be a reduced preoccupation with hypochondriacal symptoms (Hedman et al, 2011). Even with all the treatment approaches, hypochondria like any other mental disorder can be recurrent. Because of this, health care provides are advised to do regular patient evaluations. If the treatment was successful, the patient should be able to make less visits to the doctor, use less medication, increase his or her functional abilities, and be able to cope with stressful situations. The patient should also be able to form functional social relationships with family and friends which are not completely dependent and attention seeking. Like any other diseases, it is important for hypochondriac conditions to be detected early enough so that proper intervention procedures are taken. Because of this, health practioners are advised to conduct regular community awareness programs. The community should be educated on hypochondria and how to detect its symptoms. In the process, individuals might became aware of their situation and seek proper medical care. Conclusion. Hypochondria is a disorder which brings out real issues for patients, doctors and other health care givers, and the society as a whole. For the patient, if the disorder is not intervened in time, he or she ends up stressed, depressed, and socially incapacitated. There are also financial consequences which result from the costly visits to different doctors. For doctors, it is stressful to constantly try to diagnose symptoms which do not exist for patients who do not get satisfied with the real results. As a result of the litigations, doctors feel obligated to comply with the patient’s wishes or face consequences. For the society, advancement in the information technology has led to the availability of various avenues where people can research on their health concerns. However, this has some negative consequences as the availability of these materials fuel the obsession of potential hypochondriacs. Members of the society are advised to assist their friends and family members who show hypochondriac symptoms understand their conditions and seek medical and mental health care. References Xiong, G. (2013). Hypochondriasis Clinical Presentation. Retrieved from http://emedicine.medscape.com/article/290955-clinical Hedman, E. Anderson, G. & Anderson, E. (2011) Internet-based cognitive-behavioral therapy for severe health anxiety: Randomized Controlled Trial. Br J Psychiatry, 198(3):230-6. Weck, F., Neng. J., Richtberg, S., & Stangier, U. (2012). Dysfunctional beliefs about symptoms and illness in patients with hypochondriasis. Psychosomatics, 53(2): 148-54. Basavanthappa, T. (2007). Psychiatric Mental Health Nursing. New Delhi, India: Jaypee Brothers Medical Publishers. Barlow, T. (2013). Essentials of Abnormal Psychology. Wardsworth, U.S: Cengage Learning. Starcevic, V. & Noyes, R. (2014). Hypochondriasis and Health Anxiety: A Guide for Clinicians. New York, U.S: Oxford University Press. . Read More