Hypochondria - a neurological pathology or a psychological disorder? Hypochondria and its features.

Hypochondriacal disorder is an autonomous nosological entity and has ICD-10 code 45.2. It represents the fear of getting sick from something. This fear can be vague or explicit and strong. However, the problem is much broader. Fear can be part of the structure of many different states. In its pure form, the disorder belongs to the category of somatoform, but concern for one’s health is not limited to this. Hypochondria is a mental disorder that can be very complex both in terms of presentation and treatment.

Hypochondriasis is the fear of getting sick from something

Hypochondria is also a generalized name for everything that can be associated with a person’s subjective opinion that he is sick. The term then refers to the entire spectrum of imaginary diseases and disorders. This becomes a medical problem in two cases:

there is no disease, but for some reason a person believes that there is one and this is more than just an assumption;
The disease is there, but it’s not as bad as the person makes it out to be.

Both options can have unpleasant consequences. To such an extent that the ICD, adapted for Russia and other countries, even includes a separate type of mental disorder F20.8xx1 hypochondriacal schizophrenia. In the West they look at this with great surprise. The fact is that WHO made many concessions to domestic specialists. The only things not included in the classifier were “sluggish schizophrenia”, “vegetative-vascular dystonia” and other obvious forms of delusions.

What it is? Hypochondria in its modern version has become a kind of confirmation of information oversaturation. By modernity we mean not only our Internet age, but also the second half of the 20th century. Even then, people started talking about how it was enough to read the magazine “Health” or watch a program that was popular in those years with the same name, and thousands of citizens managed to find the health problems in question. In general, it is a completely natural phenomenon to project onto oneself any health problems someone mentions. “Natural” in this case is not a synonym for the word “good”. However, some people will think for a minute and forget, while for others, for some reason, this turns into a manic desire to seek confirmation of their conjectures. And not only look for, but sometimes even treat on your own diseases that do not exist. What is hypochondria in terms of risks? First of all, there is the risk that self-medication, and even undertaken in an excited state, will lead to disastrous consequences. Another risk factor is possible suicide attempts, especially if the patient considers that he has something incurable. One should not think that hypochondria in psychology is something harmless. It all depends on the characteristics of the case.

As with all serious manifestations of phobias, the underlying fear is the fear of death. This is a fundamental question that permeates human existence in many different forms. We will all die someday. Understanding this fact underlies religions and philosophy; it also builds behavioral patterns and is the guiding force for performing actions. And at the same time it can become a structural unit of internal contradictions.

If you get people with serious phobias into conversation, they will tell you that it is the fear of death that they turn into symptoms. It becomes the basis of insoluble contradictions.

Types of combinatorics of hypochondria

Let's try to create a gradation of how the fear of death is refracted in the mind and turns into various symptoms, which are then combined into syndromes associated with hypochondria.

Common hypochondriacal reaction

Thoughts that some kind of disease exists come from receiving information about how it manifests itself. It is not some sensation in the body that influences the occurrence of thoughts about illness, but the information itself. A person, having learned about a symptom of some disease, thinks like this: “ Should I go to the doctors and have my kidneys checked? I had something similar».

This is a completely natural attitude towards the problem of potential illness. It is impossible to say whether this is good or bad. If it comes to a one-time trip to the doctors or concern about some condition, then this may be very necessary. Then suspicion becomes vigilance. How else would sick people get to doctors?

Hypochondria plus phobia

Here the fear of getting sick with something, quite necessary, finds pathological forms of expression. The main symptom is that a person perceives himself as a patient before clinical trials have been carried out. Fear can become persistent and haunt your entire life - becoming more intense from time to time. Here the symptoms of hypochondria deviate from the standard ones, since it falls into the structure of another disorder.

Hypochondria plus histrionic personality disorder

Hypochondriacal in itself does not exist, but it can be called hysterical, where hypochondria is at the head. In this case, the person is trying to attract attention to himself because of an imaginary illness or an obvious one actually found. But then any ailment will become the plot of the game of being doomed or suffering. All other topics of conversation may disappear, only about your illness. Even if bad weather outside is discussed, it will be in terms of the presence of an obvious or imaginary medical problem. Here the answer to the question of how to get rid of hypochondria changes. It becomes one of the symptoms of a disorder that is very difficult to heal.

Hypochondria plus schizotypal personality disorder

Here everything is a little more serious inside and not so much actualized externally. The phases are reactions, not episodes, and the disorder often occurs in waves. Periods of activation are expressed by uniform, discrete, transient quasi-somatic states. Manifest in the form of non-delusional (co-anesthesiopathic) hypochondria. The picture is dominated by a disturbance in sensory awareness of the somatic self.

In many ways, the mechanisms are common to all disorders of the hypochondriacal type that are not delusional. Let us indicate the main ones:

periodically occurring fixation of consciousness on the activity of internal organs;
fear of somatic illness based on a false interpretation of painful sensations;
disagreement with doctors who argue the absence of physical diseases;
searching for repeated examinations, consultation or attempts to contact traditional healers.

This type of hypochondriac is a person with an extraordinary personality, therefore, despite the absence of delusions, behavior can be very different. For example, if he has magical thinking, he can perform certain rituals, but this cannot be called nonsense. No more than all people who belong to some mystical or occult groups. But the likelihood that he himself will think about how to cope with hypochondria is extremely low. He will cope with imaginary illnesses.

Non-delusional hypochondria can occur in so-called latent schizophrenia, not only in schizotypal personality disorder. The difference between this and that is established on the basis of general criteria, and the signs of hypochondria relate to the area of basic behavioral and mental structures. The most important thing is that schizotypal personality disorder completely excludes delusions, and the “diseases” of patients themselves belong to the category of somatoform. Certain vegetative symptoms play an important role.

Hypochondria may be accompanied by schizotypal disorder

Hypochondriacal personality disorder does not exist, but this does not mean that hypochondria is not related to personality disorders. Very connected...

In all cases, it is necessary to exclude both the actual presence of physical illnesses and simulation.

Hypochondria and delirium

Actually, all the conditions described above do not contain delirium. There are no productive symptoms, so the disorders are either personality disorders or closer to neuroses, as is the case with phobias. Now we come to what nonsense contains. Partially, rudimentarily, it may be present in patients with latent schizophrenia. However, the diagnosis itself is doubtful, so let’s focus on another variety:

paranoia;
hypochondriacal schizophrenia;
senestopathic schizophrenia.

At the same time, we proceed from the approach of the editors of the ICD in a version adapted for Russia.

Paranoia- a mysterious state in that paranoids themselves, in their pure form, are found more on the pages of textbooks or journals on psychiatry. In this case, the nonsense must be monothematic and have some confirmation in reality. The patient must meet the criteria for diagnosing paranoia.

Hypochondriacal schizophrenia- nonsense should be more fantastic. The patient only needs minimal confirmation of his “somatic illness” at the physical level. Moreover, the “disease” may be a consequence of the impact of some kind of weapon on him, the result of some experiments and other science fiction. In general, signs of automatism must certainly be traced, and the delirium itself must be accompanied by hallucinations: voices told that the disease exists.

Senestopathic schizophrenia- everything is the same, but the diseases themselves are fantastic. A patient with schizophrenia may suffer from an “oncological disease”, which was the result of some kind of exercise on people. Of course, in his personal psychic reality. But the disease he calls at least exists in reality. In the case of senesthopathy, completely unrealistic “miracles” happen to patients. They may believe that all their organs have completely disappeared, that they have sintered, fused, turned over, mixed up, and the like. Delusions of influence in direct or inverted form are also possible. Someone is sure that the influence was exerted on him - by special services, aliens, any enemies, while others are afraid that he himself is the source of the influence. For example, it can infect all of humanity with the organ disappearance virus.

This picture would not be complete if we did not also mention involutionary paranoid. This is a characteristic age-related mental disorder that occurs in older people, often after they retire. Delirium is an indispensable symptom. It may be expressed with notes of fantasy, or it may be completely connected with reality, but the main thing is the stability of the plot. If a patient once believed that his organs hurt because his relatives put something in his food, then they can still enter into a conspiracy with some hostile forces, for example, neighbors at the entrance, but in the plot There will be no additional fantasy in the form of aliens or representatives of ancient civilizations.

Thus, hypochondria, or an altered perception of one’s body, is expressed in various nosological units. We hope it is clear that the answer to the question of how to deal with hypochondria on your own is impossible here.

The most common forms are the combinations of “hypochondria and VSD” and involutional paranoid with elements of hypochondriacal delusion. If the first, like any types of somatoform disorders, is amenable to psychotherapeutic correction, then delirium is not. This is one of the axioms of psychiatry. It is typical that patients may be critical of someone else’s similar nonsense, but not their own.

From the above it is clear that hypochondria does not have many symptoms of its own, but in combination with other disorders it can represent a rather extensive symptom complex.

Hypochondria: treatment

Here we mean the classic form. And since the classic, pure and not mixed with anything in life is not often found, let’s consider a real case, which is extremely difficult to diagnose unambiguously.

And let’s take something completely unpleasant, so that the problems of psychiatry do not seem to anyone like something that falls into the category of “just let it happen.”

Hypochondria: symptoms and treatment of complex cases

The patient is a 27-year-old man. He thinks he has syphilis. He did not undergo a medical examination. Sexual contact with a woman actually occurred and occurred under strange circumstances. At the same time, the partner was an alternative bride for this person. At a certain point, he believed that he had contracted syphilis from her. There was no logical reason for this. Mental suffering did not allow a person to ask his partner if she was sick, just as they did not allow him to undergo an examination. Although in practice this can be done quite officially, but with complete preservation of medical secrecy. A few days after the idea arose, the patient believed that he also had HIV. Note that milder STIs were not even considered. Thoughts began to flow in a continuous stream. He couldn't contain them or control them in any way. At the same time, pain arose in the internal organs - the stomach, bladder, kidneys, and so on. For no apparent reason, the body temperature began to rise, and a state similar to derealization was observed. About a month after the problems began, he consulted a psychotherapist. It is not so important what kind of specialization psychologist will be chosen. The main thing is that this is a doctor, and not just a consultant.

Hypochondria is often associated with vegetative-vascular dystonia

Let's consider the difficulties of diagnosis.

On the one hand, this is neurosis. Just a neurosis, which is what a phobia is. However, the onset of the phase was accompanied by something that was a bit like a hallucination. The fact is that the thought of illness visited the patient in the morning, when he almost woke up. The very phenomenon of thought was very reminiscent of manifestation. He saw something vague in a dream, which indicated the presence of an illness. And whether it was a dream or a hallucination, he himself did not know. Constant and exhausting mental activity brought the picture closer to mentism, which means we have reason to talk about the presence of symptoms of schizophrenia. Especially when you consider that not only depression arose, but also negative symptoms in the form of ambivalence of thinking, autism and decentralization of the emotional-volitional and mental sphere. But these are all the doctor’s assumptions at the time of the first session.

There are also factors of common hypochondriacal disorder. The patient began to self-medicate. The logic can be understood - he read in the reference book about possible preventive measures. I bought antibiotics at the pharmacy and gave myself injections. A study of his personality showed that she belongs to the anxious-avoidant type.

What follows can either be very simple, in which case the psychotherapist cuts the Gordian knot of contradictions with one action, or it can turn out to be extremely complex. The patient is recommended to undergo a medical examination - just get tested, but in a state laboratory. Tests can be taken without a doctor’s referral, and an HIV test is included free of charge. The main one costs mere trifles. Then you need to wait a day or two. The results were negative. He has neither syphilis nor HIV. He brings the papers with the results to the psychotherapist. Here everything depends on further behavior. His monthly depression, phobia and all other mental processes may not be worthy of any diagnosis at all. Well, I got scared and afraid. Next time he will be smarter. Then the situation could develop like this:

refusal to make further attempts to do anything. There are no formal reasons for this, the person is healthy. What happened can be characterized as a neurotic reaction to stress due to cheating on his fiancée;
stubborn reluctance to agree with a negative result, attempts to still find a disease in oneself. Then it is either just a hypochondriacal disorder, or some kind of personality and behavior disorder, or something more serious, depending on how the person behaves, depending on what happens to him;
not just a reluctance to agree with negative results, but also the presence of productive symptoms in the form of voices, delirium about how the disease is caused by a curse or damage, and the like. Then it's schizophrenia. In this case - hypochondriacal.

But in practice, it is impossible to take into account and list all the options. For example, he can joyfully admit that he was worried, instantly heal, but after a couple of months he finds something new, and history repeats itself. It is possible that some other imaginary illness will cause horror that time.

In any case, it is better to start with the simplest. Do not feel confident that the patient will definitely begin to persist and look at the circumstances.

This was a rather elaborate example. It was taken specifically to create an understanding of complex situations. Or rather, they can turn out to be surprisingly simple, although they seem complex initially.

Treatment of hypochondria

Therapy for hypochondriacal disorder itself is best divided into working with the main symptoms and gradually instilling confidence that somatic sensations are connected to the psyche.

By main symptoms we, of course, mean mental symptoms. These are depression, anxiety, signs of panic disorder or too much mental activity. The drug regimen is chosen based on this. Predominantly it should rely on some type of antidepressant. The fact is that sedatives are needed only if there is a need for a strong impact on the emotional field sphere, and tranquilizers are addictive. Antidepressants of the latest generations are much more effective. In any case, a complete cure for hypochondria is quite possible.

Therapy is best understood through the example of working with panic attacks. During PA, the most obvious somatic symptoms are observed. These are tachycardia, shortness of breath, profuse sweating, tremors of the limbs, the effect of wobbly legs, and the like. Moreover, any attempts to treat the heart or lungs will not yield any results, since no serious diseases of the internal organs are observed. Moreover, nothing terrible happened to the autonomic nervous system. She simply submits to the psyche, which gives completely incorrect information, begins to defend itself against an imaginary attack and thereby provokes such sensations as if it is happening. Antidepressants and, in some cases, antipsychotics do their job and autonomic symptoms decrease or disappear altogether. It is important here that the patient himself understands that he needs to think about how to treat hypochondria, and not the organs.

However, you should not look for the answer to the question of how to cope with hypochondria on your own. Doing this without medications can be extremely difficult or even impossible. And prescribing drugs is the lot of specialists. You can reach the desired level of psychotherapist yourself by reading only three or four books, but with medications everything is much more complicated. By the way, about books... You shouldn’t trust everything that is promoted and on the lips of a wide audience. For example, Pavel Fedorenko teaches how to get rid of PA, fears, depression, and hypochondria. If all this helps someone, then we are only happy, but do not forget that this is a banal exploitation of the fact that people are trying to understand how to deal with hypochondria on their own. It’s so simple - we bought some courses, mastered them and now we are happy and live without grief and sadness, and we forgot about what hypochondria is and what it looks like. If everything were that simple, there would be no medical psychology. You don’t need to believe the phrases “don’t feed pharmacies,” “don’t pay doctors,” and the like. Nothing should be taken to the point of absurdity - depending on doctors is also no good, but indulging in the desire to do everything without leaving the sofa does no good either.

Above we did not even describe all possible types of combinatorics. It is also possible to have a combination with obsessive-compulsive disorder, in which case thoughts about some disease are obsessive in nature. Therefore, if someone has hypochondria, and he thinks about how to get rid of it on his own, his thoughts are too naive.

When treating hypochondria, you will need the help of a psychotherapist

And don’t try to look for reviews about the treatment of hypochondria. Everyone can have their own picture with their own individual characteristics. Other people's reviews about a case that is not yours will not bring you any benefit.

Any person just needs to open a medical reference book to find a whole bunch of diseases based on the symptoms listed there. But if a healthy person is likely to forget about what he read, then the hypochondriac will be sure that he definitely has them, and they need to be treated!

Hypochondria - a sham or a serious illness?

Hypochondria is a mental disorder similar to mania. A person suffering from hypochondria finds and diagnoses his own illnesses, and despite the doctors’ convictions, in their absence, he is always convinced that he is seriously ill.

How to get rid of hypochondria, or have you become a hostage to it or is your relative susceptible to attacks?

First of all, you need to determine the reasons that caused this condition. Hypochondria usually affects suspicious people, prone to melancholy, highly emotional, and neurasthenics. Neurosis can also cause hypochondria. And if you direct all efforts to cure these diseases that can manifest themselves in this way, then the patient himself will feel much better and will forget about his complaints.

Hypochondria can be caused by:

lack of attention to a person, abandonment, and attempts in this way to receive the missing love and care;
past injuries, complex illnesses and fears that they may return;
a side effect of serious mental disorders.

In any case, telling a hypochondriac that he is healthy and does not need to pretend is useless. Since such attempts will be perceived as “pressure”, “misunderstanding” and lack of sympathy.

Even the most productive treatment for hypochondria may not produce results if the person suffering from it is not inclined to adequately perceive his condition and does not want to overcome it.

How to deal with hypochondria? Should I treat it myself or still see a doctor?

First of all, you should consult a doctor and undergo an examination to make sure that you do not have any real illnesses, and that the sick condition is caused by hypochondriacal neurosis.

Suspicious people often do not listen to the advice of their relatives and consider them their enemies, who do not sympathize with them and only want harm to them. Neurosis causes them to have an additional syndrome—suspiciousness. Therefore, the best option would be to contact a psychologist and undergo a course of treatment that will help better identify the problem and solve it with the help of an experienced specialist. Of course, if the patient still wants to admit it.

An experienced psychologist, with the help of a confidential conversation, special self-hypnosis exercises and hypnosis, can lead the patient out of the “hole” into which he has driven himself, since a constant state of stress caused by neurosis will ultimately lead to real illnesses.

If hypochondriacal neurosis is aggravated by mental disorders, drug treatment cannot be avoided, and treatment in this case is carried out by a psychiatrist, at home or in a hospital.

Hypochondriacal neurosis. Why is he dangerous?

- not a sentence, but for some reason many people perceive such a person as an ordinary “whiner,” believing that his attribution of numerous illnesses to himself is just a trait of his character. They support them, consider them weak-willed people who need to be taken care of, only aggravating their condition. Thus, many hypochondriacs are captive of their fears and manias for the rest of their lives.

The particular danger of this diagnosis is that a hypochondriac not only diagnoses himself with a disease, but can also begin to uncontrollably take medications that cause serious harm to his health and cause severe diseases of the filters of our body - the kidneys and liver.

How to help yourself in treating hypochondria?

A passionate person simply does not have time to be sick or complain about anything. Treatment for hypochondria can be carried out independently, if you simply get yourself a favorite pet that will make you happy, or a hobby, express yourself in creativity, do work in the garden, arrange a flower garden under the window, start keeping a diary, or just draw. For women, we can recommend needlework - embroidery, decoupage, making jewelry and similar types of creativity. Moreover, today you can easily find something to suit every taste! Spilling out emotions in this direction will help relieve tension, and not waste time looking for new diseases in a medical reference book.

Walking in the park, working out in the gym, and communicating with people of similar interests will help very well with hypochondria. In this way, you can not only treat neurosis, but also improve your physical fitness, improve your mood, and therefore change your life attitudes.

We should not forget that neurosis, and with it hypochondriacal syndrome, can be caused by too much workload that you have taken on, by constant lack of sleep. Both good sleep and daily routine will return vigor and strength, and with them the usual chronic fatigue and painful condition will go away.

Write down your daily routine. Try to follow it and take more vitamins. Just smile at yourself every morning in front of the mirror, and you will feel how the world around you is changing!

To prevent life from becoming a series of gray everyday life, in which hypochondriacal syndrome has become its only important part, you need to add more bright colors to it - go to the theater, cinema, and exhibitions. Or even watch an interesting movie with friends or a loved one, or have a party. If you are constantly stressed, then the best way would be to do yoga, listen to calm music, and meditate.

Decoctions of soothing herbs also help well: chamomile and mint, motherwort herbs. Echinacea tincture can also be used as a tonic. Introduce - morning dousing with cold water.

All relatives who have a hypochondriac in the family need to create a calm, friendly atmosphere, put away all medical literature and communicate more with him on more abstract topics, support his interests, or try to interest him in new and interesting activities. And most importantly, be patient. Hypochondriacal syndrome is a disease that cannot be overcome in a short time!

Hypochondria (hypochondriacal disorder, hypochondriacal syndrome) is a pathology characterized by exaggerated concern for one’s health and a persistent belief in the presence of a serious illness, despite the objective absence of this pathology.

From 3 to 14% of all patients visiting doctors of various specialties suffer from hypochondriacal disorder.

In some cases, patients themselves are so convinced that they have a disease that they are able to convince even doctors of this. This condition is called Munchausen syndrome.

Causes

Hypochondria can be either a separate disease, classified under the ICD-10 subcategory hypochondriacal disorder, or it can be observed within the structure of schizotypal disorder.

This syndrome can also occur as part of a depressive disorder (). Negative experiences and a severe psycho-emotional state are reflected in the somatic state of a person.

The causes of hypochondria are not yet fully understood. Scientists offer the following explanations for the occurrence of hypochondria:

there is some hereditary predisposition to the development of hypochondria;
a certain role in the formation of this mental disorder is assigned to disturbances in the perception of stimuli from the internal organs, as a result of which ordinary stimuli are interpreted as pathological;
the direct factor that triggers the development of hypochondria is traumatic events or severe somatic illness;
Another significant factor in the development of hypochondriacal disorder is the imitation of a hypochondriacal model of behavior that the child saw in adults and was convinced from personal experience of receiving increased attention, privileges or the removal of responsibilities due to the illness.

Most often, the occurrence and persistence of symptoms of the disease has a close relationship with difficulties, conflicts, and unpleasant life situations, but the patient himself denies the psychological cause of his disease.

Portrait of a hypochondriac

People with hypochondriasis are characterized by self-centeredness, little interest in the needs of others, they consider themselves offended, unloved by others, abandoned.

A person suffering from hypochondria is convinced that he has a serious illness. To diagnose it, he visits a variety of doctors. Often normal sensations are interpreted by a person as painful; he regards them as symptoms of a serious pathology.

After doctors conduct all kinds of examinations, but do not find any data confirming the diagnosis that the hypochondriac has already made for himself, he begins to bring more and more new arguments, talk about all sorts of “felt” symptoms.

A person can regularly visit doctors of various specialties, demand repeated consultations, ask for additional (absolutely unnecessary) examinations, write letters to various authorities, complain about doctors, and even threaten them if they refuse to follow his lead.

Symptoms of the disease

Hypochondriacal disorder is a disease that meets the relevant criteria of the International Classification of Diseases, 10th Revision (ICD-10) and is coded as F45.2.

The main signs of hypochondriacal disorder:

persistent belief that there are no more than 2 physical diseases, which persists for at least six months;
persistent preoccupation with a perceived deformity or deformity;
unfounded variable complaints from internal organs;
ordinary sensations are interpreted by a person as evidence of a pathological process;
independent formulation of a diagnosis - a person himself, based on his imaginary symptoms, makes a diagnosis for himself, although it completely contradicts generally accepted criteria;
persistent denial of doctors’ assurances that there is no objective evidence of the presence of this disease; even if a person calms down and stops arguing with doctors, this will only be for a short time, after some time he will again begin to look for confirmation of his illness;
low mood;
Hypochondriacal disorder can be diagnosed only after schizophrenia and mood disorders (including) have been excluded.

Additional symptoms of hypochondria can be various obsessions, when a person is overcome by doubts about whether he has this or that pathology. Quite often, patients understand the absurdity of these thoughts, but cannot get rid of them.

Obsessive thoughts about one illness may be replaced by obsessive fears about the development of another disease.

Manifestations of an imaginary disease are widely localized, often affecting the cardiovascular and gastrointestinal systems.

When initially visiting a doctor, an emotionally inexpressive, monotonous presentation of complaints is typical, supported by extensive medical documentation that has accumulated during previous examinations. If you try to dissuade such a person, he will easily become affected. And this leads to another common manifestation of hypochondria - hysterical behavior aimed at attracting attention to oneself and one’s illness.

Hypochondria health

There is one more special condition that I want to touch on - health hypochondria. At its core, it is the opposite of hypochondria.

If a patient suffering from hypochondriacal disorder is sure that he has an incurable disease and tries his best to find evidence of this, then there may be another extreme. A person has symptoms of an incurable pathology that are detected by a doctor, and they are determined using objective research methods. And the patient himself considers himself absolutely healthy, and no doctors’ arguments about the presence of a serious illness are important to him.

Health hypochondria is very dangerous in cases where urgent treatment is necessary, and a person is confident that he is healthy and refuses treatment, risking death.

Who is susceptible and what is the prognosis?

Most often, hypochondria is observed in children, adolescents, elderly people and suspicious individuals.

Elderly people are very concerned about their health. A detailed description of the existing symptoms, comparing them with those that others have is one of the most favorite pastimes of grandmothers.

Sometimes a disease occupies a person’s consciousness so much that it reaches the point where he or she devotes all his energy to furiously searching for more and more symptoms of the disease, while simultaneously complaining to all authorities about the low qualifications of the doctors who examined him.

The disease is most easily tolerated and best treated in young people, without concomitant personality pathology.

Treatment

Treatment of hypochondria should be carried out by a psychiatrist only after a detailed examination of the patient.

So, how to cope with hypochondria, what is effective?

Drug treatment

If it has been possible to exclude other mental and somatic pathologies in a person, then the drugs of choice in the treatment of hypochondriacal disorder are antidepressants and tranquilizers:

Antidepressants not only help improve mood, but also help cope with obsessive thoughts and ideas;
tranquilizers have an anti-anxiety and sedative effect, they are indicated for the treatment of obsessive-compulsive disorder and hypochondria.

As I already indicated above, attacks of hypochondria can be observed in the structure of depressive disorders. The choice of psychiatrists in such cases is the use of antidepressants, which affect both depressive symptoms and hypochondriacal syndrome.

In the presence of severe hypochondriacal symptoms approaching the delusional level, in cases where the hypochondriacal syndrome is one of the schizotypal disorders, the use of antipsychotics cannot be avoided.

Psychotherapy

How to cure hypochondria without using drugs? You can resort to psychotherapy.

Along with drug treatment, psychotherapeutic techniques are actively used. Thanks to psychotherapy, it is possible not only to understand why hypochondria arose and to influence the etiology of the disorder, but also to influence a person’s behavior pattern and beliefs.

In the treatment of hypochondriacal disorder, suggestive psychotherapy and psychoanalysis are actively used, and to overcome obsessive hypochondria, group psychotherapy sessions are shown that can provide not only social interaction, but also support.

How to get rid of it yourself?

If the patient himself realizes that he has signs of hypochondria, this is commendable.

How to get rid of hypochondria and suspiciousness on your own, what needs to be done in order to overcome this illness?

First of all, you need to try to understand the causes of this disorder. Try to remember what traumatic situations preceded the onset of the disease, whose attention you wanted to achieve or who you were offended by?
Only after you understand the psychological causes of hypochondria and can understand what really led to its occurrence, you must try to let go of this situation. No matter what happens, you must behave like an adult: be able to forgive, be able to call problems by their proper names, let go of past grievances.
The next step is to carefully review all the medical reports, of which I think you already have quite a few. If all these tests, examination results, and doctors’ reports do not contain evidence that you have a serious pathology, then you do not have it. Believe it!
Remember that all thoughts are material, and therefore if you constantly think and prove that you are seriously ill, then you risk falling ill with some serious illness for real.

And to conclude my tips on how to deal with hypochondria, I strongly recommend that you read the article. All these available methods for overcoming depression will be appropriate in relation to hypochondria.

Be healthy and appreciate what you have now!

Hypochondriacal depression– an atypical affective disorder characterized by a combination of depressive symptoms and manifestations of hypochondria. The patient feels depressed and is overly concerned about his or her health. A person interprets the state of internal organs pessimistically, distorts natural sensations, perceives with fear any problems in the functioning of the body, anticipates his own ill health, or is overwhelmed by an obsessive conviction of the presence of a difficult-to-treat somatic illness.

The patient believes that doctors are inexperienced or deliberately hiding the truth from him, while he believes that he correctly diagnosed his own illness. The hypochondriac’s doubts do not disappear even after numerous medical examinations and tests. A person with hypochondria stubbornly refuses to agree with the objective arguments of doctors. He is convinced of the futility of medical manipulations and is confident of the inevitable unfavorable outcome of the disease.

Hypochondriacal depression is often chronic with periodic relapses. Hypochondria is characteristic of emotional, suspicious, easily suggestible individuals. Neurosis is common among elderly and senile people, among teenagers. Hypochondriacal depression often occurs in medical university students who “try on” the symptoms of the diseases being studied. A larger number of patients with hypochondria are female.

Most hypochondriacs are erudite, well-educated, well-read people. They like to improve their level of education on their own, using available sources - websites on medical topics, books by traditional healers, sensational television programs.

Causes of hypochondriacal depression

The foundation for the emergence of hypochondriacal depression is a specific personal portrait formed due to the characteristics of childhood. The cause of future hypochondria is overprotection of the child and anxiety of the parents. Overly caring adults closely monitor the health of their offspring, running to the doctor because of the slightest scratch. They constantly frighten the child with the fact that he can catch a cold, get hurt, or become infected. Protect the baby from any contact with a potentially dangerous environment. They give clear examples of how a careless person fell ill with a fatal disease. Parents require immediate communication from the child if any unusual beliefs arise.

Adults constantly criticize doctors for their illiteracy and irresponsibility. They say that in our country medicine only cripples patients. From early childhood, parents put a non-functional attitude into their children’s heads, the essence of which is: you need to fight for health yourself and you should sound the alarm at the slightest sign of illness. The child absorbs the parent's way of thinking, becoming a suspicious and wary person.

The hypochondriac pays close attention to internal processes. Actively uses self-observation of the body, thus trying to displace interpersonal problems, conflicts in society, and painful loneliness from the sphere of consciousness. Many patients with hypochondriacal depression have difficulties in social interaction and have often been misunderstood and rejected by society. They have a very narrow circle of friends and are burdened by the lack of personal and friendly relationships.

Instead of making efforts to create and maintain meaningful contacts, it is more convenient and easier for hypochondriacs to use “flight into illness,” justifying inactivity by ill health. The only acceptable communication option for patients with hypochondriacal depression is to regularly notify others about painful symptoms.

Many people with hypochondria are self-centered people. They are fixated on themselves and indifferent to the problems of others. They are not accustomed to being interested in the well-being and experiences of loved ones. At the same time, they require people to pay attention and respect for themselves. The spiritual life of selfish people is very poor and boring; often their only “interlocutor” is their own body.
Hypochondriacs are characterized by suspicion, touchiness, and vindictiveness. Patients with hypochondriacal depression are often convinced that those around them are plotting and plotting against them. They try their best to identify ill-wishers and are in anticipation of an enemy attack. At the same time, sizzling feelings of anger and hostility destroy the hypochondriac’s body from the inside, creating physiological symptoms of imaginary diseases.
Hypochondriacal depression often occurs in people with low self-esteem who are prone to self-blame and self-flagellation. Patients with hypochondria on a subconscious level want to be punished. Finding illnesses in oneself is a way to achieve “justice” of life for people who consider themselves unworthy to live in this world.
The cause of the manifestation of hypochondriacal depression is often physiological changes in the body's functioning caused by stress factors. When faced with extreme circumstances, a person, in addition to a psychological shock, is faced with unpleasant sensations from the autonomic nervous system. The naturally determined inability to change the physiological state through the efforts of will greatly frightens an anxious person. A person does not correctly interpret the manifestations of a crisis during VSD, which is why he develops an erroneous understanding of his condition.
Negative personal experience. A long-term illness, forced temporary isolation from society, staying in uncomfortable clinical conditions, unpleasant manipulations, and painful sensations create a fear of recurrence of the disease in the future. A person strives with all his might to prevent such a traumatic experience, so he observes the body in order to catch the first symptoms of ill health. The psyche has a unique ability: the more we listen to the signals of the body, the more persistently we think about illnesses, the sooner signs of illness will develop.
Death or serious illness of a relative. For example, when a loved one who considered himself healthy is given a terrible diagnosis, and he soon dies, spending the last days of his life in agony. Against this background, an anxious, suspicious person has obsessive fears for his health.

Symptoms of hypochondriacal depression

This atypical affective disorder is represented by two groups of symptoms: depressive and hypochondriacal syndrome.

Signs of depression are:

the predominance of a bad mood regardless of actual circumstances;
inability to enjoy enjoyable activities;
loss of interests, indifference to current events;
decreased performance and deterioration of labor results;
the emergence of ideas about the meaninglessness of further life due to poor health that cannot be eliminated.

The motor activity of a person with hypochondriacal depression is characterized by instability and unpredictability of changes in the “poles”. A patient with hypochondria, overwhelmed by obsessive experiences, spends most of his time alone, locked within his apartment. He doesn't want to take any action. The subject feels weak and exhausted, unable even to carry out banal hygienic procedures. He refuses to communicate with friends, answers questions from relatives in monosyllables, and stops performing household functions and work duties.

Suddenly, a person with hypochondria may experience an attack of rage. He begins to reproach his loved ones for not paying enough attention to his condition. He accuses his relatives of not caring for him properly and not wanting to put himself in the position of a sick person. A patient with hypochondria blames his household for being the cause of his ill health. He says that in order to satisfy their benefits, he was forced to work hard, and regular overload undermined his health. He makes claims that due to the need to provide for his spouse and children, he could not fully rest and deprived himself of many benefits, at the same time he does not respond to the fair arguments of his relatives and denies their well-founded arguments. Statements from relatives that he is exaggerating his ill health drive the hypochondriac into a state of rage. In a state of passion, the subject loses control over his actions and can cause serious harm to others.

As a rule, after a fit of rage, a period of “painful insight” occurs. A person with hypochondria is convinced that only he himself must fight to save his life. A person convinced of the presence of an incurable disease makes an appointment with different doctors and insists on using all existing diagnostic methods.

A hypochondriac is never satisfied with the results of the examination; he is convinced that “the donated blood was mixed up with another person’s test,” “the ultrasound machine was not working properly,” “the doctor is not properly qualified,” “the doctor is deliberately not telling the truth.”

In such a situation, hypochondriacal depression can reach the level of delusional disorder. Convinced of the negligence of doctors, a person with hypochondria begins to complain to all possible authorities. He tries to gain public support by tirelessly talking about “stupid doctors,” actively disseminating false information on social networks and becoming a regular visitor to medical forums.

Not receiving the desired reinforcement from society, the hypochondriac begins to heal himself. Convinced of the presence of a certain physical illness, he purchases pharmaceutical drugs and takes pills without observing the dosage. The patient tries on himself all existing folk remedies, visits healers, healers, and magicians. After meaningless energetic activity, the hypochondriac begins a period of loss of strength. He again becomes passive and inhibited.

Signs of hypochondria are:

excessive concern about health;
confidence in the presence of a serious, difficult to diagnose disease;
fears that timely medical care will not be provided in case of a sudden deterioration in health;
panic fear of developing complications of an imaginary illness;
anticipation of the upcoming painful treatment, painful medical procedures;
obsessive thoughts about the hardships and deprivations associated with staying in the hospital;
regular occurrence of annoying “pictures” of one’s own disability;
irrational fear of premature death.

Symptoms of hypochondriacal depression are the appearance of painful, debilitating, unpleasant sensations without clear localization in the body or emanating from internal organs, on the skin. Senestopathies occur in the real absence of physiological defects. The patient indicates that pain “migrates” throughout the body; he feels “heaviness,” “transfusion,” “pressure” in different parts of the body.

In severe cases of hypochondriacal depression, delusional inclusions are determined. The patient assures those around him that his “internal organs have decomposed,” “his body is rotting,” “his intestines are filled with molten liquid,” “a lead ball is inserted into his head.”

The main symptom of hypochondria is distorted interpretation of harmless and non-dangerous physiological phenomena. At the same time, the patient ignores the possibility of a traditional explanation for the unpleasant sensations. For example: with a headache, a person is convinced that he has a brain tumor. He is not satisfied with the explanation that cephalalgia naturally occurs during mental stress. If a person coughs in a dusty, dirty room, he claims that he has tuberculosis. He interprets pain in the stomach as a manifestation of a peptic ulcer, not taking into account that the pain syndrome is provoked by his prolonged fasting.
Typical sign of hypochondria– constant monitoring of health indicators. The patient can measure blood pressure and body temperature every half hour. Once a week he will undergo clinical blood and urine tests. Convinced of the pathology of some organ, the hypochondriac will perform an ultrasound using not one, but five machines. The hypochondriac monitors the condition of the mouth, hair and nails. Records frequency of urination and bowel movements.
With hypochondriacal depression, sleep disorders naturally occur. In the evening, the patient is burdened by the fact that he cannot fall asleep. At the same time, worrying about lack of sleep does more harm than the actual fact of insomnia. A hypochondriac may experience panic fear before going to bed, because he is sure that some dangerous attack will happen at night. Having fallen asleep, he has nightmares where he sees himself confined to a wheelchair or on his deathbed.
A symptom of hypochondriacal depression is a change in eating behavior. Most often, the patient loses his appetite, eats little and loses a lot of weight. At the same time, a person interprets weight loss as a sign of a fatal disease.

Treatment methods for hypochondriacal depression

Orthodox medicine and traditional psychotherapy do not yet have the resources to rid the patient of all manifestations of hypochondriacal depression. Treatment of atypical affective disorder is a difficult task, since the disease is protracted, often chronic, with a high risk of relapse. Therapy of hypochondriacal depression is complicated by the fact that patients associate mental suffering with an imaginary somatic illness, and try to find arguments confirming the correctness of their assumptions. Drug treatment of patients with hypochondria is often contraindicated, and when carried out it brings the opposite effect - a deterioration in the person’s well-being. This is due to the fact that prescribing pharmacological agents to a hypochondriacal patient strengthens his confidence in the existence of physiological pathology. Therefore, the leading role in the treatment of hypochondria is given to psychological support and psychotherapy.

The choice of individual methods of psychotherapy is justified by the fact that the hypochondriacal components of depression often serve as a way to hide and repress unresolved personal conflicts. A person who is unable to admit the existence of disharmony between the inner world and the environment uses imaginary problems in the body as a defense mechanism to shift the vector of attention from the need to solve real problems to thinking about imaginary diseases.

How to treat hypochondria? The main condition for overcoming hypochondriacal depression and preventing the return of the disease is to recognize the existence of a problem in the psycho-emotional sphere and be ready to transform the inner world. It is this step that often becomes difficult and impossible for hypochondriacs. Psychotherapists often encounter the fact that patients with a confirmed diagnosis refuse the doctor’s attempts to provide assistance and do not want to consider the painful condition from a psychological perspective. Many patients with hypochondriacal depression are obsessed with finding out if they have an illness and finding a doctor who could confirm this illness. Often, hints from a psychologist and psychiatrist about the need to use psychotherapeutic methods of treatment are regarded by patients as the doctor’s inability to understand them and a deliberate reluctance to prescribe “miracle” pills. Therefore, the primary action of the doctor is to interest the patient in the state of his inner world, stimulate him to work on himself and motivate him to transform his worldview.
How to get rid of hypochondriacal depression? It is necessary to explore personal history and establish the circumstances of the traumatic experience. During psychotherapeutic sessions, the doctor helps the patient to objectively assess the conditions of his growing up, analyzing the system of rewards and punishments adopted in the family. The psychotherapist recommends that the hypochondriac think about whether the attitudes learned from his parents are benefiting him. The doctor points out that the existing stereotypical way of perceiving internal and external processes interferes with a full life, lowers a person’s self-esteem, and impedes personal growth. The doctor motivates the patient to make adjustments to the value system formed in childhood, which ultimately frees the mind from obsessive ideas about one’s own ill health.
How to get rid of hypochondria on your own? To gain emotional and psychological stability and eliminate irrational beliefs, a person must live in harmony with himself and the world around him. It is necessary to learn to perceive events in life correctly, objectively, and not distortedly. You should not focus on minor problems of the body and tiny negative phenomena of everyday life. We need to stop “making mountains out of molehills,” turning ordinary problems into disasters.
How to deal with hypochondria? A person needs to choose priority life goals and understand exactly how he wants to live. If the acceptable conditions of existence for a subject are illness, then he will never get rid of hypochondriacal experiences. When an individual chooses the goal of good mental and physical health, he acts to avoid harm to his body.
How to cope with hypochondria? An important rule is that you need to stop living in the past and focus on the future. We need to stop reliving past failures, grievances, episodes of illness over and over again, and even more so transferring past adversities to the present. The hypochondriac must learn not to allow a certain problem from the past to spill over into his present.

If psychotherapeutic treatment does not show the desired effect, the doctor's efforts are aimed at minimizing hypochondriacal fears and depressive symptoms. In case of severe, persistent hypochondria, the patient is prescribed powerful pharmacological agents. The basis of drug treatment is tricyclic antidepressants with the active ingredient amitriptyline. For severe behavioral disorders, this drug is combined with antipsychotics. Amitriptyline can also be used in combination with dibenzopyrazinazepine derivatives, for example: mianserin.

It is advisable to treat hypochondriacal depression in a hospital setting. After discharge from the hospital, the person should continue treatment with antidepressants at home. You should not change the treatment regimen or dosage of the medication yourself. A hypochondriac is recommended to be examined by a psychiatrist at least once every three months. It must be remembered that recovery involves not only medical efforts and taking medications, it is, first of all, painstaking work on oneself, the care and attention of the patient’s relatives.

In ancient times, hypochondria was associated with problems in the upper abdomen, which is why the disease received its modern name, which is translated from Greek as “in the hypochondrium.”

Subsequently, the connection between hypochondria and bodily ailments was lost, but the name remained.

Today, a hypochondriac is a person who is overly concerned about his own health and the presence of non-existent diseases.

Some consider hypochondria a simulation, while hypochondriacal syndrome is an independent illness. To understand what hypochondria is, the symptoms and treatment of this disease, it is necessary to find out the causes of its occurrence.

Hypochondria refers to a person’s belief that he or she has a particular disease. Typically, the patient makes one or more diagnoses and continues to believe in them, despite the results of examinations and the opinions of specialists. Most often, hypochondriacs “find” themselves with oncology, problems with the gastrointestinal tract and heart, and diseases of the genital organs.

The variety of manifestations of hypochondria, the inability to consider it a full-fledged mental illness - all this does not allow us to identify the exact cause of the disease. At the same time, physiologists were able to discover several processes that may be “to blame” for the onset of the disease.

These include:

disturbances in the functioning of the cerebral cortex;
first manifestation of delusional disorders;
incorrect perception by the cerebral cortex of impulses received from internal organs;
dissonance between the cortex and the functioning of the autonomic nervous system.

As a rule, hypochondria appears as a result of mental changes that arise against the background of a certain disease.

Most often, excessive suspiciousness accompanies neuroses - specific forms of mental illnesses.

According to doctors, hypochondriacal syndrome can develop against the background of organic pathology - neoplasms, injuries and inflammatory processes in the brain. As for age, the disease can appear at any time: in childhood or old age. It is worth noting here that hypochondria is a sure companion of senile dementia or dementia. In childhood, the disease appears only in the presence of a genetic predisposition.

Stress and anxiety arising from fears, family troubles and problems at work can provoke the development of hypochondriacal syndrome.

Risk group

Cholerics - very emotional people - are most susceptible to hypochondria.

Most often, the disease affects suggestible individuals exposed to the influence of the media. A typical hypochondriac is an intelligent and well-read person who watches programs about health and reads articles on medical topics.

Based on what he has read and viewed, the hypochondriac discovers certain symptoms and “makes” diagnoses that no doctor can challenge.

Typically, such patients undergo examinations in clinics for years, which, for known reasons, do not reveal anything. The excessive complaints of hypochondriacs can be justified by the fact that they cannot independently control the manifestations of this syndrome (this is the main difference between hypochondria and fears for their own health).

Typically, hypochondriacs are found among pensioners and young people who are subject to the influence of others and absorb negative information. A separate category includes students of medical institutions who, during their studies, have to pass through information about various diseases. At the same time, hypochondria can appear in a representative of any gender.

Patients at risk are:

with neuroses and psychoses;
with the presence of delusional ideas;
elderly people who refuse to acknowledge their old age;
with problems in intimate life and communication.

Today on TV there are constantly advertisements for medicines and programs telling people about the emergence of new diseases. Adding fuel to the fire are medical information sites whose pages list the symptoms of various diseases. All this contributes to the development of hypochondria in both pensioners and young people.

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Symptoms

Hidden hypochondria can appear in every person who fears for their health.

However, for a real hypochondriac, experiences develop into real mania.

True hypochondria occurs in the form of sensory or ideogenic reactions. In the first case, the patient experiences real painful sensations, which his consciousness hypertrophies into voluminous complaints that do not correspond to the real state of health.

In the second case, the patient forms false ideas about painful sensations. Moreover, the patient can bring himself to such a state that real problems arise in his body.

Interestingly, the appearance of painful sensations can be triggered by any everyday activity, from eating to going to the toilet. In this case, the development of the disease is facilitated by excessive fixation on sensations, which contributes to the formation of complaints and their intensification.

A typical hypochondriac is constantly in a state of anxiety. All his conversations boil down to complaints, which begins to irritate those close to him. Over time, the patient develops multiple complaints, which are called senestopathies. These include such “symptoms” as difficulty breathing, a lump in the throat, burning of the skin, pain in the limbs, intestines, chest, etc. There are cases when hypochondriacal syndrome was transferred to others.

Separate types of hypochondria are “hypochondria of children” and “hypochondria of parents” - conditions in which people experience painful experiences about their loved ones.

Communication with patients allows us to identify two symptom complexes: obsessive and asthenic.

In the first case, painful sensations and constant obsessive complaints predominate, and in the second case, complaints of severe weakness predominate. Some patients experience panic attacks due to self-hypnosis.

Lack of treatment can cause the development of hypochondriacal personality shift. In this case, the fictitious signs of the disease worsen, and the person enters a certain rhythm of life and falls out of society.

Characteristic features of this condition are visits to doctors of various specialties, requests for surgical operations, and the desire to get into prestigious medical institutions.

Diagnostics

To diagnose hypochondria, you must first make sure that there are no real diseases. For this purpose, standard studies are carried out: analysis of stool, blood and urine, ultrasound examination, etc. If the examination excludes the presence of health problems, the patient is transferred to the hands of a psychotherapist or psychiatrist.

There are cases when it was not the hypochondriacs themselves who turned to doctors, but those around them, tired of the constant complaints of a loved one, their suspiciousness and anxiety.

Treatment of mental disorder

When choosing a program for the treatment of a hypochondriac, it is necessary to take into account the main cause of this disease.

If the patient is completely adequate, treatment is carried out using psychotherapy methods.

This includes group, rational, individual psychotherapy, social therapy and hypnotic influence.

If the doctor sees the need for medication correction, antidepressants and tranquilizers can be used on the patient.

Therapy also involves the use of methods such as aesthetic therapy and reflexology.

When treating a hypochondriac, it is necessary to correct disturbances in the cerebral cortex, to establish connections between the autonomic part of the nervous system and the cortex. If the disease is a companion to schizophrenia, it may be necessary to use powerful antipsychotics and place the patient in a hospital. In any case, treatment is based on the work of a psychotherapist/psychiatrist and the support of loved ones.

To prevent illness, people who are emotional and susceptible to other people's influence are recommended to visit a psychologist, undergo preventive therapy, and engage in auto-training. Physical activity, communication with people, travel, and caring for pets have proven themselves well in preventing the syndrome. To avoid re-development of the disease, you should avoid watching medical programs, specialized websites and reading health magazines.

Thus, hypochondria is a disease that can significantly complicate the life of any person. If a loved one develops signs of hypochondria, you need to encourage them to see a doctor. Otherwise, the disease may develop into a personality shift, which will reduce the chances of a full recovery.

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