Scare of Disease

Constant or recurring fear of disease can be a major disease by itself. Some patients are so terrified of falling ill that they spend the major part of their lives in the disabling habit of visiting doctors and undergoing tests to ensure they are free of disease.

This phenomenon is called Hypochondriasis,and is characterized by an excessive preoccupancy or worry about having a serious illness.

 Hypochondriacs become unduly alarmed about any physical symptoms they detect, no matter how minor they may be. They are convinced that they have or are about to be diagnosed with a serious illness.Even sounds produced by organs in the body, such as those made by the intestines, seem like symptoms of a very serious illness.Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, their concerns are far in excess of what is appropriate for the level of disease.

This intense phobia or anxiety about developing a disease often originates from the nightmarish experience of having watched a close relative who has suffered a similar illness. Cancer phobia is one such.  It is not uncommon in my practice, to see a healthy young person demanding and undergoing several ultrasounds, endoscopic examinations, and even CT scans, and going through that cycle again and again, driven through a constant fear of developing cancer.

Amit, a 45 year old employee of a multi-national company, consulted me with complaints of irregular movement of bowels for 10 years. His work entailed frequent travel, eating out and late untimely meals. He had undergone 3 colonoscopy examinations, the last being as recent as 6 months. My advice to regulate his diet and increase the intake of fibre did not satisfy him. He requested another colonoscopy.

On probing I discovered that he had an intense fear of colon cancer. This phobia had its origin in his middle school days, when his grandfather had complained of bowel symptoms and had been diagnosed with colon cancer. In the following months, he had witnessed the relentless deterioration in his condition culminating in a painful death.

Hypochondriasis is hyper-vigilance of the body's situation and a tendency to react to the initial perceptions in a negative manner that is further debilitating. Numerous intrusive thoughts and physical sensations push them to check with family, friends, and physicians. Other people are so afraid of illness that they will avoid medical professionals. Yet others live in despair and depression, certain that they have a life-threatening disease and no physician can help them.

Hypochondriacs often suffer from anxiety or depression.  Another problem, as was with Amit, was that the reassuring effect of a negative investigation gets shorter and shorter as they go through cycles of intrusive thoughts followed by compulsive checking, a form of obsessive compulsive disorder.

Amit improved with counselling, life style changes and mild medications to tackle his anxiety.

As published in HT City ( Hindustan Times) dated 10 March, 2013.