Hypochondria: When the Fear of Being Ill Becomes Real

Hypochondria or Illness Anxiety Disorder (as the DSM-5 calls it) is one of the most common reasons for consultation among psychotherapy patients. This disorder refers to people who live in constant anxiety that’s related to the fear of suffering from an illness.

Hypochondriacs tend to really fear the diseases that imply a progressive, long-term deterioration. Some examples are cancer, AIDS, and fibromyalgia. However, there are also many hypochondriacs who fear heart or respiratory diseases, which imply a faster, more severe evolution.

One of the biggest characteristics of hypochondria is the fear of diseases that gradually deteriorate the body. Contrarily, the fear of faster illnesses such as heart attacks or suffocation is more characteristic of a panic disorder. No matter the illness that the hypochondriac dreads, their feelings, sensations, and their actions will end up “making them sick” in the long run (psychologically speaking).

Although the main components of hypochondria are the fear of illnesses and constantly aiming at getting a diagnosis (medical tests, research, etc.), there are more psychological factors that influence its development, intensity, and duration.

In this article, we’ll explain how hypochondriacs’ irrational fear becomes a reality, as a result of exhaustively searching for control over their own body, their intolerance to uncertainty, and inadequate management of fear.

How the fear of being ill attracts the actual illness

In order for an illness-scared person to develop hypochondria, several factors are necessary. Among the most characteristic psychological factors that end up making the fear of becoming ill a reality, you can find unreal expectations and preconceived ideas of how the human body should work. 

The role that unreal expectations, self-demand, and the need for control play in the development of hypochondria

When someone has unrealistic and unfounded expectations of how their body should feel each day, any normal physical sensation (like a contraction or a nonspecific pain) becomes a warning sign that indicates that something’s wrong. 

Even though constant pain and discomfort are signs (If I find myself suffering from pain every day, then it might be true. Something must be wrong), people with an irrational fear of illnesses interpret said signs as clear indicators of a disease.

The fear of being ill becomes greater if you have a mental scheme that says there’s something wrong with you and that you might be sick because your body feels a certain type of way. Hypochondria is easier to develop when having a preconceived perception of how the body should be. This type of reasoning is pretty common among people who have a low tolerance to obnoxious physical sensations. These people think their body should always stay the same (no new scars/blemishes), pain-free, and overall “normal”.

Although physical discomfort is normal and part of being alive (our body is an organism in constant change), if you pay too much attention to it, you’ll end up amplifying it. This is explained by the Gate Control Theory, which has scientifically proven that attending to a sensation in the body amplifies it, making it more intense and long-lasting. Therefore, distraction techniques are some of the keys to success when it comes to the psychological treatment of hypochondria.

Also, a high level of self-demandingness regarding the body and the disappearance of discomfort must be present. Not only is it enough to fear the disease and not stand the physical disturbances, but there must be a high level of self-demand and search for control for hypochondria to exist. 

Avoiding being physically ill makes you psychologically ill

Not tolerating disturbing physical sensations, along with demanding the body to stop feeling them and overly controlling what happens to it, makes people end up psychologically ill, since it’s difficult to attend two things at once. If someone’s monitoring what hurts, how much it hurts, and how it’s affecting them, that person is wasting their time trying to control the uncontrollable: their organism’s normal way of functioning.

When the physical sensations become greater (thanks to the amount of attention paid to them), the person starts getting more and more anxious and they start consulting doctors or going online in order to know what hurts or why they feel that way. The online information seeking process is very dangerous. It might give the person information they could end up using against their body, also known as self-fulfilling prophecy.

Getting a negative diagnosis (there’s no real illness in hypochondria) will make the person feel temporarily at peace. However, it’s possible that this will make them become dependent on professionals’ opinions. When hypochondriacs are put in the position of a “sick person”, they start seeing themselves as such, which isn’t true.

How can we correctly manage the fear of being sick?

The mind is very powerful and it often “chooses” the wrong path very confidently. Doubting what professionals tell you and insisting you’re still sick even though doctors tell you otherwise is not the right way to manage the way you feel. When it comes to hypochondria, the person needs to realize that exhaustively looking for medical proof is making them live in fear – they have to assume they’re in the wrong even if they’re convinced that what they feel is real.

The fear of being sick is normal and adaptative. This fear is helpful and incites us to take safety measures. However, looking for profound information about the alleged symptoms isn’t the correct way to manage said fear. Firstly, they must stop needing to control every physical sensation and getting medical tests, so they leave the “sick person” role.

Secondly, they need to understand that the problem isn’t the actual illness, but the intolerance to the fear of it, which gets bigger every time they do something to appease it. It’s important to realize that fear isn’t the problem. The actual problem is the way the person manages their fear. This is what develops hypochondria.

Working with your fear is a good way to learn how to manage it. You should research why it occurs, what can be done about it, and also try to accept it. Working with a psychologist is an excellent way to try to learn to manage your fears, including the fear of being ill.

Not managing this fear correctly means you’ll most likely end up developing a psychological illness.