Mental Health Disorders – The LonePack Blog

Silent Bystander of Dementia

This is not a post about how to take care of somebody with dementia. It’s not about what you can do if you are taking care of a loved one. It’s not even about the experience. This is but a raw diary of emotions, watching from the sidelines, a mute spectator. An outpouring of the things I feel and wish I could share with somebody but I’m afraid to.

Trigger warning: Demetia, memory loss

Dementia is a disease that leads to a slow loss of memory and the ability to function normally. It’s hard to catch at first, hard to tell apart from usual forgetfulness. But at some point, it hits you hard. When you struggle to convince your loved one of something that you know as sure as day, but they refuse to accept. That was when it dawned on me that something was wrong. It took a while to get a diagnosis. Getting them to a doctor was an ordeal. Even now, there is no acceptance that there is something wrong.

As things went on, there were several realizations that were shattering. We all have our raw emotions, thoughts, prejudices all inside our heads. But those are filtered out and thought through before we speak, right? It is those very filters that also get removed when dementia strikes. You hear and see things that you would never have before. Irrespective of surroundings or the people around you. The worst qualities in the person get exacerbated. A stunning realization hits you when you hear what really goes on in their minds. That was probably always there and just was never expressed? Or maybe it was something else that was also picked up sub consciously due to the disease? You never really know. But a lot of those things can disgust and shame you. There is no better way to put it. You feel like the past has been a lie, wonder how you had never seen this side of them before. The paradox being that you still need to care for them, while slowly losing some of the love and respect. This makes the days harder as you go along.

Dementia could manifest with a lot of impatience and aggression from what I have seen. They become very demanding and irrational, be it for information, food or anything else they need. This takes an enormous toll on the care givers. Finding time for yourself, to switch off and do what you feel like becomes almost impossible. Even small delays or oversight can lead to a lot of aggression from them. Constantly nudging, pushing and bickering you, over and over again. They would not remember how many times they have said the same thing. They just keep going on and on. Your frustration is met with puzzlement, confusion and sometimes plain anger. There is no easy solution here. You may need to build up your patience and not show what you’re feeling. I had become really adept at hiding what I really feel and stoically put up a straight face.

The biggest source of frustration when dealing with a disease like this, is that there is no end in sight. Recovery and getting better are never options. The best you can hope for is that things don’t get worse. Even that means your current scenario would go on. You may desperately wish for the life before, when things had some semblance of normal. But that is but a memory, something that lies in your head, something you can dream of and yearn for but never get again. You move on, with your head down, hoping for the best, hopefully today might be a good day?

Through my experiences, I have realized something. During times like these, it is really important that you take care of yourself physically and mentally. Caring for, or just living with, someone who has dementia can be mentally very exhausting. You must be aware of what that is doing to your own health. Then, see what you can do to counter that. Make sure you have all your meals and check on your health regularly. The toll on your mental health can be even more severe. But it may not be immediately evident. You need to be really conscious and make an effort to take care of yourself and heal. If you have really disturbing thoughts and feelings, it is completely ok and understandable. Give yourself permission to feel that way, without guilt. Acknowledge what you’re feeling and process the emotions. Talk to people you trust, take some time to have someone else take your place and step out. Do something that give you joy and happiness. You need that, you deserve that!

We are all fighting battles, this particular one, watching a loved one struggle with dementia is devastating and difficult. Take care of yourselves as you power through it!

Mindfulness Techniques to Fight Self Harm

Trigger Warning: Mentions of self-harm, depression, suicide

Self-harm is a taboo topic, even in today’s world of acceptance of Pride and no prejudices. When we hear that someone self-harms, 70% of the time, the first reaction we’d have is one of horror. Not even disbelief, pity or anything else, just plain horror, followed by a poor attempt to empathize. Very few of us try to help the person out, mainly because we don’t understand what they’re going through. But that’s just our conditioning. We’ve been taught to avoid that which makes us uncomfortable and go with the crowd. It’s time to have a breakthrough.

What is self-harm?

Self-harm or self-injury means hurting oneself intentionally. Self-harm is not a mental health illness in itself. Rather, it displays an inability of the person affected to cope with a certain illness, most often something like bipolar disorder or borderline personality disorder.

To the people who self-harm: know this. You are not going through this alone. Self-harm is not something you have to live with all your life, and there are loads of people to narrate their experiences and support you. You need only reach out to seek help.

Why do people self-harm?

There is no scientific answer to this. Some people say they do it to relieve stress. Some others say they do it because the physical pain is better than the mental pain. It is a sign of great emotional distress, and the person is often engulfed by feelings of shame, frustration, guilt, and pain. Some common reasons that people reported include:

Relapse from alcohol or drug use
Anxiety
Depression
Suicidal thoughts
Low self-esteem
Peer pressure
Bullying
Family issues

But there is no weakness in asking for help. In fact, it takes great courage to open up and talk about your feelings. If you do feel overwhelmed by these negative feelings, please, reach out to someone.

Who are the people most prone to self-harm?

Though self harm is something that can affect anyone, this practice is most commonly found in young adults and adolescents, starting especially from one’s teenage years. People from unstable homes or those who have experienced trauma, neglect, and/or abuse in their early lives are also prone to self-harm.

If you are a loved one of a person who self-harms, it is important to note that self-harm is not a cry of help or a demand for attention. But this does not mean that people who self-harm don’t need care and compassion. When someone opens up about their pain, chances are that it’s not your opinion they seek; it’s your acceptance. A simple smile goes a long way!

How can we fight the urge to self-harm?

While there are no tablets or tonics for it, psychologists and therapists all over the world do commonly recommend some grounding techniques and on-the-spot hacks that can help a person relieve their urge to self-harm.

Some of the most popular grounding techniques prescribed by therapists are:

Progressive Muscle Relaxation: This is a very simple deep-relaxation technique prescribed to reduce anxiety, stress, insomnia, and many other illnesses. Here is how it works:

While inhaling, clench/contract one type of muscle in your body. For example, your biceps, for 5-10 seconds, and then when you exhale, unclench it. After relaxing for 10 seconds, move on to another group of muscles, and repeat the same.

TIP: Try to visualize the contraction and releasing of tension of the muscles in your body, so that it adds more focus to the activity. Also try visualizing all the stress and pain leaving your body with each release of tension. That helps a lot!

5-4-3-2-1 Technique: This is an interesting alternative focus technique. Look around your surroundings and answer the following questions:

What are 5 things you see (in a particular colour)?
What are 4 things you feel?
What are 3 things you hear?
What are 2 things you smell?
What is 1 thing you taste?

Other informal mindfulness/grounding techniques you can try include:

Mental Grounding exercises:

i) Describe an everyday activity, like brushing your teeth, in detail, to yourself
ii) Try to think of as many things in one category, like dogs or plants or musicians, as you can! Tests your knowledge, too.
iii) Count 1 to 100, but spell out the alphabets. O…N…E, T…W…O, etc.

Physical Grounding exercises:

i) Run warm or cool water down the place where you usually self-harm
ii) Alternatively, try to hold an ice cube in your hand for as long as you can
iii) Jump up and down

You can also carry a grounding object with you, a small pen, a rock, a ring, a marble…anything you can touch and take comfort from when you feel frustrated or anxious or stressed. As with the Progressive Muscle Relaxation technique, you can also visualize your object drawing the negative energy away from you, in order for it to be more effective!

Do you feel like you have no one who listens to you? Do you want someone to vent to? Talk to a LonePack Buddy today!

Dissociative Identity Disorder: An Overview

What is DID?

Dissociative Identity Disorder (DID), also known as Multiple Personality Disorder (MPD), is a severe manifestation of the group of psychological disorders known as Dissociation. DID is characterized by an individual experiencing a splitting or fragmenting of their original personality into two or more different ones.

This leads to a lack of clarity in a person’s thought, emotions, memories and actions.

What causes it?

Extensive research by organisations such as the American Psychiatric Association shows that DID is more often than not caused by severe emotional, physical or environmental trauma in a person’s past. These causes include physical, sexual, and mental abuse, the loss of a loved one, and life-threatening or near-death incidents, usually occurring around the age of 6.

Who does it affect?

DID occurs very rarely; studies show that it affects 0.1% to 1% of the general population. But when it does occur, there is no age bracket or cases of medical history within which patients fall. DID can affect anyone, living at any place, of any age, or with any background. The onset is commonly observed to be during childhood, but the symptoms may take years to manifest, making it very difficult to diagnose and treat the individuals.

However, it is also commonly agreed-upon by medical professionals that females are more susceptible to this disorder than men.

How can you recognize it?

The following symptoms have been recognized and grouped among individuals with DID:

Eating and Sleeping disturbances
Amnesia
Hallucinations
Self-injurious behavior
Prolonged headaches and migraines due to irregular sleep patterns

One other symptom that is observed is an alternation of personalities; a radical shift in thoughts, behavior and emotions, due to the emergence of the different ‘alters’.

Methods of Treatment

Psychotherapy: Also called ‘talk therapy’, it is designed to work through whatever triggers the DID.
Hypnotherapy: Clinical hypnosis can be used to help the person access and deal with repressed memories and feelings that are potential causes of DID.

Another effective form of therapy is encouraging the affected individual to indulge in the creative arts, music, or exercise; anything that can help to reduce stress in a positive way.

Misconceptions about DID

Multiple personality disorder, as DID is more commonly known, has been featured time and again in novels, television series, and movies, the most famous of them being the character of Gollum in JRR Tolkien’s The Lord of the Rings series, and Alfred Hitchcock’s blockbuster hit, Psycho (1960). While it makes a good premise for pop culture, the severity of this mental illness is often disregarded and misunderstood.

Though most fictitious characterizations show one or more of the personalities as being ‘good’ or ‘soft’, and some as being ‘violent’ or ‘psychopathic’, in reality, one can never predict the nature of the ‘alters’. So it is best to seek professional help when dealing with a person with DID.

How can I help?

You can help the patient by recognizing the symptoms at the right time and taking immediate action. DID is a very serious condition that needs to be treated as soon as it is diagnosed.

You can find out more here:

https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders

https://www.psychologytoday.com/intl/conditions/dissociative-identity-disorder-multiple-personality-disorder

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders

Schizophrenia – An overview

What is Schizophrenia?

Schizophrenia is a chronic and severe mental health disorder that is characterized by distortions in thinking, perceptions, emotions, sense of self and behavior. Common experiences include hallucinations and delusions.

These experiences may be difficult to describe to friends and family members, yet seem completely real to the affected person. This may make it difficult for others to understand that these are the effects of the illness.

Who is susceptible?

Schizophrenia affects an estimated 20 million people worldwide. The disorder is relatively infrequent, about 1 in 2000 people are affected. Schizophrenia also commonly starts earlier in men.

People with Schizophrenia are 2-3 times more likely to die early than the general population. The illness starts mainly in young people, ages 15 to 30, however it may start at other ages as well.

Why is someone affected by it?

It is widely thought that a combination of genetics, environmental factors such as stress or even psychological factors may contribute to Schizophrenia.

Schizophrenia can be inherited but in most cases, children of Schizophrenic patients do not develop the illness. Stress can exacerbate the illness or cause a relapse for recovering patients.

How is it treated?

Schizophrenia is effectively treated by a combination of medicines and psycho-social support. As a family member or friend you can help by,

Understanding the illness better
Encouraging the patient to access treatment
Encouraging the patient to get back to social roles as much as possible
Taking care of your personal health and mental well-being
Feeling confident to deal with the stigma and discrimination that you and the patient might experience

However, most patients with chronic Schizophrenia lack access to treatment. About 90 percent of untreated Schizophrenic cases are from low and middle income countries. There is also clear evidence that out-dated mental hospital treatment is not effective and transfer of care from mental health institutions to the community needs to be prioritized.

Where can you head to find out more?

This article has been derived almost exclusively from the WHO and SCARF websites. The following pieces can further your understanding of Schizophrenia.

Facts:

https://www.who.int/news-room/fact-sheets/detail/schizophrenia

https://www.nhp.gov.in/disease/neurological/schizophrenia

Articles on Schizophrenia by NGOs:

https://www.whiteswanfoundation.org/search-result/?q=schizophrenia&tag=True

https://www.scarfindia.org/scarf-media/2019/08/what-is-schizophrenia.pdf

Opinion articles on Schizophrenia:

https://www.thehindu.com/sci-tech/health/people-with-schizophrenia-open-up-about-the-myths-and-assumptions-surrounding-the-condition/article27186122.ece

https://theconversation.com/the-concept-of-schizophrenia-is-coming-to-an-end-heres-why-82775

Report on status of mental health in India:

https://timesofindia.indiatimes.com/india/lancet-report-mental-health-disorders-on-the-rise-in-india/articleshow/66156376.cms

High Functioning yet Dysfunctional

Some of the worst times for me was when I was 17 and felt extremely confused and left out about what I was feeling. The world seemed too big and too heavy on my shoulders and I was feeling downright miserable. My anxiety skyrocketed to the point where it manifested as physical pains and I was pretty sure that there had to be a name to call out to all the helplessness and sadness I was feeling. But I was very young and unexposed to the world of mental health, so as any other person would do, I took to Google. I put in all the things I was feeling and thought that I’d arrive at some sort of an idea as to what was going on with me. None of the people around me looked like they were suffering like I did and I didn’t have the courage to talk to it to my parents. But then my confusion increased manifold as I stared at the screen; all my signs led to Depression but I fit none of the “symptoms”. I wasn’t losing appetite, my sleep pattern didn’t change drastically yet I knew I was feeling miserable. And this prompted me to start doing more research into what I was feeling and if anyone else out there was feeling the same as I yet didn’t fit into the box of “depression and anxiety symptoms”. And a revelation was made; High-Functioning Disorders.

Let me digress for a bit. You see, the students and working professionals that make a majority of people who take their lives seem to fit a certain profile. Most of them were academically well off and seemed to have a normal relationship with their friends and family. No visible symptoms of depression or anxiety could be visibly seen and they didn’t look any different, their daily activities weren’t affected in any way, and all of them seemed normal and as they would every other day. Their suicides came as a big, unpredictable blow to their friends and family since to them, literally, nothing pointed to their loved one suffering from any kind of mental health issues or, so they thought.

This observation or the lack of it reveals a darker truth. Most of us aren’t aware of a class of disorders that has now become to be known as “high-functioning” disorders. It is a recent development in the field of psychology and one that has come in a much-needed time.

For those who don’t know what they are, High-functioning disorders are the same as any other mental health disorder that one may suffer from but possess a darker trait, they do not affect your daily life. Psychologists are more worried about the people who suffer from this class of disorders since they are extremely difficult to diagnose. People with high-functioning versions of disorders such as anxiety and depression will not seem any different from a person without the disorders, superficially. They will continue with their normal lives as if nothing affects them at all, their body and brain cope very well with their conditions and as a result, their work and academic lives remain undisturbed. They’re social and active, all smiles and whatnot but on the inside, they’re still suffering and unable reach out to anyone.

[Image source: Betterhelp]

For someone who is suffering and looks to the internet first to arrive at some kind of a self-diagnosis, it really doesn’t help when none of the mental health disorders’ so-called “symptoms” fit them. Not many articles relating to these high functioning forms of disorders are present even on the internet, which is one of, if not the largest communicative space globally. And hence understandably, not much awareness is present with regard to these issues.

However, people, one by one, are now coming forward to share their experiences with high-functioning disorders. This is an article written by a woman who suffers from High-Functioning Anxiety and Depression – https://themighty.com/2017/11/high-functioning-anxiety-depression-looks-like/

If you are suffering from not being the best version of yourself and doubt that it could be anxiety or depression or any other issues but experience none of the visible giveaways, do consult a psychologist.

It is never easy to battle these on your own and you shouldn’t either. The world is here to listen and to help. And if you doubt that one of your loved ones is suffering but do not know what to do since they do seem normal to everyone else, sit them down and talk to them. Ask them if they’re doing okay and if not, tell them that you’re there to help them get through this.

Everyone needs a hand sometimes. You could end up saving a life from further suffering because of the lack of awareness. Do your bit and spread the word.

Living a life where every moment is filled with suspicion and doubt – A review of Paranoid Personality Disorder

Paranoid Personality Disorder(PPD) belongs to the class of Personality Disorders. Paranoia involves extreme levels of distrust and suspicion. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers and they think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence. Some other common recurrent beliefs include beliefs that someone is plotting against them, they are being watched closely, everyone is conspiring against them among others.

Following is a case study of a Paranoid patient:

A woman believed, without cause, that her neighbours were harassing her by allowing their young children to make loud noise outside her apartment door. Rather than asking the neighbours to be more considerate, she stopped speaking to them and began a campaign of unceasingly antagonistic behaviour: giving them “dirty looks,” pushing past them aggressively in the hallway, slamming doors, and behaving rudely toward their visitors. After over a year had passed, when the neighbours finally confronted her about her behaviour, she accused them of purposely harassing her. “Everyone knows that these doors are paper thin,” she said, “and that I can hear everything that goes on in the hallway. You are doing it deliberately.” Nothing that the neighbours said could convince her otherwise. Despite their attempts to be more considerate about the noise outside her apartment, she continued to behave in a rude and aggressive manner toward them. Neighbours and visitors commented that the woman appeared tense and angry. Her face looked like a hard mask. She was rarely seen smiling and she walked around the neighbourhood wearing dark sunglasses, even on cloudy days. She was often seen yelling at her children, behaviour that had earned her the nickname “the screamer” among the parents at her children’s school. She had forced her children to change schools several times within the same district because she was dissatisfied with the education they were receiving. An unstated reason, perhaps, was that she had alienated so many other parents. She worked at home during the day at a job that required her to have little contact with other people. She had few social contacts, and in conversation was often perceived to be sarcastic and hypercritical.

ppd1

[Image Courtesy: https://infograph.venngage.com/p/63184/paranoid-personality-disorder]

According to the DSM-V, PPD is characterized by a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts. To qualify for a diagnosis, the patient must meet at least four out of the following criteria:

Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.
Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against them.
Reads hidden demeaning or threatening meanings into benign remarks or events.
Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
Perceives attacks on their character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

Many of these symptoms are clearly reflected in the case study.

PPD first emerged as a cluster of symptoms for Schizophrenia. It was in 1921, that Kraepelin first proposed three distinct presentations of paranoia that resembled the diagnosis of schizophrenia, delusional disorder, and paranoid personality disorder. However, for a very long time, PPD was considered only as a cluster of symptoms for schizophrenia. Paranoid personality disorder first appeared in the DSM-III in 1980. The major problem facing the study of this disorder was the initial neglect of the scientists. Secondly, not many patients would agree to participate in research studies. Yet, in reality, PPD is a severe, relatively common clinical problem that is difficult to treat. Fortunately, our understanding of PPD has improved as research has accrued.

But the question is, why is PPD important? One of the major reasons is because PPD heavily dictates the adverse outcomes in the treatment of personality disordered patients. Persons with PPD, when not disabled, stop working earlier than non-personality disordered individuals. In clinical populations, it is one of the strongest predictors of aggressive behaviour. PPD is also associated with violence and stalking as well as excessive litigation. It also has serious implications on the individual’s mental well-being often resulting in depression and has less likeability to be cured despite intense psychiatric treatment.

There are multiple risk factors involved in the development of PPD as no direct biological causations have been attributed. Childhood trauma has consistently been identified as a risk factor for PPD. Studies have shown that childhood emotional neglect predicted PPD symptom levels in adolescence and early adulthood. In adolescence, PPD has been cross-sectionally associated with elevated physical abuse in childhood and adolescence, but not sexual abuse. In a study of psychiatric adult outpatients, PPD was found associated with both sexual and physical abuse. Although these studies have focused on chronic trauma from caregivers, acute physical trauma in the form of childhood burn injury has also found to be a risk factor for adult PPD traits.

What can be some effective measures for treating PPD?

In a case report titled, “Paranoid Personality Disorder”, medics Amy Vyas and Madiha Khan have outlined certain major points with regards to treating PPD.

Because paranoid personality disorder patients are unlikely to seek or remain in psychiatric care, relevant treatments for this disorder have received less research relative to those of similarly prevalent personality disorders. Much of the published literature takes the form of case studies or case series. One such case report found cognitive analytic therapy to be an effective intervention, while another suggested that in the short-term, the use of antipsychotics(drugs) in patients with paranoid personality disorder was associated with improved prognosis. Cognitive therapy has been endorsed as a useful technique for the general psychiatrist. Recommended approaches to psychodynamic psychotherapy for these patients include working toward helping patients “shift their perceptions of the origin of their problems from an external locus to an internal one”, while maintaining special attention to the management of boundaries, maintenance of the therapeutic alliance, safety, and awareness of how the therapy may be integrated into the patient’s paranoid stance.

In conclusion, PPD is a serious mental illness that requires more and more fruitful research and in-depth understanding. No such biological or physiological causes have been found but several risks factors have been identified. With regards to treatment, there is a need for more effective intervention.

ppd2

[Image Courtesy: https://www.papermasters.com/paranoid-personality-disorder.html]

To know more about Paranoid Personality Disorder:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793931/

References

[1]Lee R. (2017). Mistrustful and Misunderstood: A Review of Paranoid Personality Disorder. Current behavioral neuroscience reports, 4(2), 151–165. doi:10.1007/s40473-017-0116-7

[2]Paranoid personality disorder. (2019, March 11). Retrieved from https://en.wikipedia.org/wiki/Paranoid_personality_disorder#DSM-5

[3]Vyas, A., & Khan, M. (2017, May 16). Paranoid Personality Disorder. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2016.110103

Googling symptoms and believing you have a medical problem: A look into Hypochondria

Hypochondriasis is as covert and confounding as ever. Regarded as a mental disorder in the Diagnostic and Statistical Manual (DSM) it is defined as “preoccupation with fears of having, or the idea that one has, a serious disease, based on a misinterpretation of bodily symptoms or to put it simply, you know how you google a symptom you’ve been experiencing and suddenly everything leads to cancer?; a constant, uncontrollable paranoia of it is what hypochondria is.

Jeff Pearlman, a revered American sports writer accounted his experiences with hypochondria in his article for Psychology Today. Here is an excerpt of it:

“ I know I am dying, because, well, I just know. I’m certain of it. I can feel it.

That pain on the left side of my stomach still hasn’t gone away. It’s been there for eight or nine months now. The ultrasound came up negative. So did the CT scan, the MRI and the colonoscopy.

“It’s probably nothing,” said one doctor.

“You likely pulled a muscle,” said another.

“I’d ignore it,” advised a third.

They are wrong. I know they are wrong. So, with nowhere else to turn, I seek out reassurance. “What do you think my stomach pain is?” I ask. “Do you think I’m OK?”

Eyes roll. “You’re fine,” my father says. “You’re fine,” my mother says. “You’re fine,” my sister-in-law says.

“You’re 37 years old. You run marathons. You play basketball every Monday. You’ve never even broken a bone,” my wife says. “You’re fine.”

I don’t believe them. I can’t believe them. I refuse to believe them. I wish I could believe them.

This is what it is to be a hypochondriac—what it is to live a life too often based upon the raw, carnal fear of inevitable, forthcoming, around-the-bend death. Though I was only recently diagnosed with the disorder, it has plagued me for more than a decade. Over the past 10 years, I have been convinced that I am dying of (in no particular order): brain cancer, stomach cancer, pancreatic cancer, testicular cancer, lung cancer, neck cancer, Lyme disease. When one ailment is dismissed by doctors, I inevitably rush to the Internet to learn why they are wrong. What? I don’t have colon cancer? Then it must be….”

[Image Courtesy: https://www.instagram.com/crazyheadcomics/]

In general most of us are concerned with our health. Any small injury or physical pain becomes a source for our discomfort. With the rise of information availability on the internet, many of us have started the trend of self-diagnosing ourselves. “Self-diagnosing” is an increasing phenomenon wherein any small physical symptom will lead us to believe that we have a major health issue. However what sets hypochondria apart, is the constant fear of having or the idea that one has a disease. Hypochondriacs face clinically significant distress and may often feel a lack in social, occupational or other areas of functioning. Despite medical reassurances and multiple clinical diagnosis, such people continue be preoccupied with the disbelief of suffering from a serious illness.

Hypochondriasis is a serious condition which has more of a psychological basis than a physical one. Hypochondria can take a huge toll on an individual’s well-being and mental health as a preoccupation with the idea that one’s physical health is on the verge of constant deterioration can prove to be a major source of stress and anxiety.

“The brain is so powerful that it really can convince itself of illness,” says Caroline Goldmacher-Kern, a New York-based psychotherapist who specializes in anxiety disorders. “You know something is wrong because you believe what you’re thinking, and what you’re thinking is what you perceive to be feeling. So you can have five people tell you it’s all in your mind and that’s not good enough.”

The basis for the symptoms of hypochondriasis lie mainly in the preoccupation with one’s health, primarily physical. Incidents like reading an article or hearing about a particular disease can lead to misinterpretation and cause hypochondriacal thoughts. The state with these symptoms is considered as a disorder when the concern of being healthy causes distress and overt clinical disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-4), some of the criteria for hypochondriasis are as follows:

Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms.
The preoccupation persists despite appropriate medical evaluation and reassurance.
The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The duration of the disturbance is at least 6 months.

[Image Courtesy: https://in.pinterest.com/pin/861383866206448155/]

Under the new 5th edition of DSM (DSM-5), hypochondriasis has been redefined as ‘Illness Anxiety Disorder’ which falls under the disorder class of ‘somatic symptoms and other related disorders’. Somatic symptom and related disorders are mental health disorders characterized by an intense focus on physical (somatic) symptoms that cause significant distress and/or interferes with daily functioning. Individuals with this condition may or may not have diagnosed medical conditions, but no serious disease is present in most cases. If a medical condition is present, the person displays anxiety around the illness that is clearly excessive. This new definition drops the idea of the fear of having a physical illness. It is rather the preoccupation with having or acquiring a serious illness.

The new definition focuses more on the anxiety surrounding the illness rather than the fear of it. People with illness anxiety disorder usually do not have physical symptoms, or if symptoms are present, they are mild. However, these mild symptoms may cause a great deal of anxiety. A doctor’s reassurance and even a complete medical evaluation often will not calm the person’s fears. Or, if it does calm them, other worries may emerge later.

To simplify the idea, illness anxiety disorder is similar to obsessive-compulsive disorder(OCD) to some extent, wherein the centre of obsessive behaviour is the idea or a thought of illness which causes people to compulsively do things to reduce the anxiety they feel due to this obsession. These activities include browsing for medical information, regularly visiting the doctor and so on.

The symptoms as per DSM-5 for illness anxiety disorder include:

Preoccupation with having or developing a serious illness
Absence of physical symptoms or, if present, symptoms are mild
Behaviour indicating health anxiety, such as checking for signs of illness
Easy alarm about medical problems; persistent fear despite medical reassurance
Overuse or underuse medical care.
Clinical distress or functional impairment
The patient has been preoccupied with illness for ≥ 6 months, although the specific illness feared may change during that time period.

Individuals with hypochondriasis and illness anxiety disorder are usually apprehensive of approaching a psychologist as they fear that people view the medical symptoms as “all in your head.” Nonetheless, a combination of support and care from the primary care doctor along with psychotherapy (when it is acceptable to the patient can be helpful. Another helpful procedure can be stress management. Learning how to cope with the stress of your health can result in significant benefits. Cognitive Behaviour Therapy(CBT), which is one of the most common form of therapies can help individuals realize what triggers their anxieties or fears with regards to their health and how it can be reduced through meaningful procedures. Nonetheless, hypochondriasis and illness anxiety disorder are still not considered to be serious mental health issues. Many people spend their entire lives not knowing they had such mental health problems. They fear that “it’s all in your head” would be frequently used to ignore their concerns. Awareness and changes in the perception towards such illness can prove to be beneficial to the well-being of all.

If you do think you are experiencing any of these symptoms, then do not hesitate in reaching out for help. There are solutions available and you are not alone in facing this and rightly shouldn’t be.

[Image Courtesy: https://m.imgur.com/gallery/mp2qoTh]

To know more about Illness Anxiety Disorder and its treatment, read the following articles:

https://www.health.harvard.edu/a_to_z/illness-anxiety-disorder-a-to-z

https://www.psychologytoday.com/intl/conditions/illness-anxiety-disorder

To know more about Hypochondria, read the following articles:

https://www.psychologytoday.com/us/articles/201001/hypochondria-the-impossible-illness

https://www.psychologytoday.com/intl/blog/life-after-50/201703/hypochondria

References:

[1] Pearlman, J. (2010, January 1). Hypochondria: The Impossible Illness. Psychology Today. Retrieved May 9, 2019, from https://www.psychologytoday.com/us/articles/201001/hypochondria-the-impossible-illness

[2]Harvard Health Publishing. (2019, March). Illness Anxiety Disorder. Retrieved May 9, 2019, from https://www.health.harvard.edu/a_to_z/illness-anxiety-disorder-a-to-z

[3]Bidaki, R., Mahmoudi, M., Khalili, B., Abedi, M., Golabbakhsh, A., Haghshenas, A., … Mirhosseini, S. M. (2015). Mismanagement of a hypochondriacal patient. Advanced biomedical research, 4, 24. Retrieved May 9, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333438/