Brain tumour 'most common' fear among hypochondriacs

It happens every now and again. You get persistent blinding headaches or feel a spasm close to your heart. Suddenly, you have these nagging suspicions that it could be brain tumour or heart attack.

The doctor fails to put your mind at rest, so you get a second and a third opinion and each time you are told there is nothing wrong except stress.

Yet, the pain is so real that nothing pacifies your anxiety but, this time, the doctor recommends you pay a visit to a clinical psychologist to cure your hypochondria.

Hypochondriacs are people who are worried about imaginary symptoms and physical complaints.

Clinical psychologist Antoine Schembri Wismayer estimates that half the people he sees suffer from anxiety disorders, with 10 per cent normally believing they have a serious illness.

Dr Schembri Wismayer said hypochondria is a very common condition. Abroad, experts believe one in every five people will go through a period where they worry about their health to such an extent that they lose sleep and disrupt their lives.

The internet, though a brilliant learning tool, could actually exacerbate matters since this means people have access to a whole new world of diseases and symptoms which they never knew about.

"Access to information is a good thing, but for those prone to worrying excessively about their health, this could actually make them worse because they discover that their aches correspond to the symptoms of some disorder," he said.

Hypochondriacs can clog the healthcare system with their imagined illnesses and burden physicians with frequent visits but according to Dr Schembri Wismayer, though these people may not have a disorder of the body, they had a disorder of thought and needed help.

"Patients are usually referred to me by doctors who would have realised they needed a psychologist instead," he said.

The most common concern he encounters is the fear of brain tumour brought on by severe headaches and dizziness. Hypochondria also tends to be slightly more common in women.

Dr Schembri Wismayer has dealt with patients in their 50s as well as in the mid-20s and 30s when people may have had children and become more aware that our lives are finite. However, hypochondria does not discriminate against age.

The problem can be relatively mild or can become so severe that the person adopts the lifestyle of an invalid. These people do a lot of doctor shopping and it is not uncommon that they would have visited 10 doctors for the same malady.

The good news is that with treatment, many hypochondriacs recover from the disorder. Therapy can take between three and six months, depending on the severity and duration of the problem.

"The first step is providing information on the physical effects of anxiety and how they control the stress through relaxation techniques," Dr Schembri Wismayer said.

It is also important to build evidence to prove to the patient that if they had something physically wrong it would generally not disappear when they are relaxed.

The key to treatment is disrupting the cycle, mostly through cognitive behavioural therapy and, at times, avoiding the word hypochondria completely.

Are you a hypochondriac?

The standard self-test for hypochondria is the Whiteley Index. As with all tests the result must be interpreted cautiously. This is how it works: for each question, select the number that best fits the way you feel.

1 = Not at all

2 = A little bit

3 = Moderately

4 = Quite a bit

5 = A great deal

1. Do you worry a lot about your health?

2. Do you think there is something seriously wrong with your body?

3. Is it hard for you to forget about yourself and think about all sorts of other things?

4. If you feel ill and someone tells you that you are looking better, do you become annoyed?

5. Do you find that you are often aware of various things happening in your body?

6. Are you bothered by many aches and pains?

7. Are you afraid of illness?

8. Do you worry about your health more than most people?

9. Do you get the feeling that people are not taking your illnesses seriously enough?

10. Is it hard for you to believe the doctor when he/she tells you there is nothing for you to worry about?

11. Do you often worry about the possibility that you have a serious illness?

12. If a disease is brought to your attention (through the radio, TV, newspapers, or someone you know) do you worry about getting it yourself?

13. Do you find that you are bothered by many different symptoms?

14. Do you often have the symptoms of a very serious disease?

There are no hard-and-fast cut-offs in the Whiteley Index but those who score between 32 and 55 are generally considered to be hypochondriacs, while those who score between 18 and 28 are generally considered not to be. These are merely indications. Note that if you are depressed you also might get a high score. The best way to know for sure is to consult a sympathetic doctor.