Hypochondria Is No Joke

‘I am, like, such a hypochondriac,’  she says.

I stare back blankly, attempting to hone my fiery stare of death with a mixture of unimpressed eyebrow. Apparently it works, because we move on topics beyond her making fun of a serious mental health condition. I make a mental note to gracefully avoid social engagements with her in the future, because behind someone who thinks that mental health conditions are hilarious usually lies someone I don’t really want to spend my time with.

I’m fortunate: I don’t have hypochondria. But I know people who do, and it is most definitely not a joke. It can be a serious, debilitating mental health condition with substantial implications — it can also manifest on a less severe level, but it still has an impact on your life. When people joke about hypochondria, they seem to think it means imagining that they are getting sick all the time, or that they spend too much time on Web MD trying to figure out whether they have headaches or brain tumours. What they don’t understand is how hypochondria feels — and because I haven’t personally experienced the condition, I can’t relay that in a personal way, but I can talk generally about it, based on my experiences with anxiety and my interactions with people who have hypochrondria.

So here’s the thing: Anxiety is an irrational demon on your shoulder that convinces you the sky is falling. This particular Chicken Little doesn’t go away no matter how much you try to ignore it, redirect it, or think about something else. The longer anxiety goes untreated (treatment options can include medication, therapy, and a variety of other modalities), the worse it gets. And because anxiety is so stigmatised, many people do not get treatment for it, or they wait until they reach a mental health crisis and realise that the situation is out of control.

Anxiety isn’t just about getting a little nervous or feeling uncomfortable. Many of us have experienced that at some point in their lives. Clinical anxiety is about panic attacks. It is about intense physiological responses to stimuli that you cannot control. In the case of hypochondria, your brain convinces you that physical symptoms — no matter how mild — are evidence that you have a serious illness. It can also involve an intense fear of exposure to infectious organisms; for example, a person with hypochondria might be unable to date people with chronic infectious diseases for fear of contracting them, even if the patient knows that the transmission rate of these diseases is extremely low, especially when people are aware of them and can take protective steps.

Someone with hypochondria doesn’t just get a little worried about a headache sometimes. It can drive an anxiety spiral that includes not just looking up endless medical websites in search for evidence that the symptom is the first sign of any one of a long list of diseases. It can trigger a panic attack, and an array of physiological responses that make the situation worse. People who don’t understand what hypochondria really is can make the situation worse by making fun of the patient and belittling the situation, which can make a patient feel like it’s impossible to reach out for support during an anxiety episode. While the person’s anxiety is spiking, it creates a cascade that can be intensely isolating.

It’s not just about being ‘a little OCD about germs’ (speaking of another completely disgusting pop culture myth). It’s about being convinced that you are incredibly prone to infection, that even casual contact with infectious organisms will result in an immediate and severe case. Even with protective measures — barriers, suppressing medications, and other tools used to limit the risk of transmission — people with hypochondria may have a hard time in intimate quarters with infectious disease. It can be difficult to be in relationships with people who have infectious diseases, it may be challenging to visit environments like hospitals, and it can be hard to deal with someone in a household who has a transitive infection. What you think is just a common cold that will pass in a while can feel like something a whole lot bigger to someone with hypochondria.

Like other anxiety conditions, hypochondria is treatable. It requires comprehensive and extensive therapy in some cases, and it may never go completely away — you can’t wave a magic wand to make it vanish, and it can be part of a complex web of mental health issues that need to be disentangled first. If a patient does have multiple conditions, the primary focus might be on more pressing issues like major depression and suicidal ideation, with plans to address the anxiety along the way. It requires professional care, along with support from people in the patient’s environment — but patients need to outline what kind of support they need, including the enforcement of boundaries, and the people around the patient need to respect what the patient is asking for.

Anxiety disorders are not jokes. They are not something to make light of. They are serious and sometimes intensely disabling medical conditions that should be respected. Every time you kid around about them, you contribute to ongoing social stigma by reinforcing the idea that they aren’t legitimate medical issues — and you also send a clear message to people living with anxiety. People don’t come out and talk openly about their anxiety, even when they need support, if the people around them are treating their lived experience as one big joke.

Image: Pills, mattza, Flickr