According to his doctor, Rich David is a healthy 32-year-old man. Yet for
years, David has believed otherwise. All it takes is a swollen gland or an upset
stomach to set him off. Immediately, he assumes -- he knows -- that he's
"I'll waste days researching gruesome cancers on the Internet," he
says. He can't concentrate on his work. He's so anxious that he can't eat; the
resulting weight loss further terrifies
him. Despite its comic reputation, hypochondria is a real psychiatric disorder,
as real as depression or anxiety. And its effects can be
A person with obsessive-compulsive disorder (or OCD) may experience:
Excessive and irrational concern about contamination or serious illness
Too much concern with keeping everything arranged in an exact way
Intrusive thoughts or horrible mental images
Sexual or religious thoughts felt to be unacceptable
Excessive fear of your house burning or flooding, of causing a car wreck, of spreading an illness, of losing something, of being responsible for another person getting hurt or killed
Hypochondria -- the conviction that one is ill, despite all evidence to the
contrary -- affects as much as 5% of the U.S. population, according to the
American Psychological Association. It often starts in a person's 20s and can
be triggered by a medical scare or the illness of a friend or relative. It then
can wax and wane over a person's life, flaring up during stressful times. It
affects men and women equally.
"Hypochondriacs get caught in a cycle," says Arthur J. Barsky, MD,
professor of psychiatry at Harvard Medical School and author of Stop Being
Your Symptoms and Start Being
Yourself. "The more they worry about a symptom, the worse it gets."
They're often highly attuned to bodily sensations that most people ignore.
Every ache, every cough, every stomach gurgle is
evidence of something going catastrophically wrong.
Hypochondriacs don't just dwell on their disease, they act. They scour the
Internet for information, earning some the moniker "cyberchondriacs."
They demand lab tests from irritated doctors. They talk about it
Many of them can even admit that their fears don't make sense. In fact, the
symptoms associated with hypochondria are not under the person's voluntary
control. "I know I'm a hypochondriac," says David. "But when I get
obsessed with a symptom, I can't shake the feeling that this time I really am
Some experts compare hypochondria with anxiety disorders, especially
obsessive-compulsive disorder. Just as someone with OCD has to check that the
lights are off a dozen times, the hypochondriac can't resist researching and
checking his symptoms.
Although hypochondriacs may think that Internet research or lab tests will
reassure them, it's never enough. The key is to break the cycle of worrying and
Hypochondria is hard to treat, but experts have made progress. Several
studies show that using antidepressants, such as Prozac and Luvox, can help.
Antianxiety medications are also used to treat the disorder. Barsky
and other researchers say that cognitive-behavioral therapy also works. With a
therapist, hypochondriacs can learn to challenge their assumptions and change
their behavior. Barsky encourages patients to be honest with their doctors
about their anxiety and to agree on a regular checkup every few months, instead
of making emergency appointments every time they get freaked out.
David says that seeing a specialist -- and getting therapy and medication --
has helped him. "I'm not cured," he says, "but it's made a
SOURCES: Rich David, MA. Arthur J. Barsky, MD, director of psychiatric
research, Brigham and Women's Hospital, Boston; professor of psychiatry,
Harvard Medical School; co-author, Stop Being Your Symptoms and Start Being
Yourself: The 6-Week Mind-Body Program to Ease Your Chronic
Symptoms. Barsky, A. The Journal of the American Medical
Association, March 24, 2004; vol 291: pp 1464-1470. Diagnostic and
Statistical Manual of Mental Disorders, fourth edition, American
Psychiatric Association, 1994. Harvard Mental Health Letter, July 2004: