A New Approach to Treating Hypochondria

A New Approach to Treating(trēt) Hypochondria(ˌhīpəˈkändrēə)

Instead of focusing on patients’(ˈpāSHənt) unexplained(ˌənikˈsplānd) symptoms(ˈsim(p)təm), cognitive(ˈkägnətiv) behavioral(biˈhāvyərəl) therapy(ˈTHerəpē) encourages(-ˈkə-rij,enˈkərij) patients to replace unrealistic(ˌənˌrēəˈlistik) or unhelpful thoughts with more rational(ˈraSHnəl,ˈraSHənl) ideas.

By Jane(jān) E. Brody

This spring, when every tree in Brooklyn(ˈbro͝oklən) seemed to be shedding pollen (ˈpälən) all at once, I developed a nagging(ˈnagiNG) itchy(ˈiCHē) throat(THrōt) with frequent spasms(ˈspazəm) of coughing(kôf) that made it difficult to talk or walk. I attributed(a) the problem to allergies(ˈalərjē) even though I’d never had such a reaction before.

But when I got worse instead of better after taking antihistamines(-mēn,ˌantēˈhistəmin) and after days of rain had presumably(priˈzo͞oməblē) cleansed(klenz) the air, I began to wonder if I had something more serious(ˈsi(ə)rēəs) — maybe walking pneumonia(-ˈmōnyə,n(y)o͞oˈmōnēə) or possibly(ˈpäsəblē) even throat(THrōt) cancer from years of drinking hot coffee through a straw(strô).

Though I tried to dismiss such sleep-disrupting(disˈrəpt) thoughts, anxiety(aNGˈzī-itē) about my health loomed(lo͞om) until the cough(kôf) finally abated(əˈbāt), then disappeared(ˌdisəˈpi(ə)r). But the incident(ˈinsidənt) hinted at what it must be like to have chronic(ˈkränik) health anxiety — a problem long called hypochondriasis, in which people are convinced they have a serious undiagnosed(ˌdīəgˈnōs) illness(ˈilnis) despite(diˈspīt) repeated medical reassurances(ˌrēəˈSHo͝orəns) that they do not.

The current(ˈkə-rənt,ˈkərənt) psychiatric(ˌsīkēˈatrik) diagnostic(ˌdīəgˈnästik) manual(ˈmanyə(wə)l) has abandoned(əˈbandənd) hypochondria as a disorder(disˈôrdər), replacing it in 2013 with two new concepts(ˈkänˌsept): somatic(sō-,səˈmatik) symptom(ˈsim(p)təm) disorder and illness anxiety(aNGˈzī-itē) disorder.

Dr. Jeffrey P. Staab, a specialist(ˈspeSHəlist) in psychosomatic(ˌsīkōsəˈmatik) and behavioral medicine(ˈmedisən) at the Mayo(ˈmā-ō) Clinic(ˈklinik) in Rochester(ˈräCHəstər,ˈräˌCHes-), Minn.(ˌminəˈsōtə), said it took two decades of research to come up with the new concepts, which eliminate(iˈliməˌnāt) the focus on medically unexplained symptoms(ˈsim(p)təm). Instead, the new diagnoses(ˌdīəgˈnōsis) put a focus on undue(ˌənˈd(y)o͞o) attention to bodily(ˈbädl-ē) symptoms and excessive(ikˈsesiv) health concerns(kənˈsərn), which, when properly(ˈpräpərlē) explained, can be very reassuring(ˌrēəˈSHo͝or) to patients.

“Health anxiety and body vigilance(ˈvijələns) are much more understandable(ˌəndərˈstandəbəl) to patients when they realize they can have these things despite(diˈspīt) what their doctor finds,” he said in an online report to health professionals(prəˈfeSHənl). “We found it much easier to engage(enˈgāj) patients if we identified(īˈdentəˌfī) what the problem was instead of what it was not.”

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https://www.nytimes.com/2018/06/18/well/a-new-approach-to-treating-hypochondria.html