No one knows what causes hypochondriasis, but there are several theories, including:
These factors increase the risk of developing hypochondriasis:
Your health care provider will perform a physical examination along with other tests to determine whether a physical disease is responsible for your reported symptoms. Your health care provider will also ask specific questions and use psychological tests to rule out the possibility of other related disorders, such as anxiety or obsessive compulsive disorder. Your doctor may consult with a trained specialist, such as a psychologist or a psychiatrist, to aid in the diagnosis and treatment.
In addition to regular visits with a health care provider who will take physical symptoms seriously, people with hypochondriasis may also benefit from psychotherapy. Studies show group therapy, behavior modification, and cognitive therapy work particularly well (see Surgical and Other Procedures section for more details). Preliminary research also suggests that mindfulness based cognitive therapy may help patients with health anxiety. People with hypochondriasis often have other mental health conditions, such as anxiety and depression, and treatment of these conditions is important in treating symptoms of hypochondriasis. Your health care provider may recommend limiting reading medical books and websites.
For more information, see Anxiety.
Doctors typically do notuse drugs to treat hypochondriasis, but they may prescribe medication for associated mental health conditions. Such medications may improve symptoms of hypochondriasis. Doctors may prescribe selective serotonin reuptake inhibitors (SSRIs), such as sertraline, fluoxetine, fluvoxamine, or paroxetine. At least one study found that patients tolerated fluoxetine well, and that the drug was moderately effective for hypochondriasis.
Several types of psychotherapy may help:
Cognitive behavioral therapy and stress management are the cornerstones of treatment for hypochondriasis. Acupuncture has also been shown to help. Similarly, participating in mindfulness techniques, such as meditation, may help patients manage symptoms. Beyond that, few studies investigated complementary and alternative therapies for hypochondriasis. Regular appointments with a CAM health care provider may help relieve health-related fears because of the regularity of the visits, the reassurance from a professional, and the focus on wellness and healthy behaviors. Work with someone who is licensed and reputable to develop a solid program of self-care and health promotion.
No scientific studies have examined the effect of nutrition on hypochondriasis. However, people with hypochondriasis who also have anxiety or depression may benefit from avoiding alcohol and caffeine.
Following these nutritional tips may also help reduce risks and symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
No herbs are specifically used to treat hypochondriasis, but certain herbs used to relieve stress or anxiety may help a person with hypochondriasis become less preoccupied with disease (which tends to worsen during stressful times). Other herbs may help lessen symptoms of hypochondriasis. Because many herbs interact with prescription antidepressants and anxiety medications, make sure your doctor is aware of all medications, herbs, and supplements you take.
Few studies have examined the effectiveness of specific homeopathic remedies. Some health care professionals, however, believe that homeopathy promotes a sense of well-being and may relieve feelings of anxiety and depression often associated with hypochondriasis. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
Several studies indicate that acupuncture may be useful in treating hypochondriasis. Acupuncturists believe the procedure balances the flow of energy (qi) in the body. This balancing effect may be particularly helpful for people who have distorted perceptions of normal body sensations. Acupuncture may be useful for:
Some health care providers believe that regular visits to a massage therapist (which include techniques to relieve stress) may help reduce symptoms of hypochondriasis. It is possible, however, that for some people, having regular massages could draw attention to their physical complaints, and increase their symptoms.
Stress and anxiety may make the symptoms of hypochondriasis worse. Many people may also struggle with costly medical tests and develop a dependency on certain medications. Hypochondriasis is a chronic illness (it persists for a long time), but getting early psychiatric treatment and having a strong motivation to change may increase the chances of getting better. Some reports suggest that one third to one half of patients improve over time, and one tenth recover completely.
Try to maintain a healthy relationship with your primary health care provider. Your health care provider will want to schedule regular appointments to monitor your symptoms.
Fallon BA, Harper KM, Landa A, et al. Personality disorders in hypochondriasis: prevalence and comparison with two anxiety disorders. Psychosomatics. 2012;53(6):566-574.
Fallon BA, Petkova E, Skritskaya N, et al. A double-masked, placebo-controlled study of fluoxetine for hypochondriasis. J Clin Psychopharmacol. 2008;28(6):638-645.
Ferri FF. Hypochondriasis. Ferri's Clinical Advisor 2015. Philadelphia, PA: Mosby; 2015:629-929.e1.
Hedman E, Ljotsson B, Andersson E, Ruck C, Andersson G, Lindefors N. Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a psychiatric setting: an open trial. Cogn Behav Ther. 2010;39(4):239-250.
Hedman E, Andersson E, Andersson G, et al. Mediators in internet-based cognitive behavior therapy for severe healthy anxiety. PLoS One. 2013;8(10):e77752.
Hedman E, Andersson G, Andersson E, et al. Internet-based cognitive-behavioural therapy for severe health anxiety: randomised controlled trial. Br J Psychiatry. 2011;198(3):230-236.
Hofling V, Weck F. Assessing bodily preoccupations is sufficient: clinically effective screening for hypochondriasis. J Psychosom Res. 2013;75(6):526-531.
Jellin JM, Gregory P, Batz F, et al. Pharmacist's Letter/Prescriber's Letter Natural Medicines Comprehensive Database. 3rd ed. Stockton, Calif: Therapeutic Research Facility; 2000.
Winter AO. Somatoform Disorders. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine, 8th ed. Philadelphia, PA: Saunders; 2014:1481-1486.e1.
McManus F, Surawy C, Muse K, Vazquez-Montes M, Williams JM. A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). J Consult Clin Psychol. 2012;80(5):817-828.
Molin G. Probiotics in foods not containing milk or milk constituents, with special reference to Lactobacillus plantarum 299v. Am J Clin Nutr. 2001;73(2 Suppl):380S-385S.
Ravindran AV, da Silva TL, Ravindran LN, Richeter MA, Rector NA. Obsessive-compulsive spectrum disorders: a review of the evidence-based treatments. Can J Psychiatry. 2009;54(5):331-343.
Weck F, Neng JM, Richtberg S, Stangier U. Dysfunctional beliefs about symptoms and illness in patients with hypochondriasis. Psychosomatics. 2012;53(2):148-154.
Williams MJ, McManus F, Muse K, Williams JM. Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients' experiences. Br J Clin Psychol. 2011;50(4):379-397.