Hypochondriacal neurosis symptoms. Treatment of hypochondriacal neurosis

Sometimes some people are overly concerned about their health; they are convinced that they have serious illnesses, although in fact there is no reason for this. And only after visiting a specialist, they understand that the cause of their complex condition is hypochondriacal neurosis.

The word “hypochondria” is translated from ancient Greek as “hypochondria”. It was there that, according to doctors of the past, the source of pain was located. This term was introduced into medical practice more than 2,000 years ago and referred to a physical disease affecting a given area. After the 17th century, melancholia, in particular some of its types, began to be called hypochondria. And only then they began to interpret it as a false belief in various diseases that, in a person’s opinion, undermine his health.

How to define hypochondria and why does it occur?

Most often, lonely elderly people, women, and teenagers over 13 years of age suffer from this type of neurosis. Hypochondria develops due to the influence of parents, family, and excessive care of the child. Genetic factors (heredity) also influence. Psychological prerequisites can be excessive concentration on experienced or ongoing troubles, self-doubt, suspiciousness, inability to understand and express one’s feelings, and others.

If a person has experienced the pain of losing a family member or his long, painful illness, then a fear of experiencing such grief may develop. An inadequate attitude towards one’s health begins and psychosomatic symptoms gradually begin to predominate. The condition and mood are constantly deteriorating: there is no strength or desire to do anything, irritability appears, performance decreases, and there is no appetite. Patients sleep poorly and feel depressed, a melancholy mood and a feeling of hopelessness prevail.

Such patients carefully look after themselves, listen to every bodily sensation, constantly go to hospitals and clinics, trying on all the diseases. They often spend a lot of time on all kinds of examinations, carefully study medical literature, and are in constant search of traditional healers and methods of alternative medicine. This obsessive state can last for months and years.

Somatically, hypochondriacal neurosis can manifest itself through headache, rapid heartbeat, shortness of breath, fever, heart pain, nausea and other symptoms. Patients perceive these symptoms as manifestations of complex or incurable diseases; they suspect that they have cancer, tuberculosis, have a pre-heart attack, etc.

Neurosis of this type can be identified by one of the main signs - the patient does not want to listen to the doctor’s opinion. The doctor is not competent, the disease has not been sufficiently studied or is still unknown to modern medicine - the patient is ready to accept dozens of versions except one that he is healthy!

Psychogenic factors

• characterological personality traits (suspiciousness, anxiety, infantilism, hysteria);
• peculiarities of upbringing (overprotection with an emphasis on health status);
• encouraging others to take care of their health;
• the presence of a seriously ill relative in the family and caring for him;
• severe shocks and stress;
• household and personal unsettledness, loneliness.

It is a proven fact that psychogenic factors predominate in the development of the disease, therefore the treatment of hypochondriacal neurosis is based on various psychological techniques, supplemented by drug therapy.

Important! Modern treatment of hypochondriacal neurotic disorders is based on a direct impact on the causes of the disease.

How is hypochondriacal neurosis diagnosed?

A diagnosis can be made based on the patient’s relevant complaints and his independent description of how he sees his health (neurotic manifestations), whether he has experienced stress. To distinguish between this neurosis and a pathology of organic origin, computer, magnetic resonance imaging of the brain and electroencephalography are used. It is also necessary to determine that the patient’s condition is not organic, for example, a disease such as schizophrenia, in which patients complain about health in a very strange way, or a manifestation of another type - hysterical or depressive neurosis.

Symptoms of manifestation

Many complaints and signs of hypochondria require their systematization in order to identify the dominant symptom complex for more targeted treatment.

Painful disorders have three main forms:

• Obsessive-compulsive syndrome.
• The main contingent
  is impressionable people. They are also characterized by demonstrative accentuation of personality. Excessive sensitivity causes the existing problem to be exaggerated. For example, a small mole is taken as an object of close observation. She shows all the features of malignancy. Similar hyperbolization occurs with any complaint. Gradually, the patient develops an obsessive fear of developing a serious illness or death. Anxiety often reaches such a level that the hypochondriac is afraid to go outside so as not to contract a dangerous infection. He does not fly on airplanes, does not eat in canteens, cafes, or restaurants. Overcoming phobias is accompanied by an “outburst” of the problem into any complaints.
• Super valuable ideas.
• The disorder begins with excessive concern for one's health.
  A person worries unnecessarily about the nature of food, diet. With pedantic rigor he follows all the recommendations prescribed by the doctor, any deviation from which he perceives as a tragic mistake leading to serious consequences. The most common deviation in this form of the disease is cancerophobia (fear of getting cancer). Patients begin to read specialized literature and exclude from their lives contact with all substances that, from their point of view, lead to the development of cancer. The abnormality of such concern lies in the exaggeration of the importance of some rules, for the sake of which hypochondriacs make sacrifices of more important circumstances. Clients idolize their health and a cult arises.
• Delusional.
  Sick people express paralogical thoughts. They are fixated on minor details, and their conclusions contain erroneous conclusions. They see sacred meaning in every look, action, and gesture. Particular importance is given to outgoing information from the doctor. It seems to be a concealment of something terrible, irreparable for their health. On this basis, patients attribute serious illnesses to themselves. The experiences reach such a degree of intensity that patients express delusional ideas and experience hallucinations.

Establishing complaints and diagnostic nuances is important for selecting medications.

How to prevent hypochondriacal neurosis?

A method for preventing neurosis 100% has not yet been discovered. But certain conclusions can be drawn. This type of neurosis develops mainly in people who do not have a goal in life, a permanent occupation, are not passionate about something, are lonely, and do not know how to communicate. This means we can say that if you have a hobby, a circle of friends, acquaintances who have common interests with you, communication, you know how to work without fanaticism and rest, relax, you have a very small probability of becoming a victim of hypochondriacal neurosis.

If you still think that you are predisposed to hypochondria, then for prevention you can keep a diary, walk more in the fresh air, play sports, find activities you like, change your job to one that will bring more joy and enthusiasm.

Causes of hypochondria

The development of hypochondriacal neurosis is most often diagnosed in depressed and suspicious people.

The importance of hereditarily determined personality traits, such as:

• pronounced impressionability;
• increased emotionality;
• anxiety.

Another feature of the disorder is a peculiar understanding of the signals received by the brain from various organs and systems of the body. Normal signals are perceived by him as pathological or painful. Until now, scientists cannot determine what this interpretation is connected with - with disturbances in the functioning of the brain or with malfunctions in the functioning of the peripheral nervous system caused by something.

Distorted ideas about illness, due to altered deep-seated beliefs and assumptions, can arise due to severe illnesses suffered in childhood. Experts who work with such people assume that their self-preservation instinct is extremely heightened, and the disorder is one of the manifestations of the fear of death.

Literature:

1. Neuroses: pre-disease, dynamics, outcomes / K. T. Sarsembayev, M. A. Lebedev; edited by N. M. Zharikova. - Moscow: Medicine: Shiko, 2007. - 190 p.
2. Psychiatry, medical psychology [Text]: textbook / N. N. Petrova. - Moscow: KNORUS, 2020. - 507 p.;
3. psychotic and neurotic disorders in patients with somatic pathology [Electronic resource]: a guide for doctors / A. M. Sprints, O. F. Eryshev, E. P. Shatova, I. N. Filippova. - St. Petersburg: SpetsLit, 2007. - 252 p.

Authorship and editing of the text:
Head of the Department of Psychiatry and Narcology of the Alkoklinik MC, psychiatrist-narcologist Popov A.G., psychiatrist-narcologist Serova L.A.
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Diagnostics

The doctor’s main task during the examination is to differentiate hypochondria from somatic ailments.
In most cases, an accurate diagnosis is not established immediately. The patient has time to go through many specialists, sometimes several times. Hypochondriacal complaints imitate various pathologies. It is quite difficult for doctors to immediately find out their cause. It can be especially difficult if irregularities are found during tests and other studies. But after prescribing medication, patients do not feel better. And only after many ordeals does the client end up seeing a psychiatrist. >It is very important to carefully study all complaints, their nature, and the sequence of occurrence.

Treatment methods for hypochondriacal depression

Orthodox medicine and traditional psychotherapy do not yet have the resources to rid the patient of all manifestations of hypochondriacal depression. Treatment of atypical affective disorder is a difficult task, since the disease is protracted, often chronic, with a high risk of relapse. Therapy of hypochondriacal depression is complicated by the fact that patients associate mental suffering with an imaginary somatic illness, and try to find arguments confirming the correctness of their assumptions. Drug treatment of patients with hypochondria is often contraindicated, and when carried out it brings the opposite effect - a deterioration in the person’s well-being. This is due to the fact that prescribing pharmacological agents to a hypochondriacal patient strengthens his confidence in the existence of physiological pathology. Therefore, the leading role in the treatment of hypochondria is given to psychological support and psychotherapy.

The choice of individual methods of psychotherapy is justified by the fact that the hypochondriacal components of depression often serve as a way to hide and repress unresolved personal conflicts. A person who is unable to admit the existence of disharmony between the inner world and the environment uses imaginary problems in the body as a defense mechanism to shift the vector of attention from the need to solve real problems to thinking about imaginary diseases.

• How to treat hypochondria? The main condition for overcoming hypochondriacal depression and preventing the return of the disease is to recognize the existence of a problem in the psycho-emotional sphere and be ready to transform the inner world. It is this step that often becomes difficult and impossible for hypochondriacs. Psychotherapists often encounter the fact that patients with a confirmed diagnosis refuse the doctor’s attempts to provide assistance and do not want to consider the painful condition from a psychological perspective. Many patients with hypochondriacal depression are obsessed with finding out if they have an illness and finding a doctor who could confirm this illness. Often, hints from a psychologist and psychiatrist about the need to use psychotherapeutic methods of treatment are regarded by patients as the doctor’s inability to understand them and a deliberate reluctance to prescribe “miracle” pills. Therefore, the primary action of the doctor is to interest the patient in the state of his inner world, stimulate him to work on himself and motivate him to transform his worldview.
• How to get rid of hypochondriacal depression? It is necessary to explore personal history and establish the circumstances of the traumatic experience. During psychotherapeutic sessions, the doctor helps the patient to objectively assess the conditions of his growing up, analyzing the system of rewards and punishments adopted in the family. The psychotherapist recommends that the hypochondriac think about whether the attitudes learned from his parents are benefiting him. The doctor points out that the existing stereotypical way of perceiving internal and external processes interferes with a full life, lowers a person’s self-esteem, and impedes personal growth. The doctor motivates the patient to make adjustments to the value system formed in childhood, which ultimately frees the mind from obsessive ideas about one’s own ill health.
• How to get rid of hypochondria on your own? To gain emotional and psychological stability and eliminate irrational beliefs, a person must live in harmony with himself and the world around him. It is necessary to learn to perceive events in life correctly, objectively, and not distortedly. You should not focus on minor problems of the body and tiny negative phenomena of everyday life. We need to stop “making mountains out of molehills” by turning ordinary problems into disasters.
• How to deal with hypochondria? A person needs to choose priority life goals and understand exactly how he wants to live. If the acceptable conditions of existence for a subject are illness, then he will never get rid of hypochondriacal experiences. When an individual chooses the goal of good mental and physical health, he acts to avoid harm to his body.
• How to cope with hypochondria? An important rule is that you need to stop living in the past and focus on the future. We need to stop reliving past failures, grievances, episodes of illness over and over again, and even more so transferring past adversities to the present. The hypochondriac must learn not to allow a certain problem from the past to spill over into his present.

If psychotherapeutic treatment does not show the desired effect, the doctor's efforts are aimed at minimizing hypochondriacal fears and depressive symptoms. In case of severe, persistent hypochondria, the patient is prescribed powerful pharmacological agents. The basis of drug treatment is tricyclic antidepressants with the active ingredient amitriptyline. For severe behavioral disorders, this drug is combined with antipsychotics. Amitriptyline can also be used in combination with dibenzopyrazinazepine derivatives, for example: mianserin.

It is advisable to treat hypochondriacal depression in a hospital setting. After discharge from the hospital, the person should continue treatment with antidepressants at home. You should not change the treatment regimen or dosage of the medication yourself. A hypochondriac is recommended to be examined by a psychiatrist at least once every three months. It must be remembered that recovery involves not only medical efforts and taking medications, it is, first of all, painstaking work on oneself, the care and attention of the patient’s relatives.