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What Is The Cause And Treatment For Hypochondriasis?

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Posted on Mon, 6 Oct 2014
Question: Hello,
I am 32 years XXXXXXX male , weighing 90 kgs and height is 165 cm.
Smoking (10 per day) , Drinking twice a week ( Party hard)

The problems I am facing are:
1. Weakness, Giddiness and tiredness. From 2 years
2. Fear ( Thinking of some disease or death) its been there for more than 10 years
3. Dullness and heaviness in the body and head. From 5 years
4. Gastric trouble. Spiky pain, Heaviniess in chest with pain or burning sensation.
5.Creepy sensations in my Head. Spinning lasts for a second or two.

I would brief about my previous health.
At the age of 21 , I had this sudden fear developed inside me , and I had a few head aches. I was worrying that some thing is wrong with my heart, and I did see a Cardiologist. A Master health check up was done in Apollo Hospitals. The doctor said every thing is perfect except a little rise in the Blood pressure ( 150/90) and the fast heart beat. He prescribed Atenolol 25 mg which I took for 4 years.
Later after few years,every thing was fine except for that fear I had developed about health and death. so I visited the doctor and again a master health check up was done. This time the Blood pressure was absolutely normal.
But he put me on Inderal 10 mg twice daily.
I did tell him about my fear , so he prescribed me Alprax 0.5 mg at night whenever required.Alprax 0.5 mg(taken at 8 pm ) seems to give me a 30% relief from my symptoms.

So I have been doing these master health check ups every year from then, and every time all the reports are normal and in the limits. Recently done Mri Scan and Endoscopy , Both reports are normal.
Now today, My symptoms have increased worsened and I am feeling more fear.
I am staying indoor at home most of the time, worrying that i may faint or might get a heart attack when i am out.
I Cannot sleep at night , but normally I could sleep at 4 am and wake up at 12.00 in the afternoon.
This fear and worry is constant all day and night. Even when i am at work , i do have this feeling back of my mind.
My work and social life is being affected immensely.
I am really confused and worried about my situation.
Present medications are:
1) Inderal 10 Mg twice daily
2) Cinitapride 3 mg before lunch
3) Alprax 0.5 mg before dinner
Please suggest.
doctor
Answered by Dr. Jonas Sundarakumar (1 hour later)
Brief Answer:
Diagnosis: Health Anxiety Disorder

Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.

I have gone through your query in detail and am able to get a clear picture about the problem that you are facing. Based on this, my opinion is that you are suffering from a Health Anxiety Disorder, also known in medical terms as Hypochondriasis.

People with this disorder have excessive fear or preoccupation about their health condition and keep worrying repeatedly whether they might have a serious illness or even about death.

In your case, it is clear that this excessive fear and anxiety is affecting you immensely - personally, socially and occupationally. So, it is essential that you seek professional help to deal with this. Don't worry, there are effective treatment strategies available to help you overcome your problem. Treatment will be in the form of a specialized counselling or psychotherapy called CBT (Cognitive Behaviour Therapy). A group of anti-anxiety medication called SSRIs are also used often to reduce symptoms. So, I would suggest that you consult a psychiatrist as early as possible for a detailed evaluation and further treatment.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar (5 hours later)
Thank you for super fast reply and diagnosis.
As I had explained in my query about my fear and other problems. There is one more thing I Really couldn't understand.
I normally have that fear feeling all the time, but every day at a specific time ( between 6pm to 8pm) the symptoms are aggravated.
1. Shaky hands and legs, feels like would loose balance.( But nothing happens)
2. Shortness of breath ( Not acute , but i can feel the difference.)
3. Lack of concentration, Irritability even to talk to people.
4. Some times sweaty palms and forehead.
5. Fear is intense, (Unable to explain the feelings)
why does this happen same time every day.
The same symptoms occur when some times in large gatherings like marriage functions.
All these days i am trying to manage it with that alprax 0.5 mg which gives me only a part of relief.
What medication should i take , do i have to undergo any tests.
I am from XXXXXXX Please suggest
doctor
Answered by Dr. Jonas Sundarakumar (11 hours later)
Brief Answer:
Explanation and advise given.

Detailed Answer:
Hi XXXX

It is important to understand that anxiety can present with not only psychological symptoms but also with physical or somatic symptoms. Shakiness, shortness of breath, increases sweating, dizziness, etc. are symptoms which are commonly seen in anxiety disorders.

Now, this does NOT mean that 'everything is in your head' and that you are simply imagining the symptoms. Not at all. It has been found that anxiety disorders are associated with certain neuro-chemical imbalance in the brain and this can cause the person's pain and sensory threshold to get lowered and he / she can become 'hypersensitive' to sensory stimuli, and therefore have tingling, burning, etc. The underlying anxiety also causes a person to become more worried as to why his / her problems are undiagnosed after multiple tests, and then this worry / anxiety itself then starts worsening the symptoms more. Soon this becomes a viscious cycle, leaving the person with more symptoms and suffering.

The reason they could be appearing at a particular time could be because that would be the time when you would be quite tired after the day's work. Also, it is possible that that is when your mind is not actively engaged in any specific work and so the anxious thoughts and fear could be easily creeping in and peaking.

I have gone through all your reports. Everything appears to be normal. So, there's nothing to worry. The only additional test that I would suggest is to a Thyroid Profile (because often thyroisd problems can worsen anxiety).

In addition to the Alprax that you are taking, I would recommend taking an SSRI medication such as Escitalopram for your anxiety problems.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar (5 hours later)
Thank you Doctor for the detailed reply.
I have done a thyroid test three months back. Its normal.

1. Will I have to do any tests before starting SSRI medications.
2. I heard SSRI could be a huge negative impact on sexual life ( dysfunction, numbness or pleasureless orgasm) . Is it true, If yes, what could be the alternatives.
3. Will the SSRI have contraindications with alcohol or smoking.
4. Can I have a Physical appointment.
doctor
Answered by Dr. Jonas Sundarakumar (7 hours later)
Brief Answer:
Answers given...

Detailed Answer:
Hi XXXX

It's good that you have checked your thyroid functions and that it was normal.

Here are the answers to your questions:

1) If you have done all the tests recently, then there is no need to repeat them.

2) Yes, SSRIs can have sexual side effects. But usually, they are temporary and tend to subside with time. However, if you are very concerned about this aspect, then there are other alternative medication like Bupropion which do not have sexual side effects.

3) There are no absolute contraindications to smoking or drinking, but it is better to avoid them while on medication.

4) Yes, you can see me at V.K. Hospital, Purasawalkam, XXXXXXX on Wednesday evenings. You can call me and fix an appointment. (0000)

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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What Is The Cause And Treatment For Hypochondriasis?

Brief Answer: Diagnosis: Health Anxiety Disorder Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. I have gone through your query in detail and am able to get a clear picture about the problem that you are facing. Based on this, my opinion is that you are suffering from a Health Anxiety Disorder, also known in medical terms as Hypochondriasis. People with this disorder have excessive fear or preoccupation about their health condition and keep worrying repeatedly whether they might have a serious illness or even about death. In your case, it is clear that this excessive fear and anxiety is affecting you immensely - personally, socially and occupationally. So, it is essential that you seek professional help to deal with this. Don't worry, there are effective treatment strategies available to help you overcome your problem. Treatment will be in the form of a specialized counselling or psychotherapy called CBT (Cognitive Behaviour Therapy). A group of anti-anxiety medication called SSRIs are also used often to reduce symptoms. So, I would suggest that you consult a psychiatrist as early as possible for a detailed evaluation and further treatment. Wish you all the best. Regards, Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.) Consultant Psychiatrist