When we deal with condition like ME/CFS or something similar, we often hear the word “hypochondria”. I have been feeling that people use the terminology without knowing what it is. The way I see or hear, “hypochondria” was used to insult someone who displays many mysterious symptoms, although it is a medical condition and need a proper treatment. It seems doctors get anxiety or fear of dealing with possible hypochondriac. And we tend to stigmatise hypochondria in order to defend ourselves from being stigmatised.
It was interesting to read and was thoughts provoking. The article has five pages.
In the first page, it introduced Gardon who suspect he has been suffering from MS and his ordeal obtaining the diagnosis. At this point, there was nothing significant about him. What he was going through was familiar to most of us MEites.
In the second page, it portraits Gardon’s wife’s perspective, who has survived cancer twice, yet has strong mind to deal with the problem. I felt she was too harsh to Gardon as not every illness is like cancer, which gives clear diagnosis, amazing support from community while undergoing the treatments, and realistic prognosis and so on. I am not saying cancer is an easy illness to deal with. I empathise it is a scary illness and not everybody have happy ending. (I hope you can understand that I am not saying which illness is harder to deal with, but I am trying to point out the different hardships between the illnesses of different nature and we should prepare our minds to understand each other.) It also explains hypochondria in detail. In this page, it already portrayed Gardon as hypochondriac. It upset me as judging from the information given so far, I felt it was a reasonable anxiety and natural wish to receive answer for the symptoms. Due to controversy diagnosing particular illnesses, many people who suspecting the illness were often treated with insults by medical practitioners. Gardon’s behaviour was not much different from many of MEites (or probably MS sufferers) who are seeking for diagnosis in order to treat the condition properly.
It seemed to me that the author of the article judged Gardon as hypochondriac from the set of symptoms he has. Does it make me hypochondriac, too?
In page three, it explained behaviour and mind of hypochondriac in detail with examples. It made me clearly understand that the hypochondriac is not even close to Malingering or Attention Seeking, it is closer to Obsessive Compulsive Disorder and Phobia. I remember watching a TV documentary on people living with OCD. Sufferer’s life is trapped in their own mind, fear and behaviour, and a limitation the OCD brings to their quality of life is unspeakable.
The better words for me to describe Hypochondria are Obsession to Diagnosis. Obsession is not just an anxiety, but it is a state of mind that they must have “it” no matter what.
In page four, it explained hypochondria with psychological analysis. Interestingly, it explained that there are subgroups of hypochondria. One shows characteristics of OCD. And the other is the result of environments and conditioned thoughts/fear due to the environments.
In the last page, it finally revealed the obsessive behaviour of Gardon and the environments that may have conditioned Gardon’s mind to be prone to hypochondria. With these information, I felt easier to agree that Gardon is suffering from hypochondria, not MS. And I could understand his wife’s harsh attitude and felt it was reasonable. I was also relieved to see that this is very different from what I am going through. I am not hypochondriac because I don’t have the obsession or phobia.
I don’t know personally how doctors draw a conclusion that a patient is suffering from hypochondria. According to my understanding from this article, it cannot be diagnosed just because patient has complains of many mysterious symptoms or symptoms can be categorised as psychosomatic. Patients’ mind and behaviour are also needed to be observed before the diagnosis. And when a patient is confirmed to be suffering from the hypochondria, doctor should be able to offer medical treatment, not insults and/or disgust.
The stigma towards hypochondria needs to be dealt in order for patients to accept the diagnosis as hope to get better.
Since obsession is involved with hypochondria, I am little confused with definition between Hypochondria and Munchausen Syndrome. Some of us may have heard of Munchausen Syndrome because it is also used to insult MEites. Munchausen Syndrome is a factitious disorder, and the words malingering and attention-seeker suit better than hypochondria.
Symptoms A person with Munchausen syndrome gains intense satisfaction from the attention associated with playing the ill patient or victim. Signs and symptoms that may suggest Munchausen syndrome include:
A spectacular medical history that includes a large number of tests, medical procedures and operations
Odd collection of seemingly unrelated symptoms
No conclusive results despite intense medical investigations
New symptoms that appear after medical tests prove negative
Extensive medical knowledge of many different illnesses
Frequenting many different doctors, sometimes in other states
Frequent presentation at emergency departments, usually at different hospitals
Requests for invasive medical procedures or surgeries
Failure to improve despite medical treatment, including relapsing for unknown reasons.
Common tactics A person with Munchausen syndrome may convince doctors in many ways. For example, they may:
Pretend to be in pain
Fake symptoms, including psychological symptoms
Poison themselves with chemicals
Infect themselves with unclean substances
Tamper with diagnostic tests – for example, contaminate a urine sample with sugar or blood
Interfere with a medical condition so that recovery isn’t possible – for example, repeatedly open or contaminate a skin wound or not take prescribed medication
Ignore a genuine medical problem until it becomes serious.
Comparing to this illness, ME/CFS is an innocent illness, isn’t it? Some doctors must have mixed up their knowledge of ME/CFS and Munchausen Syndrome.
One could assume a person may behave unethically if he/she is obsessed with something. For example, a person may tamper the lab test if he/she is obsessed to be diagnosed with particular illness. They would study what lab result(s) give the diagnosis and what they can do to make sure the lab report shows positive results.
Previously, I thought that Munchausen Syndrome and Hypochondria are completely different condition. But I felt there is gray area between two conditions. As you know, I am not medical professional. So it is better to leave this debate to them.
But one thing I can say is that once Munchausen Syndrome sufferer leans how it is like to live with ME/CFS, they will lose their interests in mimicking ME/CFS. We don’t get sympathy, support and there is no dramatic surgery or medical treatment. We are isolated, so that nobody sees us how we suffer. Having no diagnostic tests for ME/CFS, efforts of convincing medical practitioner would be a different challenge comparing to other illnesses. (Apparently, they have expertise in getting collection of diagnosis.) As you can see, there is no reward for Munchausen snuffer’s efforts of mimicking us.
Going back to the hypochondria, I feel we all need to be careful not stigmatise any medical condition. There is a delicate line between reasonable anxiety and hypochondria. Nobody can tell exactly until we get to know the person well. Just because someone has unpleasant personality, such as tendency of worrying too much, we cannot assume the person is suffering from mental disorder. Faulty/Unpleasant personality is not an illness. We all need to learn how to deal with it. People suffering from Hypochondria are not seeking attention or sympathy. They are trapped in their own obsession and fear. Wrong diagnosis can harm a person’s life.
When I come across with situation attached to stigma, I prefer to understand the situation before I agree or disagree. There are just too many stigmas in this world with or without health issues.