Hypochondriasis and Substance Abuse

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In our health-conscious society, it’s easy to be preoccupied with physical and mental wellness. Pharmaceutical companies advertise on TV and on the Internet, new health magazines and blogs are published daily, and the media often focuses on the latest medical studies. But when a concern for your health takes over your life, you may become dangerously obsessed with illness. Obsessive fear about coming down with a serious medical condition is called hypochondriasis, or hypochondria. Consulting physicians and having tests rarely brings any relief; instead, the compulsive search for a diagnosis only heightens your anxiety.

Hypochondriasis can extend its reach to every aspect of your life. Constant worries about illness can interfere with work, friendships and social activities. The need to visit doctors, take medications and consult therapists can take a severe toll on your finances. Ironically, taking multiple prescription drugs and having unnecessary medical procedures can also put your health at risk. Using alcohol or drugs to deal with this disorder can be even more devastating to your mental and physical health.

How Common Is Hypochondriasis?

Hypochondria is not an uncommon disorder. The Nurse Practitioner estimates that between five and nine percent of patients who visit primary care doctors show excessive, unrealistic concerns about their health. But when it’s taken to extremes, hypochondriasis can lead to self-isolation, relationship difficulties, financial problems and self-destructive behavior.

Many hypochondriacs struggle with alcohol or drug addiction, reports the Mayo Clinic.

Depression, phobias, obsessive-compulsive disorder and anxiety disorders are also common in these troubled individuals. Alcohol and drugs may initially provide some relief, but they ultimately make depression and anxiety even worse. Dual Diagnosis treatment programs offer a way out of the self-perpetuating cycle of hypochondria and substance abuse.

Losing a Sense of Proportion

For the average person, a headache or a stomach bug is a minor annoyance. After a couple of aspirin or a day of rest, it’s back to the daily routine. But for a hypochondriac, the smallest twinge or sniffle is viewed as a possible symptom of severe illness. An abdominal cramp could be a sign of colon cancer. A headache could be a warning sign of a brain tumor. Every discomfort or physical change is blown completely out of proportion.

In fact, hypochondriasis shares many of the characteristics of a phobia, or an unrealistic fear:

  • The fear of illness can become debilitating, affecting your quality of life
  • Health-related anxiety can cause physical side effects, such as heart palpitations, sweating, tremors and a choking sensation
  • Your fears can drive you to excessive lengths to avoid illness or injury
  • Your fear of getting sick has little or no basis in reality

The Journal of the Louisiana State Medical Society points out that hypochondriasis also shares some of the physical side effects of panic disorder. Hypochondriacs may become so terrified of getting ill that they suffer disabling anxiety attacks. The prospect of being diagnosed with a terminal condition can be so frightening that they may have chest pains, breathing difficulty, dizziness and sweating. In a self-perpetuating cycle, the fear of a panic attack can bring on further episodes.

Hypochondriacs can devote hours to researching their own symptoms in search of answers. The Internet, with its wealth of medical information, can be a minefield for someone with unrealistic beliefs about their health. WebMD notes that the compulsive search for health-related information has led to a new term in medical circles: “cyberchondria.” Someone with cyberchondria can dedicate hours of time to researching symptoms, often ending up with a false diagnosis that only intensifies their fears.

Testing Relationships

It’s not easy to have a close friend, family member or significant other who’s obsessed with illness. Hypochondriacs crave reassurance that they are not sick. However, they are often unwilling to believe doctors or loved ones who try to reassure them. They tend to visit multiple doctors and undergo numerous tests in the search for a diagnosis. But negative medical tests rarely bring any relief. When one condition is ruled out, the disorder will drive the hypochondriac to obsess on another set of symptoms.While some hypochondriacs hide their fears, others verbalize their anxiety so often that it drives others away. The need to be constantly comforted can put a strain on intimacy. Using drugs or alcohol to cope with hypochondriasis can make it even harder to be close to others. Substance abuse can destroy trust between loved ones, colleagues and friends.

Hypochondria and substance abuse can also undermine professional relationships with doctors. Busy physicians may get tired of consulting with these patients, who can come across as needy and demanding. Medical professionals who aren’t trained in addiction treatment often get frustrated with people who have complicated mental health issues combined with substance abuse problems. As a result, hypochondriacs typically go from one doctor to another, or from one relationship to another, in search of emotional relief that always escapes them.

It’s not easy to have a close friend, family member or significant other who’s obsessed with illness. Hypochondriacs crave reassurance that they are not sick. However, they are often unwilling to believe doctors or loved ones who try to reassure them. They tend to visit multiple doctors and undergo numerous tests in the search for a diagnosis. But negative medical tests rarely bring any relief. When one condition is ruled out, the disorder will drive the hypochondriac to obsess on another set of symptoms.While some hypochondriacs hide their fears, others verbalize their anxiety so often that it drives others away. The need to be constantly comforted can put a strain on intimacy. Using drugs or alcohol to cope with hypochondriasis can make it even harder to be close to others. Substance abuse can destroy trust between loved ones, colleagues and friends.

Hypochondria and substance abuse can also undermine professional relationships with doctors. Busy physicians may get tired of consulting with these patients, who can come across as needy and demanding. Medical professionals who aren’t trained in addiction treatment often get frustrated with people who have complicated mental health issues combined with substance abuse problems. As a result, hypochondriacs typically go from one doctor to another, or from one relationship to another, in search of emotional relief that always escapes them.

Where Does Hypochondriasis Come From?

Hypochondriasis resembles an anxiety disorder in many ways, but the mental health community classifies it as a somatoform disorder. Somatoform disorders cause physical symptoms that have no apparent medical cause. Because these symptoms can’t be linked to a disease or an injury, they are attributed to a mental health condition.

To make matters even more complicated, the anxiety and stress caused by somataform disorders can produce their own physical symptoms, including:

  • Chronic sweating
  • Joint pain
  • Nausea
  • Dizziness
  • Loss of appetite
  • Weight changes
  • Heart palpitations
  • Tremors


The exact origins of hypochondriasis are unknown, but a number of risk factors have been identified, according to the University of Maryland Medical Center. People who have a close family member with hypochondriasis are more likely to have this condition, suggesting that it may have a genetic factor. Growing up with a serious illness can increase your chances of developing the disorder as an adult. People who grow up identifying themselves as sick may have trouble giving up this role in adulthood. Hypochondriasis has also been linked with a childhood history of sexual or physical abuse. Someone with hypochondria may focus on his health as a way of compensating for childhood trauma or neglect.

Stress can make hypochondriasis worse. An anxious person may become fixated on her health as a way to cope with a job loss, divorce or the death of a loved one. At the same time, she may use drugs or alcohol to deal with these painful experiences. However, this self-medication can intensify the depression and anxiety that often accompany hypochondriasis, making it even more difficult to get back to a healthy state of self-perception.

For hypochondriacs who get the right treatment and support, the chances of recovery are good. A study published in the Journal of the American Medical Association found that Cognitive Behavioral Therapy (CBT), which involves re-educating the mind to eliminate destructive thought patterns, was an effective way to relieve the symptoms of hypochondriasis. In a randomized, controlled trial, 102 study subjects who underwent CBT showed improved social functioning, a better quality of life and a reduction in unrealistic fears about their health, as compared to 85 participants who received traditional medical care.

Helping a Loved One

Caring about someone with hypochondriasis can be extremely challenging. If someone in your life has this disorder, you’ve probably dedicated a lot of time and energy to reassuring them that they’re not seriously ill. You may have accompanied them to doctor appointments and waited with them for the results of medical tests. You may have even helped them in their efforts to find a diagnosis by doing research on their symptoms, seeking out doctors or recommending new treatments.

But if you’re like a lot of people who care about someone with this disorder, you’ve also felt hopeless and frustrated at times, especially if drugs or alcohol are involved. It’s hard to keep devoting your time and attention to a person whose substance abuse has spiraled out of control.

How can you help someone with this complicated, frightening condition?

  • Remember that for the hypochondriac, his or her fears are completely real, even if the symptoms have no apparent medical origin.
  • Offer your support, but don’t let yourself be overwhelmed by the need to reassure your loved one.
  • Instead of helping the hypochondriac search for new doctors or treatments for an imagined illness, look for a treatment program that addresses both hypochondriasis and substance abuse.
  • Take care of your own physical and mental health; your needs are important too.
  • Never give up hope that your loved one can recover with the help of a Dual Diagnosis treatment plan.


Dual Diagnosis treatment offers a multifaceted approach to helping people with hypochondriasis and addiction. The professionals at our facilities understand the challenges of treating mental health conditions that co-occur with substance abuse. At our centers in California and Tennessee, we provide a full range of integrated services for our Dual Diagnosis clients, including individual and group therapy, counseling for families, 12-Step programs and holistic therapies. Our treatment plans are designed to reflect your unique needs. Call our admissions coordinators at any time to find out how we can help you recover your strength, health and hope.

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