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Carrie Steckl, Ph.D.Carrie Steckl, Ph.D.
Finding Meaning Through the Many Windows of Wellness

Self-Advocacy vs. Hypochondria: Where Do We Draw the Line?

Carrie Steckl, Ph.D. Updated: Jul 13th 2012

We've all been there. We experience an unusual symptom - a pain, skin bump, or otherwise unpleasant feeling - and we wonder what it could be. In previous times, we'd wait a bit to see if it subsided. If it didn't, we'd call the good old doctor.

woman in painNot anymore. Now our first move is a beeline to the Internet. The cornucopia of medical information available to the lay public is, well, stunning.

I'm not saying it's a bad thing. In fact, the media practically beats us over the head about being our own health advocates. In an era of dwindling medical generalists, brief appointment visits, and abundant reporting of medical errors, we need to self-advocate to ensure we're receiving the medical care we need and deserve. And to do that, we need information.

But what happens when self-advocacy crosses the boundary into the land of hypochondria? According to Dr. Catherine Belling, an assistant professor of medical humanities and bioethics at Northwestern University's Feinberg School of Medicine and the author of "A Condition of Doubt: The Meanings of Hypochondria," the condition is more prevalent than ever these days. She agrees that the overwhelming amount of medical information available to us as well as pressure from advertising and media to worry about our health and to fix ourselves has fueled this hypochondriacal surge.

I love the analogy Belling uses to describe hypochondria because it happens to refer to one of my very favorite movies: "Jaws." Belling cites the opening scene, where the poor woman swimming in the dark is attacked by the monstrous shark. She can't see it, so she doesn't know exactly what or where it is, but she knows something's down there. And as we all recognize, not knowing the whole deal about something like that really sucks.

For those with hypochondria, it's the same thing. They know there's something very wrong inside them, but they can't see it and don't know exactly what it is. Many of us have been there to some degree. The difference is that in most cases, eventually there is some sort of resolution.

Belling provides a few more details about the nature of hypochondria. She says it's defined by five qualities:

  • fear (of having or getting a serious disease)
  • doubt (of the medical community's capabilities)
  • embodiment (a belief that his or her body contains problems that are difficult to find)
  • information (he or she is well-informed)
  • narrative (his or her story is a complicated one that contradicts the "short stories" preferred by doctors - evaluate symptoms, diagnose, and treat)

If you feel you might have symptoms of hypochondria, be sure to talk to a mental health professional. Cognitive behavioral therapy as well as anti-depressant medication have been shown to help.

As Belling says in an interview with the Chicago Tribune, "There's a fine line between being a diligent health citizen and being a hypochondriac." Here are some things I do to try to walk that line with grace:

Only read reputable websites. It's a blessing and a curse that anyone can publish anything online. To find reputable health information, stick to government websites (National Institutes of Health, Centers for Disease Control and Prevention), professional medical journals, and disease-specific associations (American Cancer Society, American Lung Association).

Don't jump to conclusions. You may recall the "Brady Bunch" episode during which Peter thought he had a fatal disease. It turned out that the pages he was reading in an old medical text were stuck together. He started reading symptoms of the common cold, but when he thought he turned the page, he ended up reading the prognosis for a horrible illness. Yep, the "Brady Bunch" actually did have morals to its stories. This one? Don't jump to a conclusion about your health without making sure you have the proper information.

Gain perspective. If you're worried about your health, talk it over with your spouse, partner, or other close family member or friend. Be sure it's someone you trust, someone you know will listen unconditionally, and someone who will also tell you what he or she really thinks. Talking about your concerns can help you gain perspective on them and point to your next steps and decisions.

I'd love to hear your thoughts on the differences between self-advocacy and hypochondria. What do you do to navigate the fine line between the two? Your strategies may help others who are also struggling with this delicate balance.

 

Carrie Steckl, Ph.D.

It’s a true blessing to have you visit my blog on mental health and wellness. I also write blogs on faith and caregiving in addition to teaching part-time for Columbia College of Missouri. For more information about my background and writing, visit my webpage at carriesteckl.com.

    Reader Comments
    Discuss this issue below or in our forums.

    Hypochondria vs healthy concern - Patti - Feb 7th 2013

    I've never been dx with hypochondria but for many years I was told nothing was wrong with me. I began having chest pain when a teen. One doctor after another said nothing was wrong. Because of them belittling me I developed severe depression. Nothing like the feeling of not being believed. In 1998 the supposed fake problem was found and required a pacemaker. Doctor said it was one I was born with. Recently I felt off physically. I went to an obgyn who found I had a few fibroids. But he downplayed it because of my emotional issues. Later I went to a different one who did a total hysterectomy. He said there too many fibroids to count. I saw the path report which confirmed it. Point is going from one doctor to another is sometimes needed to find out what is wrong. Being over worried is different from healthy concern. Being afraid of being accused by family and friends I tend to not tend enough to my heart, diabetes and seizure problems. All of which I see specialists for. Trying to look past others' judgements and taking care of myself is very, very hard. It's also very overwhelming to have all of this wrong. By the way the diabetes was confirmed through blood work, the seizures through various EEG's and the heart problems also through testing. It just took a lot of persistence and finding the right doctors. I never really was afraid of dying from any of it. Is following doctor's orders even though there are many of them being overly worried?

    My Experience With Self Advocacy - - Jul 15th 2012

    Self advocacy has on the whole taken me to a crazy making place in my mind, caused me to be at odds with my doctors, and to a total lack of faith in modern medicine.  Not self advocating, however, took me to death's door.

    Hypochondria and OCD - Janet Singer - Jul 15th 2012

    As an advocate for OCD awareness, I find this article interesting. Hypochondria is often seen as a form of OCD, where sufferers are obsessed with their health. There is always that doubt, that uncertainty, that something terrible might be wrong with them. They need constant reassurance (compulsion) that they are okay. As you say, having the internet at our finger tips is not always such a good thing. Thank you for recommending CBT, as ERP Therapy, a type of CBT, is the treatment of choice for OCD.

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