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Am I a Hypochondriac?

Being a Hypochondriac is Different Than Having OCD

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Updated April 23, 2014

Being a hypochondriac is often mistaken for OCD; however, each illness has a number of unique features, which healthcare providers can use to tell these two disorders apart. Let's look at the difference between being a hypochondriac and having OCD

How Are OCD and Hypochondriasis Different?

  • The biggest difference between OCD and hypochondriasis is the focus of the person’s worry and anxiety. People with OCD have obsessions that relate to a variety of themes, such a contamination, sexuality, religion, personal harm or morals. In contrast, people with hypochondriasis have obsession-like concerns primarily related to their health. These concerns often have to do with developing a serious medical condition, such as cancer.

  • People with hypochondriasis are often preoccupied (or even consumed) with bodily symptoms that can be quite vague (“my heart is tired”) or very specific (“my throat is always sore”). People with OCD are generally less preoccupied with physical sensations.

  • People with hypochondriasis often have difficulty accepting that their problems are anything but physical, and as such, seek medical rather than psychiatric or psychological help. On the other hand, people with OCD are much more likely to seek psychiatric or psychological help for the intense anxiety or distress caused by their symptoms.

  • In general, people with hypochondriasis have less awareness or insight as to the irrationality of their fears than people with OCD.

How Are OCD and Hypochondriasis Similar?

  • Just as people with OCD often use compulsions or rituals, such as counting, checking, ordering or washing to reduce anxiety related to obsessions, people with hypochondriasis will often try to reduce anxiety about their health by taking their pulse or checking their blood pressure. People with hypochondriasis may also frequently seek reassurance from doctors, family or friends to reduce anxiety about their health.

  • Whether the person has OCD or hypochondriasis, “safety” behaviors, such as checking or reassurance seeking, are used:

    • to prevent a feared outcome

    • reduce distress and anxiety, which feels good, and are therefore used again and again

    • to actually maintain the fear and anxiety they are supposed to prevent, because they keep the person from having new experiences that could help disprove their worries. For example, constantly running to the doctor for reassurance at the first sign of a stomach ache does not allow a person with hypochondriasis to learn that “dangerous symptoms” often go away on their own. For someone with OCD, constantly ordering shirts in the closet to prevent the death of a loved one will never allow them to learn that their loved one will be OK despite having not performed the ritual. For this reason, psychological therapies for both OCD and hypochondriais specifically target these kinds of rituals or compulsions.
  • For both OCD and hypochondriasis, the distress and worry is often so intense that there is a severe impact on interpersonal relationships and/or performance at work.

Can I Diagnose Myself?

Only a qualified mental health professional should diagnosis a complex illness, such as OCD or hypochondriasis. Extensive assessment is often required to arrive at the correct diagnosis. The treatment you receive is very much tied to your diagnosis, so it is essential that the diagnosis be correct. If you feel that you are experiencing symptoms of either OCD or hypochondriasis, be sure to speak with your family doctor.

Sources:

Abramowitz, J.S. “Hypochondriasis: Conceptualization, treatment, and relationship to obsessive-compulsive disorder.” Annals of Clinical Psychiatry 2005 17: 211-217.

Abramowitz, J.S. & Braddock, A.E. “Hypochondriasis: Conceptualization, treatment, and relationship to obsessive-compulsive disorder.” Psychiatric Clinics of North America 2006 29: 503-519.

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