Actually, after many years, the term has been changed to a more politically correct one: Illness Anxiety Disorder. <\/p>\n\n\n\n
Naturally, some degree of anxiety is totally appropriate when you are confronted with anything that might bring you protracted physical discomfort or shorten your precious lifespan (\u201cCould this be it? The top line item on my Death Certificate?\u201d). But when months and even years go by and that sense of dread starts dominating your thoughts long after no illness has been found (\u201cMaybe the doctors are missing something\u201d), and you\u2019ve heard that your tests were \u201cnormal\u201d yet again, maybe you wonder (or your spouse wonders) if you might be a bit of a hypochondriac. You think \u201cMaybe I need more tests. A different doctor. A different medical center, perhaps even THE MAYO CLINIC!\u201d.<\/p>\n\n\n\n
Now you\u2019re entering the rabbit hole, the slippery slope, when I, as a Functional Medicine physician, start hearing sentences like, \u201cYou\u2019re the fifteenth doctor I\u2019ve seen for these symptoms and no one can find the cause,\u201d or \u201cthe symptom’s not there today (in fact, I feel okay today) but I felt terrible last week,\u201d and \u201cHere are my tests\u2014I know there\u2019s quite a lot of material here.\u201d<\/p>\n\n\n\n
Well, first of all, you\u2019re really not a hypochondriac<\/strong> which is a very judgmental term. Let\u2019s agree that you\u2019re a bit anxious simply because you want relief <\/strong>and some answers.<\/strong><\/p>\n\n\n\n When you present your symptoms (fatigue, chest pain, bloating, whatever) to your doctor, she was taught in medical school\/specialty training to think in terms of \u201cpathology\/disease\u201d and orders \u201ctests\u201d appropriate for her specialty to locate that disease. If tests are \u201cnegative”, you\u2019re moved, assembly line style, to the next specialist in her mega-medical center, and the next, and you might end up with a big fat nothing. However, you\u2019ll be told, \u201cWe couldn\u2019t find a thing wrong with you!\u201d (You might have a bit of PTSD from the whole shebang.). This is classic disease based medicine.\u00a0<\/strong><\/p>\n\n\n\n But, if your problems are not disease but dysfunction (hormones out of whack, poor digestion or imbalanced intestinal bacteria, susceptibility to black mold, Lyme, food sensitivities, nutritional deficiencies), you\u2019ll likely be written off as a hypochondriac. Oh, pardon me, \u201cIllness Anxiety Disorder”.<\/p>\n\n\n\n We currently spend 18% of our Gross Domestic Product (GDP) <\/strong>or about $5 Trillion a year<\/strong> on health care. This will rise by 5% a year to $7 Trillion a year\u00a0by 2031. We outspend other Western countries despite declining lifespans, increased infant mortalities, and lots of other unpleasant parameters.\u00a0<\/p>\n\n\n\n The two factors most responsible for this: fee for service and pharmaceuticals. Much to the chagrin of physicians and hospitals, the insurance industry does put some controls on fee for service charges but pharmaceuticals live life with an American Express Black Card. <\/p>\n\n\n\n For you with illness anxiety disorder, <\/strong>if you\u2019ve got good insurance, you can have an excellent diagnostic workup at Northwestern including all tests and specialists. However, if you feel in any way dissatisfied, thinking you deserve \u201cmore”, take an Uber to Rush or the U. of C., not say a word that you\u2019ve just left Northwestern, and have the entire workup repeated and covered by your insurance. Then, a few months later, fly to Rochester, MN, for Mayo to do the whole thing again.\u00a0<\/p>\n\n\n\n Although I myself use the internet to keep up with advances in medicine, I began to notice several years ago how more and more patients were bringing in really bizarre stuff, wanting tests for illnesses for which they had nary a symptom. When I did further reading on the term cyberchondria<\/strong> I found it first used in British medical journal in 2001. The Brits have been tracking reasons for people coming to the doctor (remember, they\u2019ve got National Health) and discovered that one out of every five visits was due to \u201csomething\u201d read on the internet. <\/p>\n\n\n\n So \u201ccyberchondria\u201d can give you a lot of misinformation, making you even more anxious about illnesses you don\u2019t have, or keeping you from a treatment that could save your life. <\/p>\n\n\n\n To me, the most important \u201ctake-away\u201d is this: Your symptoms are real. No discussion here.<\/strong><\/p>\n\n\n\n However, a \u201cdisease-based symptom\u201d (like cancer, or an auto-immune illness, or an infection) starts at a certain time (say January 1st<\/sup>) and gets progressively worse fairly quickly (weeks to 2-3 months). Tests flip from \u201cnegative\u201d to \u201cpositive\u201d. Diagnosis is easier.<\/p>\n\n\n\n \u201cFunctional symptoms\u201d (chronic fatigue, irritable bowel, migraine, mold biotoxin illness and many others) last for years, have good days and bad days, often elude diagnostic tests.<\/p>\n\n\n\n Conventionally trained physicians are not educated in functional illness. <\/p>\n\n\n\n They term \u201cAdrenal Fatigue”, \u201cFibromyalgia\u201d, \u201cChronic Lyme\u201d, \u201cCandida”, and many others, as \u201ccontroversial\u201d.<\/p>\n\n\n\n And you get labelled as a hypochondriac. Oh, sorry, \u201cIllness Anxiety Disorder”.<\/p>\n\n\n\n And last, if you do feel so anxious about symptoms that you\u2019re not able to function on a day-to-day basis, I recommend a therapist for Cognitive Behavioral Therapy. Patients with Illness Anxiety also respond to the SSRI group of antidepressants. These raise the neurotransmitter serotonin which acts as a stress buffer and can be useful to calm the obsessive thinking about your symptoms.<\/p>\n\n\n\n Be well,<\/p>\n\n\n\n David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Actually, after many years, the term has been changed to a more politically correct one: Illness Anxiety Disorder. Naturally, some degree of anxiety is totally appropriate when you are confronted with anything that might bring you protracted physical discomfort or shorten your precious lifespan (\u201cCould this be it? The top line item on my Death […]<\/p>\n","protected":false},"author":4902,"featured_media":31478,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,2,2316,67,50],"tags":[2710,2707,1059,2711,2706,2708,2709,2712,1593,2713],"class_list":["post-31476","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-a","category-blog","category-featured","category-h","category-healthy-lifestyle","tag-cognitive-behavioral-therapy","tag-cyberchondria","tag-functional-medicine","tag-healthcare-costs","tag-illness-anxiety-disorder","tag-medical-misinformation","tag-mental-health-stigma","tag-misdiagnosis","tag-overdiagnosis","tag-ssris-and-antidepressants"],"yoast_head":"\r\nPart One: What Doctors Know and What They Don\u2019t Seem to Know<\/strong><\/h3>\n\n\n\n
Part Two: The Entire Healthcare System Encourages Egregious Overspending with Little in Return<\/strong><\/h3>\n\n\n\n
Part Three: \u201cCyberchondriasis\u201d can be much more dangerous than you think<\/strong><\/h3>\n\n\n\n
Part Four: What to do with \u201cIllness Anxiety Disorder\u201d<\/strong><\/h3>\n\n\n\n