Q: We believe our 57-year-old friend is an over-medicated hypochondriac. She just spent 4 or 5 days in the hospital with abdominal pain and diarrhea. The symptoms subsided while in the hospital but as soon as she learned she was to be dismissed, they came back. She had multiple tests performed by a gastroenterologist, endocrinologist, surgeon, and her primary doctor. All results were negative. As soon as she was released from the hospital she immediately started taking her Demerol and Ambien for sleep.
She’s 75 to 100 pounds overweight, has type II diabetes for which she takes oral medication. However, she does not test her blood sugars and does not follow a diabetic diet. She has sleep apnea for which she had surgery and sleeps with a Cpap machine, high blood pressure (takes medication for this, too), and takes something for gout and arthritis. In the 15 years I have known her, she always takes muscle relaxers to help her sleep and in the last couple of years, she’s combined that with the Ambien.
She’s in the medical field and insists on seeing specialists for her condition. She is always in search of a new doctor because “he/she wasn’t doing me any good”. Her primary doctor does whatever she tells him to do. I certainly believe she has legitimate health concerns that need to be addressed. I also believe she has a lot more issues that are not real. She reads your column faithfully and frequently falls victim to conditions/diseases that are discussed in your column a few weeks after they are published. We don’t know what to do. During this last hospital stay, we all told her that this is her wakeup call, to start taking care of herself, but it has fallen upon deaf ears. What do you recommend to get our friend out of this vicious cycle?
A: Hypochondriasis is a fear of having a disease or disorder. An individual may have a persistent conviction that he or she is ill or likely to become ill when symptoms and illness are absent, despite reassurance and medical evidence to the contrary. Healthy people occasionally feel they may have a very serious disorder. This is normal. However, the hypochondriac is consumed with fears every waking hour of every day, and about 85% of those individuals also suffer from depression, anxiety, or obsessive compulsive disorder.
It’s not clearly understood why some individuals fall into this category. There may have been a history of abuse involving a household member when your friend was a child, or perhaps an elderly individual in the family got extra attention while being cared for, or a sickly child was always thought of or cared for first. These situations do not represent hypochondriasis but could be perceived as a method by which extra attention can and must be given. As you have discovered, individuals so diagnosed may read something in a medical column, newspaper, pamphlet received in the mail, watched a medical television program, have done their homework through the internet, or are in the health care field and know what symptoms to have, what drugs might be prescribed, what tests might be performed, all in the name of getting to the cause. Well, with HIPAA laws, you are pretty much restricted from interfering with the doctors she sees. Her business is exactly that…her business. Doctors and hospitals cannot, should not, and will not divulge information. If one of her concerned friends has something of a working relationship with a member of her health care team, he or she may be able to offer an opinion for consideration but that’s about as far as it goes.
Her health care provider should explain she does not have a disease, however continued medical follow-up will help control her symptoms. She is under a great deal of stress so her symptoms should neither be denied or challenged. Antidepressants such as selective serotonin reuptate inhibitors (SSRIs) can help reduce the worry and physical symptoms of the disorder. Finding a mental health provider with experience in treating this disorder through talk therapy (psychotherapy) or cognitive behavioral therapy can be helpful. Tell her you care for her, want to be there when needed, but the road she has chosen to travel is not one you are willing to condone. Then walk away.
