Mired in malaise

PHOTO: Mired in malaise

In the movie, The Sixth Sense, a little boy possesses extrasensory perception and communicates with spirits.

Most of us do not have such a "gift", yet mere shadows can appear as apparitions. Have we not, at one time or another, experienced situations where we were scared out of our wits by our own heightened perception of things that are not, shadows that became apparitions of doom?

One stormy night, I remember staying alone in an old bungalow by the beach. The rustling of leaves and percussion of branches rattling the window pane (orchestrated by a howling wind) sent my imagination running wild. Haunting images from movies and ghostly scenarios from novels drove rational logic out of the window that night.

Fortunately, sanity returned with the rising of the morning sun.

Some poor souls are cursed with an intense gut feeling and intuition that they have a sinister disease. For them, their gloomy world is engulfed in darkness and surrounded by fear. They are preoccupied with a fear that they have a serious ailment, yet to be discovered.

It is estimated that about 5 per cent of patients who seek a physician's advice suffer from hypochondriasis (chronic and abnormal anxiety about imaginary symptoms and ailments).

Student of worry

Students of medicine are often overwhelmed when they learn about new diseases for the first time. On occasions, one or two may succumb to mental indigestion, leading to the "Medical Student Syndrome".

Bombarded by disease information, that little mole appears like skin cancer, that headache could be a growth in the brain, that itch around the butt must be due to little creepy-crawlies depositing their eggs ... get the picture?

Once, burning the midnight oil and going through a chapter on lymphoma, I came to the section on "How to detect abnormal lymph nodes". Upon self examination, I was horrified to find the tiny lumps in my neck. Anxiety worsened as the next chapter described the staging of the cancer. Laying flat on the couch, I could feel fairly big "tumours" in the abdomen.

That night, I resigned my fate to terminal malignancy! Fearing for dear life, I scuttled up to the professor's office the next morning to get a "second opinion".

With great relief, he pronounced that my time was not up yet and subsequent psychological counselling reassured me that my reaction was a common phenomenon among stressed out students struggling to navigate the turbulent waters of medical literature.

With advancing technology, the gates of the information highway can be opened with just a tap of the finger. Search engines bring us to the doorstep of a plethora of health and disease sites, some trusted, and some of dubious content (and intent), all on the same page.

Surfers on this route have carved out a new niche for themselves, and they have become known as "cyberchondriacs". These folks develop highly misplaced concerns over information that is browsed from the Internet, and subsequently become computer-generated hypochondriacs.

Distinct profile

Distinct profile

Categorising a person to a particular condition in itself can be damaging as the label bestows negative implications. A person harbouring hypochondria traits is not suffering from a serious illness in the first place, but shouldering the tag makes him an ill person, in the mind, at least.

For that reason, the diagnosis is only made after a person exhibits persistent and disproportionate fear of "hosting" a disease, for a period of at least six months.

The typical hypochondriac is often well read and has done some research into certain health issues, particularly pertaining to some vague symptoms. Sometimes, the perception of illness is simply the result of an over-exaggerated response to what is otherwise normal.

The disease may be imagined, but the fear and anxiety are not.

The afflicted person soon embarks on a journey to uncover the mysterious illness, often hopping from one doctor to the next, setting off on a trail of "doctor shopping".

It is perfectly fine to get a second opinion, but dissatisfied with one physician's interpretation and reassurance, they continue their search. The sufferer is convinced that certain tests need to be done, leading to an array of unnecessary and hazardous investigations.

As results are often unrevealing, patients are driven to the point of frustration. Some eventually land on the lap of alternative therapists who, in all fairness, may actually offer some recourse for their discomfort and fear. Unfortunately, a few fall victims to touts of quackery.

Many hypochondriacs require constant reassurances from the doctor, family and friends to ease their torment, while others prefer not to share their troubles as they fear that their incessant complaints will fall on sceptical ears.

Often, as the quest for confirming the illness ends up a blind alley, another unrelated symptom takes centre stage. The merry-go-round continues at the expense of the sanity of self, not to mention diminishing wealth as the barrage of medical tests do not come with a discount based on the number of symptoms.

These sufferers are real people in deep distress. Although they are not really seriously ill, their reactions to minor bodily changes and discomfort cause them to reel out of control.

Embroiled in turmoil, they are crying for help.

A word of caution: Hypochondriasis may be the ugly head of a more sinister body of underlying co-existent psychological conditions like anxiety disorders, obsessive-compulsive personality, and depression, which may escape notice.

Challenging as it may be, the physician would have to tease out the decoy distractions and run the necessary tests to exclude possible disease states. Overindulgence in investigations and treatment fuels the disease philosophy, but a dismissive attitude leads the frustrated sufferer to seek answers elsewhere.

Professional psychological evaluation is indispensable in identifying the root cause of such behaviour. The subsequent modification therapy is beyond the scope of this discussion. Co-existing ailments are treated accordingly, and in certain situations, anti- anxiety and antidepressant medication can offer some reprieve.

It is certainly a good measure to understand more about the health challenges that we face from time to time, if we know what we are looking for. If, after the search, the feeling is one of empowerment with a sense of relief, then that is an accomplishment. However, after taking in all that information, anxiety and fear ensues, then confusion may turn into conviction that one is indeed afflicted with a disease.

This article describes an extremely common dysfunctional state which can cause significant debilitation in the affected individual. The mind of a hypochondriac is akin to a fertile garden that can sprout good or bad seeds that land on it.

If weeds take root, the wild grass will crowd out the flowering plants, choking the garden, just like wild imaginings overruning cohesive logic.