By Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutr
Here is a definition of hypochondria by
Ingvard Wilhelmsen, MD, Ph.D
“A person with hypochondria is preoccupied with physical health and body. The diagnosis is used when a person during at least 6 months believes, fears or is convinced that he has a serious disease despite medical reassurance. This fear of disease or preoccupation with symptoms is unpleasant, interferes with the patient’s daily life in a negative way and leads to medical examinations and/or treatment. The patient can only temporarily accept assurance that there is no physical explanation to his symptoms.” Wilhelmsen
Some of the symptoms in hypochondria are real, such as headaches, muscles tension, heart palpitations, stomach aches, insomnia but are usually exaggerated into more serious illnesses such as cancer or heart attacks. This illness should not be confused with Munchausen syndrome which is a mental disorder in which the patient fakes illness to gain attention and sympathy or even as fraud for financial gain.
Most people with hypochondria become aware that their fears are irrational and this may be one important step towards overcoming the problem. However, knowing that hypochondria is one of many forms of irrational anxiety, is not going to help a sufferer, just as knowing that having an irrational fear of height, spiders or mice is going to reduce the symptoms of phobia.
Traditional treatment for hypochondria centres around drug and/or psychotherapy. Drug therapy aims at reducing the physical symptoms of the disease, whereas psychotherapy hopes to address the cognitive (thinking) aspects of the disorder. Talk therapy is based on the assumption that cognitive or psychological thought processes may trigger a ‘somatizing’ effects on the body, thus creating the physical symptoms of hypochondriacs. Hypochondria is a real disease and should be distinguished from malingering, or feigning to have an illness in order to escape one’s duty or work or gain some legal advantage. Conventional treatment centring around medication and/or psychotherapy has been generally disappointing.
A different approach to hypochondria is to see this illness in terms of a real illness with common features of other forms of abnormal anxiety reactions.
The major hormones of fear are adrenaline and cortisol. Normally these hormones are activated when the body needs to prepare itself for quick action in the face of danger. Adrenaline draws biological energy away from the digestive system to the muscular and the brain in readiness for strenuous action. This may cause a variety of symptoms associated with the activation of the Autonomic Nervous System. (1) and stops the production of relaxing hormones such as serotonin and perhaps dopamine. The hormone adrenaline also helps us to FOCUS on the danger.
The question is “how can this valuable survival mechanism be activated without the presence of real danger?”
There is sufficient evidence to show that that excess adrenaline can be produced as a result of internal (endogenous) biochemical processes that are related to our diet.
When the person suffers from insulin resistance (also called hypoglycemia, also a factor in Syndrome X), the receptors for insulin in our body are not responding properly to insulin’s action in pushing glucose across cell membranes. This results in higher than normal blood sugar levels (hyperglycemia), which will trigger the release of more insulin (hyperinsulinism) in the body. Excess insulin causes a sudden descent of blood sugar levels (hypoglycemia). The brain (hypothalamus) senses a sudden threat to its normal supply of biological energy (glucose) and sends a hormonal message to the adrenal glands to pour adrenaline (or cortisol) into the blood stream in an attempt to rebalance the energy supply to the brain. Adrenaline functions to convert sugar stores (glycogen) into glucose. (See image)The brain is entirely dependent on stable supply of glucose as a source of biological energy called ATP necessary in the production of feel good neurotransmitters, such as serotonin. See here.
The presence of the Hypoglycemic Syndrome can be medically tested by a special Glucose Tolerance Test designed by Dr George Samra and described at our web site here. He describes the various types of hypoglycemia in his book “The Hypoglycemic Connection II”. The results of such a test can be compared with he description of the various types of hypoglycemia here.
Hypoglycemia can also be tested by a home test called The Nutrition-Behavior Inventory Questionnaire (NBI) or the Hypoglycemia Questionnaire. If your scores are high it is most likely that you have the hypoglycemic syndrome that can account for the symptoms.
Thus adrenaline is a stress hormone that can be produced without any reference to anything going on in the environment or the mind.
If you inject an animal with adrenaline it will FOCUS on any unusual object in its environment and react to it ‘as if in a danger’.
It is not difficult to see that if we are hit by excess adrenaline from within, then we will FOCUS on anything that could possibly explain our internally driven fear reaction. Excess adrenaline also interfere with the synthesis of serotonin – our feel-good hormone – and thus melatonin – the sleeping hormone also derived from serotonin – and so we have a cluster of symptoms closely related to the symptoms of depression.
The non-drug treatment for depression and therefore hypochondria is adopting the hypoglycemic diet. This diet, accompanied with several vitamins and minerals and adjusted to the individual, specifically helps to normalise blood sugar levels, as well as insulin and stress hormone levels. An immediate release from anxiety can be achieved by supplementing with glycerine, although this should not be consider3ed a cure!
Thus an essential part of any psychological treatment for hypochondria is the inclusion of the hypoglycemic diet as part of overall treatment.
Munchausen syndrome differs from hypochondria, in that the patient is deliberately faking physical illnesses in order to obtain sympathy from the medical profession or to procure drugs. Its causes are said to be unknown, but having regard to the impact on the mind of metabolic disorders, we can not exclude the possibility of pre-diabetic insulin resistance or hypoglycemia as one of the important factors affecting this disease.
Please discuss this article with your health care worker, doctor or nutritional doctor or therapist