Do you suffer from hypochondria? In a world that keeps inventing ever more sicknesses, it seems increasingly hard not to. We have, for example, pleasure deficiency syndrome, which is sweeping Britain, according to a survey last year. Symptoms apparently involve tiredness, boredom with work and lethargy. If that doesn’t get you panicking, then try celebrity worship syndrome, which “affects one in three Britons” and is “borderline pathological” in severe cases, according to a study in the
Journal of Nervous and Mental Disease. Watch out if you find yourself stalking a minor celeb. You could also lie awake at night fretting about unicyclist’s sciatica, tight pants syndrome or lutraphobia — a morbid fear of otters.
Daft diseases are becoming an epidemic. I’ve found enough in the past two years to fill a new book. But why do they keep emerging? There’s money, for a start. Doctors, therapists and drug companies continually need new conditions to keep their bank accounts healthy. Their constant inventiveness would not work, however, if we were not all willing accomplices. We all carry the germ of hypochondria. We evolved mild doses as a survival tool. Our ancient cavepersons’ brains are hard-wired to obsess about threats. Thanks to sanitation and medicine, the dangers are nowhere near so real. But civilisation also gives us time, cash and energy to spend fixating on sickness.
So the Western world has seen a huge drop in mortal illnesses — and a leap in new diagnoses. The drug industry needs new plagues as badly as the rest of us. If it cured everything, growth would grind to a halt. The industry thrives by providing cures — though companies have found it is a cute trick to invent cures for diseases that don’t exist. Mere conditions get juiced up into diseases, and rare illnesses are “on the increase”.
Roche developed the drug Mannerix to treat “social phobia” and claimed that one million Australians suffered from it. But the company could not initially find enough sufferers for clinical trials. That was some years back. Now, social phobia is becoming accepted as a condition. Pfizer markets the drug Zoloft in America as a cure for “social anxiety disorder”. Yep, SAD.
Lawyers also encourage people. An Alberta University research study comparing car crashes in Canada and Greece found that whiplash injury is unheard of in Greece, even though the accidents are the same. You can’t get compensation for whiplash in Greece, so it does not exist there, they concluded.
Many doctors worry about the trend to prescribe ever more new drugs for a growing list of new illnesses. The British Medical Journal in 2002 polled British doctors on the top “non-diseases” which are being redefined as medical conditions. In first place was ageing, followed by work, boredom and bags under the eyes. But many other doctors are keen to discover, or to invent, new illnesses for us. It gets them published in the profession’s fast-proliferating research journals. If their new disease is scary or sexy enough it gets their name in the newspapers.
Many of the bizarre conditions that get thrown up are compellingly daft, such as hairdresser’s nipple (inflammation caused by stubble burrowing into the nipple), telephone stroke (holding a receiver twixt head and shoulder can block bloodflow), waterskier’s enema (when women fall bottom-first into water at high speed) and information fatigue syndrome (confusion caused by excess media). But there is a dark side. Hypochondria can be very harmful — not least for the thousands who are sent by doctors and nurses for unnecessary investigations or operations because the Zeitgeist encourages them to feel and to act ill. There is also the “nocebo” effect. It is the placebo effect’s evil dark side. A placebo makes you get better because it helps you to believe you will get better. The nocebo effect makes people who worry about illness become ill.
In one example, researchers discovered that women who believe that they are prone to heart disease are nearly four times as likely to die as women with similar risk factors who don’t hold such negative views. The study, reported in the Journal of the American Medical Association, covered more than 5,000 women in Framingham, Massachusetts. The same journal reports how researchers at three medical centres who undertook a study of aspirin in heart patients at three hospitals discovered that if you warn people about possible side-effects, the number who suffer them increases.
The nocebo effect also blights accident victims fighting long legal damages cases. This phenomenon has its own title: compensation neurosis. The process of going through the courts means that they never get better — especially if they win their case. A report in Clinical Orthopedics says they are not malingering but all the courtroom drama convinces their subconscious brains to ensure that they stay wounded. A fat cheque does not help. “Because any improvement in the claimant’s health condition may result in denial of disability status in the future, the complainant is compelled to guard against getting well,” it says.
Recently, psychologists announced some potentially devastating news for hypochondriacs — or at least for the medics, therapists and drug companies that profit from them: there may be a cure for hypochondria. Last March, Arthur J. Barsky reported in the Journal of the American Medical Association that therapy can banish imaginary ailments. He and colleagues at the Brigham and Women’s Hospital and Harvard Medical School, Boston, gave six weeks’ worth of 90-minute psychotherapy sessions to 102 patients whose reported medical symptoms could not be explained by real illness.
A quarter of the patients left the programme as soon as they learnt it was offering mental rather than physical treatment. “Most hypochondriacs will never go to a psychiatrist,” says Barsky. “They will say: ‘I don’t need to talk about this, I need somebody to stick a biopsy needle in my liver’.” But those who stuck with the six psychotherapy sessions were encouraged to stop being hypervigilant about bodily functions, to reflect on the stresses that make them feel ill and to stop habits that worsen their symptoms, such as Googling for disease information or browsing newspaper obituaries.
A year later, Barsky says that almost 57 per cent of the patients had “significantly lower levels of hypochondriacal symptoms”. That’s an encouraging increase over the 32 per cent of hypochondriacal patients whose lives improved after going through the normal medical system.
Individuals might be curable. But what about a remedy for today’s hypochondriacal society? Would Western civilisation be able to carry on without a diet of new health threats? Given Homo sapiens’ innate drive to fixate on threat and danger, it seems more likely that we would end up like the urban myth about hedgehogs, which says that if you rid them of their fleas, they start to suffer from withdrawal symptoms. Don’t sell those drug-company shares just yet.
