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Fear and the Physical

Perhaps what is more disturbing than any reality or actual situation is the haunting fear and anticipation of the fruition of such a reality or situation. When it comes to one's health or impressions of oneself, the fears are no doubt more frustrating and panic-causing. There is probably no more frustrated patient than the one with Hypochondriasis or Body Dysmorphic Disorder. Both of these disorders are problems in the thought life of a person rather than in physical reality. The physical reality is invisible to these patients, however, which makes for a very difficult situation for physicians. They receive the brunt of the frustrations regardless of their increasing attempts to discover any problem in the patient. Following are basic descriptions of the two disorders.

Hypochondriasis

Since medical symptoms start slowly and develop, typically, the hypochondriac is easily convinced that he has some serious disease. He notices slight changes in his physical feelings and overall condition. He also pays close attention to the media and to medical information in order to compare his own symptoms to that of the latest known disease. He is concerned over a period of years that his body is at serious risk and is succumbing to some deadly or otherwise serious disease. It is true that diseases will be much more curable and much less serious if they are treated early, so the hypochondriac is not totally unwise in getting his symptoms checked out. The irrationality is that he continues to get his symptoms checked. He gets second and third and fourth opinions. Even when every doctor gives him a clean bill of health he is only more frustrated and convinced of his imminent fall into sickness. A person may be suffering from Hypochondriasis if he has had the same worries for more than six months even after he has been to a doctor and been reassured that he has good health.

Body Dysmorphic Disorder

Body Dysmorphic Disorder is less heard of than Hypochondriasis. The problem is similar though. If a person is suffering from this disorder, he is totally convinced that some part of his face or body is horribly disfigured or ugly. The truth is that, to most people's perceptions, the part is either attractive or without cause for attention at all. Regardless of people's opinions and even after the sufferer has been reassured of their acceptable appearance, he is nevertheless obsessed with the supposed ugly part of his body. He is embarrassed to venture into public places. He assumes that people are always staring at and talking about his appearance. The preoccupation affects daily life and productivity.

Treatment

Obviously, the problem that the sufferers of these disorders feel they have cannot be treated. The people with the conditions should, rather, attempt to trust those around them. A thorough and complete medical evaluation is a good idea. Avoid retesting over very short amounts of time. Also, trust those who care about you to tell you the truth and to have your best interests in mind.

Frances, Allen MD and First, Michael B. MD. Your Mental Health: A Layman's Guide to

the Psychiatrist's Bible. New York: Scribner, 1998.