Generalized anxiety disorder usually comes across in the patient who does not worry about any one topic or fear in particular, but instead always characteristically worries. It is a free-floating anxiety that might be described as a mosquito that cannot be swatted, or a background noise that cannot be turned off. The anxiety switches back and forth from one topic to the next.
A generalized anxiety sufferer might worry about the latest airplane crash, switch to the next terrorist attack, return to his boss’s reaction to his latest business report, focus on the redness on his arm as indicative of a likely first sign of cancer, fret over the weather turning bad for tomorrow’s party, and then focus on a feeling that he has now become too heavy from eating that donut.
Generalized anxiety disorder in its purest form seems to suggest a basic level of not feeling safe in the world. It also reinforces someone’s feeling very important. If he has to think about everything so much that his thoughts are central to every action, then he must indeed be very powerful and in control of the universe.
He must compromise when including someone else or some level of risk in a situation while also keeping very alive the possibility that the other person’s involvement could lead to a bad outcome.
What is hypochondriasis?
Hypochondriasis is an anxiety that manifests itself in and around the body. The patient with hypochondriasis constantly fears and believes that any bodily symptom that he or she experiences is attributable to a serious and/or malignant medical illness. A patient with hypochondriasis fears that she will die from this medical condition or she has a medical condition that is not diagnosable with appropriate clinical or physical examination and/or laboratory findings.
This anxiety can take over the life of the patient’s mind. A hypochondriac with a pimple on his penis believes it can become a lethal, sexually transmitted disease. A numbness on the finger can cause concern that it is the first symptom of a brain tumor.
Nausea can be interpreted as stemming from ovarian cancer, and that worry, like in any other condition, can mushroom into an all-consuming pattern. The evaluation and management of hypochondriasis usually responds best to regular visits with an internist or family medicine doctor who can reassure the patient, over time, that he is not dying.
However, psychological treatment—if these anxious patients are willing to engage in it—can be markedly helpful. The key is to try to help the person see that the discomfort that she is feeling stems from anxiety rather than from a bodily condition, and to then focus on the patient’s need to create the anxiety rather than the actual somatic disturbance. Oftentimes, there will be a history in the family of someone who has been sick and has received love and attention for being sick.
The patient then has a learned behavior of obtaining gratification by being in the sick role. It may create “legitimate” attention for a patient who does not attend a given family function, or it may be a means to get attention that otherwise would not be permissible in a family system. For example, a patient who harbors longstanding resentment and jealousy towards a sibling but knows that displays of frustration and aggression will only create family havoc might unwittingly find themselves in an emergency room on the day of the sibling’s graduation from college, being evaluated again for a brain tumor after experiencing a migraine headache.
Hypochondriasis
an exaggerated fear that one has an illness or disease based on a misinterpretation of a bodily symptom and without any medical basis.