The final words on Spike Milligan’s gravestone in an English cemetery read as “Dúirt mé leat go raibh mé breoite”, the Gaelic rendition of “I told you I was ill”. This eccentric choice arose from the church leadership’s reluctance to the Irish comic’s humour, resulting in a clever linguistic workaround from his family.
Milligan’s post-death jibe at hypochondria mirrors the negative connotations the term held until not too long ago. Hypochondria denotes an ongoing and unnecessary fear or conviction of being severely ill, a definition that earned a negative status within and beyond medical circles.
Presently, in an attempt to shed the adverse connotations related to hypochondria, the World Health Organisation now utilises the term “health anxiety”. Furthermore, the medical fraternity widely accepts the term “illness anxiety disorder” (IAD).
The prevailing concept of the hypochondriac in mainstream culture is a completely healthy individual persistently believing they are unwell. However, as Caroline Crampton’s brilliant work, “A Body Made of Glass”, on the history of hypochondria points out, it’s possible for health anxiety to coexist with actual sickness. Having been diagnosed with lymphoma in her teens, and subsequently treated, she recounts her constant anxiety that the serious illness might return unbeknownst to her. This relentless awareness and hyper-vigilance about every minor pain and discomfort eventually matured into her health anxiety.
A recent Swedish investigation has discovered that excessive health worriers tend to have a shorter lifespan compared to those who worry less. But why, despite having no medical issues, do hypochondriacs, who worry about their health more than others, tend to have reduced lifetimes?
The Swedish scientists monitored around 42,000 individuals (1,000 of whom had IAD) for two decades. Over this timeframe, those with the disorder had a higher mortality rate. Those who worried more passed away five years earlier than their less anxious counterparts.
Individuals suffering from Illness Anxiety Disorder (IAD) face higher mortality rates due to cardiovascular and respiratory causes, according to an unexpected finding. Interestingly, this demographic does not exhibit an increased death rate from cancer, despite a common correspondence between anxiety over illness and fear of cancer. Suicide was identified as the primary cause of unnatural death among IAD patients, indicating a fourfold increase in comparison to individuals without IAD.
Dr Stephen Hughes, a distinguished lecturer in medicine at Anglia Ruskin University, attempts to shed light on this peculiar correlation between disease apprehension and premature mortality. He highlights the well-established relationship between IAD and psychiatric disorders, underlining the increased suicide risk associated with psychiatric disruption. Drawing attention to the societal stigmatisation and dismissal faced by IAD patients, he suggests this might exacerbate feelings of anxiety and depression that could potentially culminate in cases of suicide.
Nevertheless, explaining the amplified risk of dying from natural causes in IAD sufferers still remains a complex task. Dr Hughes speculates that lifestyle variables may play a crucial role. He points out that habits such as consuming alcohol, smoking and drug intake are more prevalent amongst those prone to anxiety and with a psychiatric disorder. Such destructive practices may shorten life expectancy, thereby possibly contributing to the higher mortality rate associated with IAD.
While it is recognised that IAD is more prevalent in individuals who have witnessed a family member suffer from a severe ailment, Dr Hughes’s rationale for this seems to be contentious. He argues that given several serious diseases have a genetic link, there could be inherent reasons for the heightened mortality, such as truncated lifespan due to ‘defective’ genes.
Although general practitioners often adopt a carefully challenging approach and propose treatments like Cognitive Behavioural Therapy (CBT) for IAD patients, a study from Sweden recommends increasing the scrutiny of their health. While the quest for everlasting life is unattainable, it invariably stands true that every individual with IAD is finally validated.