Am I a Hypochondriac? Is It Different Than Having OCD?

Similarities and Differences Between Hypochondriasis and OCD

Girl contemplating an array of perscription drugs
What are the differences and similarities between hypochondriasis and obsesive compulsive disorder (OCD)?. Peter Dazeley/Photographer's Choice/Getty Images

Being a hypochondriac is often mistaken for obsessive-compulsive disorder (OCD). However, each illness has a number of unique features, which healthcare providers can use to tell these two disorders apart. 

Similarities and Differences Between Hypochondriasis and OCD

Hypochondriasis and obsessive-compulsive disorder (OCD) have many similarities. Behind conditions reflect an underlying effort to reduce anxiety.

  In response, many types of "safety behaviors" may be shared by both conditions. In contrast, there are important differences as well. Let's begin by noting the ways in which these conditions differ, as distinguishing these conditions is important, since the proper treatment depends very much on an accurate diagnosis.

How Are OCD and Hypochondriasis Different?

There are several differences between obsessive compulsive disorder (OCD) and hypochondriasis. Here is a list of some of them:

1. Focus: Obsessions vs Specific Concerns

The biggest difference between OCD and hypochondriasis is the focus of the person’s worry and anxiety. People with OCD have obsessions that relate to a variety of themes, such as contamination, sexuality, religion, personal harm, or morals. In contrast, people with hypochondriasis have obsession-like concerns primarily related to their health. These concerns often have to do with developing a serious medical condition, such as cancer.

(Nosophobia or "cyberchondria" in contrast, is the fear of having a specific disease.) The type of intrusive thoughts are often significantly different between these two disorders as well.

2. Preoccupation With Physical Sensations

People with hypochondriasis are often preoccupied or even consumed with bodily symptoms that can be quite vague, like “my heart is tired," or very specific, such as “my throat is always sore." People with OCD are generally less preoccupied with physical sensations.

3. Type of Help Sought: Medical vs Psychological

People with hypochondriasis often have difficulty accepting that their problems are anything but physical, and as such, seek medical rather than psychiatric or psychological help. On the other hand, people with OCD are much more likely to seek psychiatric or psychological help for the intense anxiety or distress caused by their symptoms.

4. Awareness and Insight

In general, people with hypochondriasis have less awareness or insight as to the irrationality of their fears than people with OCD. A person with OCD will often seek psychological treatment after recognizing the symptoms. A person with hypochondriasis, in contrast, will often have a medical professional recommend psychological treatment.

How Are OCD and Hypochondriasis Similar?

Though the differences between OCD and hypochondriasis exceed the similarities, there are some symptoms that remain similar between the two. Some of these include:

1. Ways of Reducing Anxiety

Just as people with OCD often use compulsions or rituals, such as counting, checking, ordering or washing, to reduce anxiety related to obsessions, people with hypochondriasis will often try to reduce anxiety about their health by taking their pulse or checking their blood pressure.

People with hypochondriasis may also frequently seek reassurance from doctors, family or friends to reduce anxiety about their health.

2. Impact of Life, Relationships, and Work

For both those who are living with OCD and those with hypochondriais, the distress and worry is often so intense that there is a severe impact on interpersonal relationships and/or performance at school or work.

3. Safety Behaviors

Whether a person has OCD or hypochondriasis, safety behaviors, such as checking or seeking reassurance, are used for these reasons:

  • To prevent a feared outcome.
  • To reduce distress and anxiety. The safety behaviors feel good, and are therefore used again and again.
  • To actually maintain the fear and anxiety they are supposed to prevent, because they keep the person from having new experiences that could help disprove their worries. For example, constantly running to the doctor for reassurance at the first sign of a stomachache does not allow a person with hypochondriasis to learn that dangerous symptoms often go away on their own. For someone with OCD, constantly ordering shirts in the closet to prevent the death of a loved one will never allow them to learn that their loved one will be OK despite having not performed the ritual. For this reason, psychological therapies for both OCD and hypochondriais specifically target these kinds of rituals and compulsions.

Can You Diagnose Yourself With Hypochondriasis or OCD?

Only a qualified mental health professional should diagnose a complex illness, such as OCD or hypochondriasis. Extensive assessment is often required to arrive at the correct diagnosis. The treatment you receive is very much tied to your diagnosis, so it is essential that you are diagnosed correctly.

If you feel that you are experiencing symptoms of either OCD or hypochondriasis, be sure to speak with your family doctor.

Bottom Line on the Distinction Between Hypochondriasis and OCD

As noted above, there are some important similarities between hypochondriasis and OCD, and this can lead to an inaccurate diagnosis, especially if you are attempting to diagnose yourself. Yet there are several differences between the two conditions as well, and distinguishing the conditions is important in properly treating the disorder.

Sources:

Romero-Sanchiz, P., Nogueira-Arjona, R., Godoy-Avila, A., Gavino-Lazaro, A., and M. Freeston. Differences in Clinical Intrusive Thoughts Between Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, and Hypochondria. Clinical Psychology and Psychotherapy. 2017 July 26. (Epub ahead of print).

Stein, D., Kogan, C., Atmaca, M. et al. The Classification of Obsessive-Compulsive and Related Disorders in the ICD-11. Journal of Affective Disorders. 2016. 190:663-74.

Torres, A., Fontenelle, L., Shavitt, R., et al. Comorbidity Variation in Patients with Obsessive-Compulsive Disorder According to Symptom Dimensions: Results from a Large Multicentre Clinical Sample. Journal of Affective Disorders. 2016. 190:508-16.

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