When 'Illness' Takes Over Someone's Life: Munchausen Syndrome Vs Hypochondria

Hypochondria and Munchausen are two words we've almost all heard. Both, we know, refer to people who are obsessed with disease and illness without actually having the serious medical issues they talk about. What exactly is the difference between Munchausen Syndrome and Hypochondria, though? What are the tell-tale signs?

What's Hypochondria Really About?

Worrying about health is, I think, something that we all do from time to time. Those heart palpitations, that lump in our breast or testicle, that abdominal pain... whatever it is, we're prone to Googling it, seeing the worst-case scenario come up on our screen rather quickly, and giving ourselves a death sentence before we even get to the doctor. 

For most of us, however, this feeling of panic is of a passing nature. Once that instant of panic is over, we make an appointment with our physician and get a diagnosis, or, of course, the all-clear. Though excessive Googling may get you to label yourself a hypochondriac, most people who go through this process suffer from nothing more than living in an age where information is readily available. 

The diagnosis of "hypochondria" doesn't actually exist anymore, having been replaced with two alternative conditions in the latest Diagnostic and Statistical Manual of Mental Disorders, the DSM 5. They are both characterized by excessive worry or obsession with illness or symptoms that are not anchored in reality.

1. Illness Anxiety Disorder: People with Illness Anxiety Disorder obsessively worry about medical conditions in the absence of any physical symptoms, or in the presence of mild symptoms, often even after their doctor has reassured them they do not suffer from the condition they are preoccupied with. [1]
2. Somatic Symptom Disorder: People with Somatic Symptom Disorder do actually have physical symptoms, but they occur in the absence of an actual disease or injury. [2]

Illness Anxiety Disorder Symptoms

People who suffer from Illness Anxiety Disorder will be extremely focused on the idea that they are ill or at risk of an illness, interpret normal bodily processes or minor symptoms as symptoms of a serious disease, excessively worry about diseases that run in their family, and constantly worry about their health in general. Notably, people who suffer from Illness Anxiety Disorder don't find much reassurance when their doctor informs them they don't have the disease they were worried about, and their concerns about being or becoming ill take up so much of their time and mental energy that daily functioning is impaired. 

If you recognize yourself in these symptoms, you should consider visiting a therapist or at least try relaxation techniques for anxiety.  

Somatic Symptom Disorder Symptoms

People with Somatic Symptom Disorder actually experience physical symptoms like chronic pain, shortness of breath, diarrhea, and abdominal bloating. Diagnosing this disorder is a matter of excluding physical disorders. Somatic Symptom Disorder may be a real mental disorder, but extreme caution is warranted before diagnosing someone with it: the possibility that a patient's symptoms are the result of a very real physical problem that has simply not been identified yet — because it's very rare, for instance — should not be dismissed.

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Risk Factors

While no specific cause of hypochondria has been identified, there are known risk factors. They include having a family history of disease, having had a serious disease in the past (for example, if you've had breast cancer before, you may worry about the cancer coming back), going through a period of major stress, and — take note! — spending a lot of time researching health issues online. [3] People with a history of childhood abuse and those that are generally prone to anxiety are also at a higher risk of developing one of the disorders that would previously have been classified as hypochondria.

What Is Munchausen Syndrome?

While hypochondriacs sincerely believe they either have or are at a high risk of developing a disease, people with Munchhausen Syndrome are in a completely different category. They know the symptoms they talk about are either ones they faked or ones they only have because they caused those symptoms themselves. While they pretend to have diseases, illnesses, emotional or cognitive disorders they don't actually have, they ironically really are ill: Munchausen Syndrome is a mental illness that falls on the spectrum of factitious disorders. 

What's The Deal With Munchausen?

Named after the literary character Baron von Munchausen, an 18th-century German officer who liked to tell tall tales, Munchausen Syndrome patients have an inner need to have others see them as ill in order to get reassurance, sympathy, or attention. It's important to note that people with Munchausen Syndrome aren't scam artists: those who pretend to be ill for financial or other concrete gain don't qualify for this diagnosis. The underlying issue is an emotional need. [4]

People with Munchausen Syndrome embellish or make up symptoms to gain the attention of medical professionals and others, and are often willing to subject themselves to painful medical tests, invasive procedures, or take extreme measures to create symptoms that didn't previously exist. Like hypochondriacs, they may tell the people in their lives all about their medical worries, all the time. Unlike hypochondriacs, they are aware that they don't have the disease they pretend to have, and they inflicted the symptoms they have on themselves.

Munchausen Syndrome Symptoms

How can you tell whether someone you know has Munchausen Syndrome? The diagnosis can only be made by qualified health professionals, but here are some of the warning signs:

• An extremely dramatic and often varied medical history.
• A history of seeing many different medical professionals for the same problem, but not wanting those professionals to communicate with each other or with relatives and friends.
• Symptoms that get worse, rather than better, with treatment.
• Extensive medical knowledge. 
• Symptoms get worse after negative medical test results.
• Being extremely willing to undergo numerous medical tests.
• Dramatic symptoms occur in private without witnesses.
• Self-esteem and identity issues. 

Munchausen Syndrome Vs Hypochondria

What are the key differences between hypochondriacs and those with Munchausen Syndrome, then? Hypochondriacs are genuinely worried or convinced they have a disease, while those with Munchausen Syndrome are in it for sympathy and attention, and can go to extreme lengths to make themselves sick. They are quite aware, meanwhile, that they are fabricating their own symptoms, either physically or by lying.