Psychological Sickness

February 28, 2005

Ever notice how some people always seem to be sick or complain about something being physically wrong with them? These are the people who always seem to have a cold… a sinus infection… a headache… something. We call them hypochondriacs and those people who truly do believe they have all of these problems have what the mental health field calls hypochondriasis (from which hypochondriac is obviously derived).

Technically speaking, hypochondriasis is considered a somatoform disorder (which are characterized by physical symptoms with no physical, otherwise noted mental, or substance-related causes). During past wartimes, some pilots have reported suddenly going blind, and therefore, have been deemed unfit to complete their missions. After a careful physical examination, it is often concluded that there is no physical damage or explanation for the sudden blindness but something truly has taken these people’s sight. Most eventually recovered their vision after a period and to this day are unable to explain why such an event happened. This is a prime example of a real somatoform disorder; that is, something in the brain has spontaneously triggered a physical response to a perceived mental stress (in this example, the stress of flying a bombing mission). The majority of the pilots who said they were blind were not lying… they were not making up excuses… and they were not consciously trying to get out of something. The stress of the missions they were being asked to carry out was so great that the brain’s best defense was simply to shut down the primary means by which the mission could be carried out, and thus, shut down the stress.

This example is extreme, I know. Very true, but extreme none the less. My point in making the example, however, is that somatoform disorders (including hypochondriasis) generally occur in people who are under some sort of extreme stress or duress. Your average run-of-the-mill daily stresses do not normally cause such profound reactions from the brain.

So my question becomes: are hypochondriacs trying to alleviate stress… or is it something else?

This question came to mind today because someone I know was “sick” yet again this morning. It’s like a weekly issue with this person… something different seems to be wrong with them every week. Some days things are fine… the next day is another story. When I first met this person I thought they might just be one of those sickly types who really does seem to catch everything going around. But it didn’t take very long for me to figure out that the things this person claims to have caught were not things that would be gone in a day. The flu, for instance, generally lasts more than a day or so. And can you really have food poisoning at least once a week? I suppose it’s possible… but if so, maybe you should find somewhere new to eat… or try eating something else. And isn’t it ironic that a lot of these “problems” seem to crop on the weekend… when you’re working… and would rather be at home?

Take out the benefit of the doubt and assume for a minute that these “problems” aren’t being caused by anything physical. Could this person be a diagnosable hypochondriac? Let’s examine this person’s stress level for a moment. What’s going on in the world around them that’s stressful? Hmmm… nothing major… just the basics that everyone deals with. No death… no real disease… no bombing missions. That rules out hypochondriasis.

So what, then, is the motivating factor behind all of the “illness”?

I’ve narrowed it down to a couple of possibilities:
1) Attention
2) Depression
3) To get out of something
4) Morbid fascination

First comes good ol’ fashioned attention-seeking. People love attention. I even think the majority of the so-called recluses and introverts secretly love the attention their behavior gets them. Think about it… the people who never really talk… never really do anything… seem to keep to themselves… and are very guarded about prying by others seem to get more real attention than the clowning, screaming, obvious attention-hog-banshees that we all know. Everyone wants to know what’s going on inside their head… what are they doing locked up in that house all the time… what are they thinking about me that they can’t say out loud? I think these recluses actually feed on the attention they get by being “reclusive”. By not reacting like “the crowd” (or at all), they are almost guaranteed attention by everyone else. Keeping your mouth shut during a chatty gathering will also almost always get you a spotlight eventually - Why are you so quiet? What are you thinking about over there?… What’s wrong?…etc. But I digress… the point of this was just to state the obvious: being sick or ill or “dying” gets us attention. If you’re craving some spotlight, and you can’t get it on your own merits, then just be sick - someone will eventually spotlight you.

Next we have depression. Another of the “good ol’” behavioral patterns. It seems like you can’t have a bad day without someone thinking you’re depressed. Trust me… there is a big difference between “a bad day” and being depressed. Everyone has a bad day, and on that bad day, may feel “blah”. Sometimes the only way to describe feeling “blah” is to describe feeling ill or sick. That’s understandable. Everyone does that. Occasionally. But what if the always-ill person is simply trying to describe feeling “blah” every other day. That could be the sign of something more than just a bad day. Lots and lots of bad days aren’t normal… that’s depression. Instead of spending two or three days a week in bed nursing “an illness”, our proposed hypochondriac might spend time working on the REAL root of the problem… whatever it is that’s making them have so many bad days.

Ya know… life is full of crap that no one wants to do - shoveling horse shit… spending time with in-laws… work in general… you get the idea. What do we do when these things present themselves? We make up excuses. We’d rather not tell our spouse that we hate their family, so instead, we come up with something legit-sounding that will keep us from having to deal with them. As long as your excuse is good enough and sincere, it’ll work. It also has to be something that a snoopy, suspicious type wouldn’t be able to dispel. You can’t use work as an excuse to get out of something unless you actually go… to work… and, like… work. And you’d better hope you don’t get noticed on the golf course when your boss thinks you’re at a funeral. Unless you work in hospital or a doctor’s office, illness is probably the most fool-proof excuse in the world. No one can tell you how you feel or what’s going on inside of you. So if you talk the talk and walk the walk, you can pull off a sickness pretty easy. Seeing as how we’ve all been sick, we all know that it’s like. If you see someone acting sick… and then they tell you they’re sick… you almost have to believe that they really are sick. Eyebrows begin to raise, however, when you walk the walk and talk the talk so often that some people start to wonder if you just always act that way regardless of the way you feel. Sickness will get you out of the occasional unpleasant circumstance. But too much will get you into another one.

Some people just love weird things. Hell… most of us probably love something that someone else would consider weird. I knew a girl that loved the smell of a skunk… a guy who loved soured milk… another who enjoys looking at throw up… and how in the world does anyone enjoy the taste of an olive? To me, these things are weird. To those people, they’re not. Difference of taste is normal, natural, and healthy (thank gawd everyone doesn’t love olives… they’d be everywhere!). Some people love sickness… illness… death… rotten things… bloody things… and all of the images, ideas, and fantasies that go along with them. If you need proof, just check out any number of websites hosting images of dead bodies, autopsies, war victims, accident footage, and everything in between. It’s like roadkill… you just can’t NOT look. But the difference lies in the fact that most people would simply look at passing roadkill… they would not stop… pull over… take pictures of… or even collect the run-down carcass on the side of the road and take it home for dinner (either as a guest or as the main course). My advanced photography professor loved roadkill. Everything she photographed involved something dead. She even went as far as to take a self portrait of her shadow… naked… with a dead, rotting crow between her legs (I know… that mental image is just plain wrong!). Maybe some people get a thrill off the idea that something is internally wrong with them. At any minute their head could split open and their brain could come leaping out onto the floor for all to see. Or maybe there’s an unknown virus eating it’s way through their body. Or maybe their stomach is SO messed up that anything and everything irritates it. Thoughts that would bother most people (and send them to the doctor) are actually exciting to these people. They don’t go to the doctor about it… because if they went to the doctor, they might be cured… and the thrill would be gone!

No matter the cause, there will always be people who are perpetually “ill” and in need of something… from someone. But the next time I feel the need to label someone a hypochondriac I’m going to consider if that’s even a valid label… maybe they need a different one…

Or none at all?

Posted in Human Nature

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