Hypochondria: medical condition, creative malady

Abstract

‘One can feel well but one can never know one is well’ wrote the philosopher Kant, acknowledging his own inclination towards hypochondria. Told that he does not have an ulcer, one of Woody Allen’s neurotically anxious film counterparts simply retorts ‘they haven’t found one yet’. The hypochondriac may be in good health but remains tormented by supposed symptoms and the certainty of the illnesses to which they point. In Mark Haddon’s novel A Spot of Bother (2006), the central character finds a small lesion on his hip and plunges into hypochondriac panic; though diagnosed as no more than discoid eczema, he knows the spot is a fatal cancer. That tests indicate nothing wrong brings no relief to the hypochondriac; indeed, so-called health is a very doubtful state of affairs, which was Kant’s point. None of which makes hypochondriacs altogether welcome at their medical centre, arousing as they can impatience and professional unease with their unshakeable conviction that something is amiss. M, the title character of Graham Swift’s story ‘The Hypochondriac’ (1985), turns up repeatedly at his local surgery always to be reassured that all is well, until ordered never to return. Subsequently informed that M is seriously ill, his doctor delays a home visit, finally arriving to find that M has died in hospital—but of what? Autopsy reports ‘could reach no certain conclusions about the causes of M’s death’, which is a tribute to his hypochondriac identity: his hypochondria was justified and medical science failed him. The medical term today is ‘hypochondriasis’, leaving ‘hypochondria’ as the lay term for more or less excessive health anxiety. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) includes hypochondriasis among the somatoform disorders, defining it as preoccupation with fears of having, or the idea that one has, a serious disease based on …