Crying wolf

Hypochondria isn’t always a mania of the mind, writes BARU, putting forth a strong case for geriatric sensitivity.

Real or imagined?

Oxford dictionary defines hypochondria as ‘abnormal anxiety about one’s health’. However, the medical definition practically discounts the bodily illness as the basis. Oxford Companion of Body defines it as ‘a condition in which a person believes that he or she is ill when no objective signs of illness can be observed’. The Columbia Encyclopedia defines it as ‘a disorder characterized by an exaggeration of imagined or negligible physical ailment’.

Allow me to define it as an over-the-top concern about the well-being mostly of one’s ageing body and the related anxiety.

Having contracted diabetes in the early forties and having had my fasting and post-prandial blood sugar numbers under control over the next decade and half with diet, minor lifestyle adjustments and mild medicine, once I had probably appeared a trifle smug about the disease to a diabetic old gentleman suffering from some debilitating side effects. The man gave me a wry smile and said ‘wait for another 15 years !’. Long before the predicted doom, I am beginning to see some dark spin offs of diabetes and the recalcitrant response of the critical numbers to some medicine I was using earlier with confidence. As if the sweet assassin busily coursing through my arteries and veins remains unruffled by the puny attempts made by ineffectual medicines and is focused on its long-term goals.

Being pursued relentlessly by an unseen adversary, living on a razor’s edge doing just the right amount of exercise, eating the right food (denying oneself any indulgence); remembering and taking ever-growing number of pills in an involved schedule (some before meals, some after, this one only once a day and that one twice); taking periodic tests and keeping a watch on the numbers staring from the crisp print outs handed in by the analyst’s assistant; living under a cloud of the escalating prices of medicine and hoping that my body responds to medicines that do not happen to be within the shadow of 17 years of patent protection and that the chemist does not procure medicines from a stockist who routinely passes off chalk or some such stuff in regulation packaging as drugs. The worry multiplies.

A relative used to complain, any time of the day or night you met her, about constipation, occasionally about gas problems and lack of sleep in the night. GPs came and GPs assured that some of these might be imaginary stuff though partly associated with an ageing body, and therefore, almost inevitable. Muscles lose flexibility making motions a bit of a struggle, lack of exercise and propensity to eat fried stuff causing indigestion and gas formation and worse cases of insomnia are known. A triumvirate of common sense and inexpensive remedies – a laxative, an antacid and a tranquilizer before bed-time should do. But her arms looked increasingly thin, smile wan on a shrinking face, plaints more frequent and strident. Until one day, like a thunderclap, she announced that she had been having difficulty in swallowing food and even water. Her dysphagia was diagnosed as a consequence of a form of malignant thickening of her esophagus inner walls, choking the food pipe. On hindsight, one could begin to understand the terror striking at her heart in the middle of the night when sleep would suddenly desert her for hours. And the need to communicate her anxiety.

Through out the illness, probing diagnostic procedures and increasingly desperate firefighting, she was stoical and dignified. She had stopped talking about her illness and its manifestations. As if she felt graduated to a malady in respect of which her complaints were self-evident. There was no longer any need for her to persuade anybody that she was indeed suffering a real illness and not just visited by a mania of an old woman.

Next time you meet a hypochondriac old person, try being a little patient. Hypochondria may be a disease of the mind but being mindful of the diseases inflicting the body that might have spun it off in some cases may be a step towards improved geriatric sensitivity.