How to Support and Cope with a Hypochondriac

Offering Your Support

Accept the person’s feelings as real and legitimate. It doesn’t matter whether the physical illnesses they believe they have are real or not—the anxiety they experience is very real. They’re not “faking,” or “exaggerating,” or “trying to get sympathy.” Never say something like, “Stop worrying so much—you’re not sick and you know it!” If you feel exasperation building up, walk away before you mistakenly say something hurtful. Instead, show empathy and compassion: “I know you are feeling very stressed because you’re worried about being sick.”

Listen closely and compassionately about their feelings. Part of validation is being willing to listen without judgment. If they want to open up about what they’re feeling, lend a supportive ear. Even without saying a word, you can make it clear that you’re there for them. When they start speaking, make frequent eye contact and confirm that you’re listening by nodding and saying “yes” or “mm-hmm” when appropriate. Some people will be ready and willing to express their feelings, while others may need a bit of encouragement. Don’t press them to talk, just say things like, “If you’d like to talk about it, I’m happy to listen anytime.”

Validate their feelings without encouraging them. Listen to the person and assure them that you know their feelings are genuine. However, no matter if you have good intentions, never encourage them to believe that their feelings may be based on them actually being sick. This kind of encouragement may actually worsen their condition. Even if you think your trying to be supportive, avoid saying things like, “Well, nobody believed my aunt had cancer until it was too late,” or, “You do look a little pale today, actually.”

Encourage the person to be socially engaged. People with hypochondria often close themselves off from others. However, social interaction may help them to better manage their condition. At the very least, socializing will help keep their mind off their anxieties about possible illnesses they may have. If the person is a co-worker, for instance, invite them along to social gatherings after work. If you think they may be overwhelmed by the thought of going to a noisy pub, opt for a coffee shop instead.

Praise every effort they make to manage their condition. Look for the smallest signs of positive change, such as watching a prescription drug ad on TV without mentioning that they have some of the listed symptoms. Tell them something like, “I’m really proud of how hard you’re working to manage your anxieties.” Or, if you both go for a long walk and the topic of medical conditions never comes up, mention how nice it was to have a pleasant chat while enjoying the outdoors. Praise is a great way to reinforce positive behavior.

Helping Them Get Treatment

Support their choice to visit their doctor. You can’t force an adult hypochondriac to seek treatment, but you can offer as much support and encouragement as possible. If they decide they’re ready to talk to their doctor about it, praise their decision and, if you think they’d appreciate it, offer to go with them to the appointment. Depending on the circumstances, you may go into the actual appointment with the person. In this case, you can help describe their symptoms. Otherwise, remain in the waiting room and support them before and after the appointment. The doctor will use an assessment of the person’s described symptoms to diagnose illness anxiety disorder (IAD), the modern medical term for hypochondria.

Encourage them to attend therapy if advised by their doctor. For most cases of IAD, mental health therapy with a trained professional is a front-line treatment. People with IAD often have interrelated anxiety and depression issues, so therapy sessions are critical to effective management of their conditions. Voice your support for any of the following commonly-recommended treatments: Cognitive behavioral therapy (CBT) can help the person to identify unhealthy thoughts and feelings, and replace them with healthier alternatives. Stress management therapy may increase the person’s ability to relax and manage their anxieties about illness. Talk therapy may be especially helpful if the person is dealing with traumatic experiences from their past.

Advise them to take any medications as prescribed. There aren’t any medications that are currently approved for the specific treatment of IAD. However, some people with the condition may benefit from taking antidepressants or anti-anxiety medications. Selective serotonin reuptake inhibitors (SSRIs), for instance, are sometimes prescribed to people diagnosed with IAD in order to help manage depression or anxiety. Always follow the lead of the medical professionals treating the person. Don’t say something like, “Maybe you should be on medication” if the doctor hasn’t advised it, since this can further fuel their feelings that their medical issues aren’t being taken seriously enough. Offer encouragement if they're hesitant to take medication: "Your doctor believes this will help you, and so do I. Let's at least give it a fair try."

Go with them to a support group, or at least encourage them to go. Attending a support group can help the person recognize that they’re not the only one who feels the way they do. If the person’s doctor or therapist recommends going to a support group, help the person find one, and consider going along if it’s a group that includes friends and loved ones. If it’s not appropriate for you to attend the support group sessions, you still can offer to drop the person off and pick them up. Online support groups for IAD may be another option. For both in-person and online support groups, though, get recommendations from a doctor or therapist.

Managing Your Own Needs

Set clear boundaries on the help you’re able to provide. It’s great that you want to help a hypochondriac, but it’s important that you also take care of your own mental and physical health. If the person is demanding too much of your time, or turns every conversation into one about their real or perceived illnesses, let them know that there have to be limits for your own well-being. For instance, you may need to tell a loved one that they can’t call you in the middle of the night to discuss their anxiety, unless it is a true emergency. Or, if they always bring the conversation back to themselves, you might need to say something like, “I’d like the chance for us to talk about the illness that I have been diagnosed with, rather than the illnesses you think you may have.”

Reassure them, but don’t feed their attention-seeking behavior. Hypochondriacs often crave reassurance from doctors, friends, loved ones, and sometimes even strangers. While it’s important to validate their feelings and reassure them that you want to help, giving them constant reassurance may encourage even more attention-seeking behavior. Instead of saying, “Yes, I suppose it’s possible that both doctors you visited are wrong,” be honest with them: “I know you’re still worried, but both doctors said your heart is working perfectly fine, I trust their judgment, and so should you.” If you don’t end the cycle of constant reassurance, you’ll find yourself without adequate time to take care of your own physical and mental health needs.

Don’t feel guilty because you can’t solve every problem for them. In some cases, the person might resent the fact that you won’t give them the reassurance or attention they crave, and claim that “you don’t care” or “you don’t believe” them. It’s important for you to accept that you’re only human, and there’s only so much you can do to help another person. Give the care and support that you can, but accept your own limits. If they say that “you don’t care,” respond calmly: “I’m sorry you feel that way. I’m doing the best I can to support you, but I’m only one person with my own responsibilities and concerns as well.” Don’t respond in anger and say something you might regret: “Fine, then—if you don’t appreciate my help, manage your fake illnesses all by yourself!”

Stay active and socially-engaged, even if they won’t. Despite your efforts to help them, a person with IAD may isolate themselves from the world due to their anxiety. For your own well-being, it’s important that you not let them drag you into isolation as well. If the other person stops exercising, visiting friends, going out to dinner, or other activities, don’t let guilt or misplaced compassion keep you from doing those things. You might have to say something like, “I’m sorry that you don’t want to go to bingo night anymore, but I really enjoy going there and catching up with our friends. I’ll see you in a few hours when I get back.” If you allow your physical and mental health to suffer, you’ll be less capable of caring for both yourself and the other person.