Family and Caregiver Schizophrenia Discussion Forum

Hypochondria + SZA?

Hey everyone,

Is anyone else’s loved one a hypochondriac in addition to their SZA diagnosis? How do you manage this? Especially in relationships?

It has taken me a while to catch on, but my husband has some hypochondriac tendencies. He has several “real” issues, like asthma, as well as SZA, but he is also constantly worried about getting sick, having a heart attack, an embolism, or an aneurysm, etc. However, he won’t make changes to improve his lifestyle (exercise, diet, etc) and after multiple hospital visits (and many hospital bills) I am overwhelmed.

I know hypochondria is usually a form of OCD or anxiety, and so I’m wondering if this is something I should bring up with his psychiatrist. I have not approached talking with my husband about this because I know that if I bring up my concerns, even with data and notes I’ve taken, it will just feed into his paranoia loops. Most literature on hypochondria suggests listening to individuals as they talk through their health complaints, but this doesn’t seem practical when it’s comorbid with other health conditions?

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Dealing with this right now!

I’ve ventured into this territory from time to time myself. My advice is have him have regular visits to a primary care physician or internist who’s aware of his SZA diagnosis if he doesn’t have one already. Preferably referred by his psychiatrist or at a minimum having both doctors share medical information on him. Continuity of care and appropriate testing and screening are important because SZ and SZA diagnoses have a higher incident of many diseases. Repeated trip to emergency rooms and urgent care facilities are not only expensive, but add to anxiety about medical care in general.

His hypochondria may mask real concerns and often leads to getting less appropriate care, rather than more. I have a medical condition I only learned about from an eye exam, and I wouldn’t have the doctor I have today unless I was referred by my Psychiatrist at his insistence.

That’s really helpful advice. Usually, visiting the PCP is something he avoids, like exercise or diet changes, but I can make that happen.

I am definitely trying REALLY hard not to just dismiss his concerns-- I know many things can be masked, and I am conscientious of when he is complaining about something nebulous, but realistic (diabetes in his family, high blood pressure, etc)
However, there was a string of months this past summer where he was CONVINCED he was dying of gallstones, despite going to the doctor, and the hospital, and having a sonogram done. As our financial planner, I had to redirect him by citing healthcare costs (we had spent almost $1k at that point, and I am a teacher.)

easy one here, mine has 10,000,000 different illnesses

I simply say: “smoke another cig and you will be fine” works great…

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My son has self-diagnosed himself with something he doesn’t have, but it doesn’t lead to serious problems. About every 6 months he decides he needs to see his primary care physician. I never go back with him when he sees this doctor, but the dr is aware of my son’s SZ diagnosis.

My son also seems to over-react a bit over what most of us might consider everyday pains and problems. I try to just reassure him that “oh, a lot of people experience that, let me know if its still bothering you in a day or two”.

Hah! That is very funny. Made me laugh.

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Yeah, my brother smokes and has very few teeth left won’t quit smoking to get implants even though my sister said she’d pay for them. This is after he kept telling us that all his teeth were rotten and he needed money to go to Costa Rica to get implants put in cheaply. We were like, ‘dude, why don’t you go to a dentist and get this confirmed and we’ll consider it.” This went on like a broken record for what seems like five years. Eventually my sister called his bluff and scheduled an appointment.

I was floored when they said they have to remove about 18 teeth! They said it was a combination of the smoking and poor dental care that did it. So many contradictions. He’s goes on and on about allergies, but his house is messy and dusty and basically hoarded out. He won’t run his oil heater because he doesn’t like the fumes, yet he smokes. He has some aversion to air conditioning too and goes on about air pollution from a printing company ten miles away, and on and on.

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Yes my son is def suffering from physical problems lately but no answers after ct, us, X-ray bloodwork Yao it’s on to more specialists but cost is in the back of my mind. Is his physical back pain exacerbating his psych condition?

Well any kind of stress will exacerbate mental issues, but there’s a strong chicken and egg problem here. Your mind and mood effect your physical reality and vice versa. Having a PCP look at the big picture and do sensible screening tests seems best to me. The more objective versus subjective information you can get that doesn’t cost a lot of money seems appropriate.

SZ / SZA thinking tends toward the mystic and magical, so alternative medicine may have its place. My brother really seemed to get benefit from acupuncture for a while. He also gets very tied up in bedside manner and credentials. He has to believe in the doctor to want to accept treatment plans or explanations. There are a lot of mind/body dualities to consider when treating someone with a SMI, and sometimes playing along when things don’t make sense or fostering continued relationships with doctors is beneficial.

Per cost containment, I think there’s an angle where the insurance companies can play the role of “the man”, and it’s a perfect out because everyone knows that insurance companies are capricious and arbitrary so you can hide behind that. Strategies like saying insurance won’t pay unless you get a referral from you PCP even if it isn’t true can help. If discovered you can always say, well that’s what they told me on the phone. Nobody truly understands this stuff, so use this to your advantage.

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