Hypochondria & Fear of Illness in Children
Excessive anxieties over illness or fears about getting sick are often seen in children with a generalized anxiety disorder, and can also be a sign of tendencies towards hypochondria. But they may also emerge in otherwise normal kids for a few other reasons.
What causes fears over illness?
1. When someone close to a child gets sick or they witness someone who becomes deathly ill, this can often trigger a fear or phobia about illness in children. Such fears are usually temporary and will abate in several weeks or several months time. However, the more personal the impact, the more likely it is that such fears will endure. If an illness or death was particularly traumatic--a parent getting cancer, for example, or someone close to a child dying of the flu – then a child's phobia over illness can be especially difficult to overcome.
2. Fears of illness are often triggered by media coverage, especially news stories that follow disease outbreaks. Reports about flu bugs and other "invisible' threats can be very frightening to young children. It becomes the monster under the bed: scary precisely because it's unknown and intangible. "A fire or hurricane happens, and it's over," says Harold Koplewicz, a child psychiatrist and director of the New York University Child Study Center. "But a biological event like this (flu pandemic) is hard for kids to understand. It's invisible and can be very frightening...left to their own devices, they can put a story together that's far more frightening than reality." (Elias, 2009)
Even if your own child doesn't watch the news, they can pick up information from other kids at school, who often relay bits and pieces of what they watch in a less than accurate way. A child who sees a report on how H1N1 is "sweeping the nation" with its "high death rates" and how it's "especially lethal to children, with hundreds dead thus far" may not fully comprehend the story. So by the time this information hits the playground it may get turned into "I heard on the news that children who get the flu this year will all die." So if a child suddenly develops a fear of getting sick, talk to them and see if these fears are based on bad information they may have picked up.
Dealing with a child's fear of illness
Hypochondria and illness fears that arise from a general anxiety disorder are more ingrained and thus more difficult to overcome. It will require continued hypervigilance because such fears arise from a child's natural disposition towards anxiety. Parents need to be patient, and understand their task is more about managing these fears rather than trying to overcome them completely.
Episodic fears that arise because a child witnesses an illness or otherwise picks up sickness anxieties are easier to treat. Either way, both cases are dealt with in similar ways:
Helping children overcome their fear of illness
1. Be sure kids understand the difference between normal pathogens and something like cancer. Often times a child who witnesses a loved one experience severe health complications might confuse this for something they can easily catch. This is frequently the cause of illness-related fears.
2. Talk up the body's defenses and speak about how it can match just about anything a germ throws our way. Kids tend to hear a lot about pathogens and disease, but very little about the many miraculous ways in which our bodies keep us healthy.
3. Talk about the importance of colds and germs in building up our immune system, and how our body gets stronger with every virus it's exposed to.
4. Help them understand how miniscule the odds actually are that they'll come down with some morbid illness. The odds of a healthy child contracting a serious health issue are around one in several thousand. That's like putting 8 or 9 average-size elementary schools together and getting 1 child who may experience something like this. (Such facts tend to be lost on children with true hypochondria, since no illustration will convince them that they aren't that 1 person who will get it.)
5. Be sure kids understand that as people get older, they become more prone to illness and disease. But young ones like them have very little to worry about.
Dealing with hypochondria in kids
Helping children overcome hypochondria is an ongoing process. This disorder is frequently tied to a general anxiety condition in the child and thus does not easily go away. Parents should recognize that while annoying, hypochondria is typically harmless. Adults just need to keep it in check and ensure it doesn't disrupt a child's normal functioning. So do your best to show plenty of patience and avoid getting frantic about it. Overreacting often causes a child to obsess about it more.
1. Try to discern whether the hypochondria is actually just a proxy for attention. If so, find ways to reward your child with attention for prosocial behaviors, while ignoring or rebuking those associated with fears about illness.
2. For kids with genuine hypochondria that isn't attached to attention seeking behaviors, arguing with them is seldom productive. When you try to reject a child's concerns outright, they tend to just double down on their paranoia. Instead, calmly listen to their concerns. Ask them to name their symptoms or inquire about why they're convinced they have something. Don't support this view, but sometimes just hearing them out can start the process towards extinction of this particular fear.
3. In a non-argumental way, remind them of the previous times they've had concerns that they were mortally sick or dying, and how in each case these fears turned out to be false. Hypochondria is often part of a general anxiety condition which leads a child to believe that bad things are bound to happen to them. So the more you point out all the ways they are resilient and all the bad things that DO NOT happen to them (in regards to any aspect of living) the more it will help them keep these anxieties in check.
4. Help school-age children recognize that feelings aren't accurate reflections of reality. One of the keys to helping a child manage hypochondria is to separate the sense of fear and panic they feel from a more rational assessment of what's actually going on. So when they express concerns, respond by saying something like "I imagine you must feel afraid, but let me tell you why I think these fears are deceiving you." Give them the example of a roller coaster and how they can feel genuinely afraid even though there’s nothing threatening to worry about. This is the same thing: it's important we distinguish between fear and anxiety and actual threats.