"I feel dizzy. It's an aneurysm! I can feel it!"
I remember my sister whispering those words from the twin bed a few feet away late one night when she was seven or eight. I sunk under the covers to protect myself and my dolly from the imminent explosion of blood and brain matter that she stated would soon cover the room, but woke up the next morning to find her skull remarkably intact. It wasn't an aneurysm—or the brain tumor she had identified as a viable back-up option. And the mild cough she'd picked up at school the week before wasn't pleurisy or a sign of a collapsed lung. And the weekly bouts of appendicitis she's continued to experience for the past 35 years have, miraculously, never resulted in surgery.
My sister has hypochondria, or—as the condition has been rebranded in the latest version of the Diagnostic and Statistical Manual of Mental Disorders—"Illness Anxiety Disorder" (IAD). I, on the other hand, regularly share potentially germy beverages with family and friends, frequently purchase chewing gum packed with controversial artificial sweeteners, and often eat food off the floor regardless of the five-second rule. When a "helpful" stranger came up to me when I was nine months pregnant and let me know that the first case of Zika virus had been identified in Los Angeles County, where I live, I simply replied: "Cool. Thanks."
My sister and I grew up in the same home and were born less than three years apart. So why is she constantly scanning her body for signs of scurvy while I've always wanted to work in a hospital to be closer to illness and death because I feel most at ease when surrounded by crisis? We were raised with two extremely anxious parents, but neither of them were hypochondriacs.
An estimated 75 to 85 percent of people with hypochondria also suffer from anxiety, depression, or another psychological condition. Passing on IAD is more about passing on anxiety in general than it is about passing on anxiety that's specifically related to health concerns, says clinical psychologist Michael Brustein.
"People with [hypochondria] often have a history where one or both of their significant caretakers have anxiety. It doesn't have to necessarily be [hypochondria]…Regardless of their specific history, they develop a core belief that the world is a fragile place and that something bad is lurking. There is often a belief, sometimes unconscious, that if they worry about something enough they can control and protect themselves," he says.
My sister says that her deep-seated fear of illness is one of the reasons she chose not to have children. "I'm so paranoid about all of the sicknesses they could get," she says. I sometimes wonder how her hypochondria developed and if either of our parents' anxiety impacted her lifelong preoccupation with illness.
"I know our mother's and grandmother's obsessions with food going bad, or as they called it 'spoilage,' haunts me to this day," she says. "They made me feel like food wasn't safe, and if food wasn't safe, how could anything be safe? I still throw out perfectly good food because of it. I hate buffets to this day because Mom said they breed germs. I feel like sickness is lurking there and if I eat anything I could be in the hospital by midnight."
Recent statistics estimate that between 1 and 5 percent of Americans experience Illness Anxiety Disorder, but hard numbers on childhood hypochondria are especially difficult to identify since it's the caregivers who are ultimately making the decision to seek medical treatment. When caregivers are in charge of triage, it's their own level of health sensitivity that matters most.
Parenting blogger and lifelong, self-proclaimed hypochondriac Kathleen Dennehy is convinced her four-year-old's health anxiety is a direct result of her own illness obsession. Dennehy was convinced she had polio at an early age and regularly fantasized about how she'd cope with her imminent paralysis. Now, her daughter drags herself around by her arms at bedtime exclaiming, "My legs just don't work!" A recent cut on her finger resulted in the proclamation, "I need a whole new arm now! I need medicine!"
While there's hard scientific evidence that anxiety can be passed on both genetically and through children mimicking their parents' behaviors, Dennehy says her own mother was the opposite of a hypochondriac.
"My mom was a sickness denier. Her mom was a nurse and always sick or fearing sickness. My mom grew up always being dragged to doctors, so when we were growing up, she dragged us to school no matter what, even with pneumonia and appendicitis. We only went to hospitals and doctors when we fainted or began hemorrhaging. So I think my hypochondria was also a reaction to my mom's seeming indifference to our real or imagined medical needs," she says.
Many people told me that my own lack of health anxiety would go out the window when I had a baby of my own. While I admittedly spent the first week of my son's life staring at him with arms outstretched like a spotter ready to flick away any germ or speck of dust or errant asteroid, that quickly faded. We eat off the floor together now. I let the dog wash his face. I tried to stop him from putting my iPhone in his mouth for a while because it's both absolutely filthy and emits radiofrequency waves. Then I realized letting him suck on it kept him fully entertained long enough to afford me the essential two minutes of daily mom time that it takes me to brush my hair and put on clean underwear and I just let him do it.
I do have lifelong anxiety of my own, though, and have seen extensive evidence that I've inherited symptoms of my father's combat PTSD. So if the theory that any anxiety disorder can lead to childhood hypochondria holds true, my son could be diagnosing himself with bubonic plague before he hits preschool.