A letter containing four pages or more, closely written and narrating — Hypochondriasis

"In 1909, Sigmund Freud told the that "the position of hypochondria is still suspended in darkness," and more than a hundred years later it does not feel as if there is much light on the subject. Even in the most widely used and up-to-date clinical literature, its definition is still shifting and changing. For instance, for the latest edition of the (), which was published in 2013 by the and is often referred to as "the bible of psychiatry," the diagnosis of hypochondria was entirely recategorized into two separate entities: and illness anxiety disorder. Both describe patients with "extensive worries about health," but the former features so-called somatic or physical symptoms the patient feels in their body that medicine cannot detect or explain, whereas the latter is focused solely on "preoccupation with having or acquiring a serious illness" and "excessive health-related behaviors."

"Hypochondria seems to be a (that is, a response to) so many different kinds of troubles that the disorder assumes dozens of different forms. Taken together the hypochondrias are so common, in fact, that some doctors believe that they are among the most common symptoms of . ... Is this because among certain groups hypochondria is a more socially acceptable expression of distress than divorce, , alcoholism, and the like? Is it biologically or psychologically more efficient than other defenses?"

"... my therapist tells me that to worry unceasingly about getting cancer is as irrational as worrying about getting hit by a on . In fact, I am terrified of getting hit by a bus on Flatbush Avenue, and I think he is the madman for being so cavalier on the subject. Has he been out there recently? Belling says that hypochondria is “always ironic,” by which she means that, despite all its convolutions, hypochondria is always right. You will get sick and die. The question is only when and how. The bus is coming."

"Are hypochondriacs born or made? Is the product of your particular roll of the genetic dice, or the result of something in your childhood or environment? These questions are worth asking, because people like me cost the extra trouble and money. Were constantly making appointments for symptoms that feel real bur arent. We doubt our s, so we seek second and third and even fourth opinions asking for (or demanding) unnecessary medical tests, and running up , too."

"He who, in the study or the treatment of the human machinery, overlooks the intellectual part of it, cannot but entertain very incorrect notions of its nature, and fall into gross and sometimes fatal blunders in the means which he adopts for its regulation and repair. Whilst he is directing his purblind skill to remove or relieve some more obvious and superficial , the worm of may be gnawing inwardly and undetected at the root of the constitution."

"After died in 1380, his 11-year-old son was next in line to inherit the throne. However, for the next 8 years it would be his uncles who ruled in his stead, spending money from the royal treasury and extorting heavy taxes from the common people. Overthrowing these avaricious regents and replacing them with highly competent advisors earned young Charles VI the title of ‘the Beloved’. Just a few years later, this title would be replaced by one not so kind: ‘le fou’ or ‘the mad’. In 1392, Charles had what was thought to be the first psychotic episode of many. During a military expedition he became paranoid, and when a servant accidently dropped a lance, Charles turned around and began attacking his own knights, some of whom died. In another episode Charles came to believe that he was made of glass – the , which would occur intermittently throughout his life. noted that Charles even had iron rods sewn into his clothes as reinforcement to stop him from breaking. Although perhaps the most famous person to suffer from the glass delusion, Charles was by no means the only one – in the 15th to 16th centuries it was not uncommon for such delusions to be reported. Case numbers dropped after this period, and cases of the glass delusion are now rare."