Sick with worry?: A look at the arc of hypochondria
From kings with ‘glass delusion’ to fretful names from the worlds of art and literature, the story of hypochondria is a long and riveting one.
In the late Middle Ages, a strange fear swept parts of Europe. People became convinced that their bodies were so fragile, they might shatter into thousands of pieces, like glass.
Among these people was the French king, Charles VI or Charles the Mad (1368-1422; his nickname came from bouts of paranoia that once led him to kill four of his knights).
King Charles became so convinced of his body’s fragility, he wrapped himself in layers of blankets, and slept on a bed of straw.
Today, such cases (there have been a few in recent times) are linked to post-traumatic stress.
In the 14th century, however, psychiatrists say the glass delusion was likely a form of hypochondria: a fear that the body was fragile and vulnerable beyond the known extents.
It didn’t help that there was still little actual knowledge about the workings of the body; that medical intervention was often torturous and still unsuccessful. That average life expectancy was 35 years; and a simple cut or bruise could, for still-mysterious reasons, cause an agonising end.
Today, we have come full circle: from too little knowledge, to arguably too much.
It’s an arc Caroline Crampton traces in her new book, A Body Made of Glass: A Cultural History of Hypochondria (Granta; 2024). In her research for it, the UK-based writer and podcaster dug through memoirs, letters and autobiographies across centuries, to identify thoughts and patterns that allude to hypochondria.
It’s a condition she has been plagued by herself, she writes, ever since her battle with Hodgkin lymphoma at 17. The book began as an attempt to feel less lonely.
It turns out the list of hypochondriacs through history is long and illustrious. The English naturalist Charles Darwin, Canadian pianist Glenn Gould, French novelist Marcel Proust and British poet John Donne all left behind traces of intense, unrelenting and unfounded concerns over their health.
The term “hypochondria”, incidentally, was coined by the Greek physician-philosopher Hippocrates in the 5th century BCE. It comes from the Ancient Greek hupo (for “under”) and khondros (for “ribcage”). Hippocrates believed there was an organ here that, if disturbed, could cause a kind of melancholy.
Today, science is unravelling hypochondria too.
In 2013, the Diagnostic and Statistical Manual of Mental Disorders (the US text that forms the basis of psychiatric care and insurance cover worldwide) replaced the term with two new ones: Somatic Symptom Disorder (SSD; characterised by an extreme focus on physical symptoms such as pain) and Illness Anxiety Disorder (IAD; an excessive fear of developing or having a serious medical condition). Treatment differs for each one, and of course for those who display symptoms of both.
Back to the illustrious hypochondriacs, Crampton explores how the British novelist Jane Austen created some of the most dramatic such sufferers of the literary world, perhaps inspired by her mother, Cassandra Leigh Austen.
The American playwright Tennessee Williams kept almost-daily records of his health and his anxieties. He feared the loss of his eyesight, worried his heart would stop beating. When he died in 1983, aged 71, The New York Times included the term “monumental hypochondriac”.
“If we can see that all is well, or if we can pinpoint the exact nature of what is wrong, perhaps our bigger fears will disappear,” Crampton writes, in her witty, insightful and always empathetic book. “And yet, with this transparency comes an awareness of the million minute things that need to function well for us to be healthy and the ease with which any of them could fail.”
Or, as Donne put it, in An Anatomy of the World (1611):
“There is no health; physicians say that we
At best enjoy but a neutrality.
And can there be worse sickness than to know
That we are never well, nor can be so?”
