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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Agoraphobia is a condition where sufferers become anxious in unfamiliar environments or where they perceive that they have little control. Triggers for this anxiety may include wide-open spaces, crowds (social anxiety), or traveling (even short distances). Agoraphobia is often, but not always, compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public. Most of the time they avoid these areas and stay in the comfort of their safe haven. This is also sometimes called "social agoraphobia", which may be a subtype of social anxiety disorder.
Agoraphobia is also defined as "a fear, sometimes terrifying, by those who have experienced one or more panic attacks". In these cases, the sufferer is fearful of a particular place because they have experienced a panic attack at the same location at a previous time. Fearing the onset of another panic attack, the sufferer is fearful or even avoids a location. Some refuse to leave their homes even in medical emergencies because the fear of being outside of their comfort areas is too great.
The sufferers can sometimes go to great lengths to avoid the locations where they have experienced the onset of a panic attack. Agoraphobia, as described in this manner, is actually a symptom professionals check when making a diagnosis of panic disorder. Other syndromes like obsessive compulsive disorder or post-traumatic stress disorder can also cause agoraphobia. Essentially, any irrational fear that keeps one from going outside can cause the syndrome.
Agoraphobics may suffer from temporary separation anxiety disorder when certain other individuals of the household depart from the residence temporarily, such as a parent or spouse, or when the agoraphobic is left home alone. Such temporary conditions can result in an increase in anxiety or a panic attack or feeling the need to separate themselves from family or maybe friends.
Another common associative disorder of agoraphobia is thanatophobia, the fear of death. The anxiety level of agoraphobics often increases when dwelling upon the idea of eventually dying, which they may consciously or unconsciously associate with being the ultimate separation from their emotional comfort and safety zones and loved ones, even for those who may otherwise believe in some form of afterlife.
Agoraphobia patients can experience sudden panic attacks when traveling to places where they fear they are out of control, help would be difficult to obtain, or they could be embarrassed. During a panic attack, epinephrine is released in large amounts, triggering the body's natural fight-or-flight response. A panic attack typically has an abrupt onset, building to maximum intensity within 10 to 15 minutes, and rarely lasts longer than 30 minutes. Symptoms of a panic attack include palpitations, rapid heartbeat, sweating, trembling, nausea, vomiting, dizziness, tightness in the throat, and shortness of breath. Many patients report a fear of dying or of losing control of emotions and/or behaviors.
In cognitive models of social anxiety disorder, those with social phobias experience dread over how they will be presented to others. They may feel overly self-conscious, pay high self-attention after the activity, or have high performance standards for themselves. According to the social psychology theory of self-presentation, a sufferer attempts to create a well-mannered impression towards others but believes he or she is unable to do so. Many times, prior to the potentially anxiety-provoking social situation, sufferers may deliberately review what could go wrong and how to deal with each unexpected case. After the event, they may have the perception that they performed unsatisfactorily. Consequently, they will perceive anything that may have possibly been abnormal as embarrassing. These thoughts may extend for weeks or longer. Cognitive distortions are a hallmark, and are learned about in CBT (cognitive-behavioral therapy). Thoughts are often self-defeating and inaccurate. Those with social phobia tend to interpret neutral or ambiguous conversations with a negative outlook, and many studies suggest that socially anxious individuals remember more negative memories than those less distressed.
An example of an instance may be that of an employee presenting to their co-workers. During the presentation, the person may stutter a word, upon which he or she may worry that other people significantly noticed and think that their perceptions of him or her as a presenter have been tarnished. This cognitive thought propels further anxiety which compounds with further stuttering, sweating, and, potentially, a panic attack.
Physiological effects, similar to those in other anxiety disorders, are present in social phobics. In adults, it may be tears as well as excessive sweating, nausea, difficulty breathing, shaking, and palpitations as a result of the fight-or-flight response. The walk disturbance (where a person is so worried about how they walk that they may lose balance) may appear, especially when passing a group of people. Blushing is commonly exhibited by individuals suffering from social phobia. These visible symptoms further reinforce the anxiety in the presence of others. A 2006 study found that the area of the brain called the amygdala, part of the limbic system, is hyperactive when patients are shown threatening faces or confronted with frightening situations.
They found that patients with more severe social phobia showed a correlation with the increased response in the amygdala.
A variety of symptoms can be seen in someone suffering from telephone phobia, many of which are shared with anxiety. These symptoms may include nervous stomach, sweaty palms, rapid heartbeat, shortness of breath, nausea, dry mouth and trembling. The sufferer may experience feelings of panic, terror and dread. Resulting panic attacks can include hyperventilation and stress. These negative and agitating symptoms can be produced by both the thought of making and receiving calls and the action of doing so.
People who have repeated, persistent attacks or feel severe anxiety about having another attack are said to have panic disorder. Panic disorder is strikingly different from other types of anxiety disorders in that panic attacks are often sudden and unprovoked. However, panic attacks experienced by those with panic disorder may also be linked to or heightened by certain places or situations, making daily life difficult.
As with other anxiety disorders, children with SAD face more obstacles at school than those without anxiety disorders. Adjustment and relating school functioning have been found to be much more difficult for anxious children. In some severe forms of SAD, children may act disruptively in class or may refuse to attend school altogether. It is estimated that nearly 75% of children with SAD exhibit some form of school refusal behavior.
This is a serious problem because, as children fall further behind in coursework, it becomes increasingly difficult for them to return to school.
Short-term problems resulting from academic refusal include poor academic performance or decline in performance, alienation from peers, and conflict within the family.
Although school refusal behavior is common among children with SAD, it is important to note that school refusal behavior is sometimes linked to generalized anxiety disorder or possibly a mood disorder. That being said, a majority of children with separation anxiety disorder have school refusal as a symptom. Up to 80% of children who refuse school qualify for a diagnosis of separation anxiety disorder.
Social anxiety disorder (SAD; also known as social phobia) describes an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction. This fear can be specific to particular social situations (such as public speaking) or, more typically, is experienced in most (or all) social interactions. Social anxiety often manifests specific physical symptoms, including blushing, sweating, and difficulty speaking. As with all phobic disorders, those suffering from social anxiety often will attempt to avoid the source of their anxiety; in the case of social anxiety this is particularly problematic, and in severe cases can lead to complete social isolation.
Social physique anxiety (SPA) is a subtype of social anxiety. It is concern over the evaluation of one's body by others. SPA is common among adolescents, especially females.
Agoraphobia is the specific anxiety about being in a place or situation where escape is difficult or embarrassing or where help may be unavailable. Agoraphobia is strongly linked with panic disorder and is often precipitated by the fear of having a panic attack. A common manifestation involves needing to be in constant view of a door or other escape route. In addition to the fears themselves, the term agoraphobia is often used to refer to avoidance behaviors that sufferers often develop. For example, following a panic attack while driving, someone suffering from agoraphobia may develop anxiety over driving and will therefore avoid driving. These avoidance behaviors can often have serious consequences and often reinforce the fear they are caused by.
A specific phobia is any kind of anxiety disorder that amounts to an unreasonable or irrational fear related to exposure to specific objects or situations. As a result, the affected person tends to avoid contact with the objects or situations and, in severe cases, any mention or depiction of them. The fear can, in fact, be disabling to their daily lives.
The fear or anxiety may be triggered both by the presence and the anticipation of the specific object or situation. A person who encounters that of which they are phobic will often show signs of fear or express discomfort. In some cases, it can result in a panic attack. In most adults, the person may logically know the fear is unreasonable but still find it difficult to control the anxiety. Thus, this condition may significantly impair the person's functioning and even physical health.
Specific phobia affects up to 12% of people at some point in their life.
People with panic attacks often report a fear of dying or heart attack, flashing vision, faintness or nausea, numbness throughout the body, heavy breathing and hyperventilation, or loss of body control. Some people also suffer from tunnel vision, mostly due to blood flow leaving the head to more critical parts of the body in defense. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the "fight-or-flight response", in which the hormone causing this response is released in significant amounts). This response floods the body with hormones, particularly epinephrine (adrenaline), which aid it in defending against harm.
A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering, difficulty moving, and derealization. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety and forms a positive feedback loop.
Often, the onset of shortness of breath and chest pain are the predominant symptoms. People with a panic attack may incorrectly attribute them to a heart attack and thus trigger seeking treatment in an emergency room. However, since chest pain and shortness of breath are indeed hallmark symptoms of cardiovascular illnesses, including unstable angina and myocardial infarction (heart attack), especially in a person whose mental health status and heart health status are not known, attributing these pains to simple anxiety and not (also) a physical condition is a diagnosis of exclusion (other conditions must be ruled out first) until an electrocardiogram and a mental health assessment have been carried out.
Panic attacks are distinguished from other forms of anxiety by their intensity and their sudden, episodic nature. They are often experienced in conjunction with anxiety disorders and other psychological conditions, although panic attacks are not generally indicative of a mental disorder.
Hypochondriasis is categorized as a somatic amplification disorder—a disorder of "perception and cognition"—that involves a hyper-vigilance of situation of the body or mind and a tendency to react to the initial perceptions in a negative manner that is further debilitating. Hypochondriasis manifests in many ways. Some people have numerous intrusive thoughts and physical sensations that push them to check with family, friends, and physicians. For example, a person who has a minor cough may think that they have tuberculosis. Or sounds produced by organs in the body, such as those made by the intestines, might be seen as a sign of a very serious illness to patients dealing with hypochondriasis.
Other people are so afraid of any reminder of illness that they will avoid medical professionals for a seemingly minor problem, sometimes to the point of becoming neglectful of their health when a serious condition may exist and go undiagnosed. Yet others live in despair and depression, certain that they have a life-threatening disease and no physician can help them. Some consider the disease as a punishment for past misdeeds.
Hypochondriasis is often accompanied by other psychological disorders. Bipolar disorder, clinical depression, obsessive-compulsive disorder (OCD), phobias, and somatization disorder are the most common accompanying conditions in people with hypochondriasis, as well as a generalized anxiety disorder diagnosis at some point in their life.
Many people with hypochondriasis experience a cycle of intrusive thoughts followed by compulsive checking, which is very similar to the symptoms of obsessive-compulsive disorder. However, while people with hypochondriasis are afraid of having an illness, patients with OCD worry about getting an illness or of transmitting an illness to others. Although some people might have both, these are distinct conditions.
Patients with hypochondriasis often are not aware that depression and anxiety produce their own physical symptoms, and mistake these symptoms for manifestations of another mental or physical disorder or disease. For example, people with depression often experience changes in appetite and weight fluctuation, fatigue, decreased interest in sex and motivation in life overall. Intense anxiety is associated with rapid heartbeat, palpitations, sweating, muscle tension, stomach discomfort, dizziness, and numbness or tingling in certain parts of the body (hands, forehead, etc.).
In some cases, hypochondriasis responds well to antipsychotics, particularly the newer atypical antipsychotic medication.
If a person is ill with a medical disease such as diabetes or arthritis, there will often be psychological consequences, such as depression. Some even report being suicidal. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations of these affective fluctuations, often in the form of medically unexplained symptoms. Common symptoms include headaches; abdominal, back, joint, rectal, or urinary pain; nausea; fever and/or night sweats; itching; diarrhea; dizziness; or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms feel they are not understood by their physicians, and are frustrated by their doctors’ repeated failure to provide symptom relief.
Panic disorder sufferers usually have a series of intense episodes of extreme anxiety during panic attacks. These attacks typically last about ten minutes, and can be as short-lived as 1–5 minutes, but can last twenty minutes to more than an hour, or until helpful intervention is made. Panic attacks can wax and wane for a period of hours (panic attacks rolling into one another), and the intensity and specific symptoms of panic may vary over the duration.
In some cases, the attack may continue at unabated high intensity, or seem to be increasing in severity. Common symptoms of an attack include rapid heartbeat, perspiration, dizziness, dyspnea, trembling, uncontrollable fear such as: the fear of losing control and going crazy, the fear of dying and hyperventilation. Other symptoms are sweating, a sensation of choking, paralysis, chest pain, nausea, numbness or tingling, chills or hot flashes, faintness, crying and some sense of altered reality. In addition, the person usually has thoughts of impending doom. Individuals suffering from an episode have often a strong wish of escaping from the situation that provoked the attack. The anxiety of panic disorder is particularly severe and noticeably episodic compared to that from generalized anxiety disorder. Panic attacks may be provoked by exposure to certain stimuli (e.g., seeing a mouse) or settings (e.g., the dentist's office). Other attacks may appear unprovoked. Some individuals deal with these events on a regular basis, sometimes daily or weekly. The outward symptoms of a panic attack often cause negative social experiences (e.g., embarrassment, social stigma, social isolation, etc.).
Limited symptom attacks are similar to panic attacks, but have fewer symptoms. Most people with PD experience both panic attacks and limited symptom attacks.
Just how SAD affects a child's attendance and participation in school, their avoidance behaviors stay with them as they grow and enter adulthood. Recently, "the effects of mental illness on workplace productivity have become a prominent concern on both the national and international fronts". In general, mental illness is a common health problem among working adults, 20 to 30% of adults will suffer from at least one psychiatric disorder. Mental illness is linked to decreased productivity, and with individuals diagnosed with SAD their levels at which they function decreases dramatically resulting in partial work-days, increase in number of total absences, and "holding back" when it comes to carrying out and completing tasks.
A fear of receiving calls may range from fear of the action or thought of answering the phone to fear of its actual ringing. The ringing can generate a string of anxieties, characterized by thoughts associated with having to speak, perform and converse. Sufferers may perceive the other end as threatening or intimidating. Anxiety may be triggered by concerns that the caller may bear bad or upsetting news, or be a prank caller.
Fear of making calls may be associated with concerns about finding an appropriate time to call, in fear of being a nuisance. A sufferer calling a household or office in which they know several people, may be concerned at the prospect of failing to recognize the voice of the person who answers, with resultant embarrassment. Some sufferers may be anxious about having to "perform" in front of a real or perceived audience at their end of the line: this is a particular problem for those required to use a phone in the workplace.
Fear of using the phone in any context (for either making or receiving calls) may be associated with anxiety about poor sound quality, and concerns that one or other party will not understand what has been said, resulting either in misunderstandings, or in the need for repetition, further explanation, or other potentially awkward forms of negotiation. These fears are often linked to the absence of body language over a phone line, and the individual fearing a loss of their sense of control. Sufferers typically report fear that they might fail to respond appropriately in the conversation, or find themselves with nothing to say, leading to embarrassing silence, stammering, or stuttering. Past experiences, such as receiving traumatic news, or enduring an unpleasant and angry call, may also play a part in creating fear.
The symptoms of autophobia vary by case. However, there are some symptoms that a multitude of people with this disease suffer from. An intense amount of apprehension and anxiety when you are alone or think about situations where you would be secluded is one of the most common indications that a person is autophobic. People with this disorder also commonly believe that there is an impending disaster waiting to occur whenever they are left alone. For this reason, autophobes go to extreme lengths to avoid being in isolation. However, people with this disease often do not need to be in "physical" isolation to feel abandoned. Autophobes will often be in a crowded area or group of people and feel as though they are completely secluded.
There has also been some connection to autophobia being diagnosed in people who also suffer from borderline personality disorders.
Below is a list of other symptoms that are sometimes associated with autophobia:
- Mental symptoms:
- Fear of fainting
- A disability to concentrate on anything other than the disease
- Fear of losing your mind
- Failure to think clearly
- Emotional symptoms:
- Stress over up-coming times and places where you may be alone
- Fear of being secluded
- Physical symptoms:
- Lightheadedness, dizziness
- Sweating
- Shaking
- Nausea
- Cold and hot flashes
- Numbness or tingling feelings
- Dry mouth
- Increased heart rate
Death anxiety is anxiety which is caused by thoughts of death. One source defines death anxiety as a "feeling of dread, apprehension or solicitude (anxiety) when one thinks of the process of dying, or ceasing to 'be'". It is also referred to as thanatophobia (fear of death), and is distinguished from necrophobia, which is a specific fear of dead or dying persons and/or things (i.e. others who are dead or dying, not one's own death or dying).
Additionally, there is anxiety caused by death-related thought-content, which might be classified within a clinical setting by a psychiatrist as morbid and/or abnormal, which for classification pre-necessitates a degree of anxiety which is persistent and interferes with everyday functioning. Lower ego integrity, more physical problems, and more psychological problems are predictive of higher levels of death anxiety in elderly people because of how close to death they are.
Individuals with scopophobia generally exhibit symptoms in social situations when attention is brought upon them like public speaking. Several other triggers exist to cause social anxiety. Some examples include: Being introduced to new people, being teased and/or criticized, embarrassing easily, and even answering a cell phone call in public.
Often scopophobia will result in symptoms common with other anxiety disorders. The symptoms of scopophobia include an irrational feelings of panic, feelings of terror, feelings of dread, rapid heartbeat, shortness of breath, nausea, dry mouth, trembling, anxiety and avoidance. Other symptoms related to scopophobia may be hyperventilation, muscle tension, dizziness, uncontrollable shaking or trembling, excessive eye watering and redness of the eyes.
Symptoms include:
- intense anxiety prior to, or simply at the thought of having to verbally communicate with any group,
- avoidance of events which focus the group's attention on individuals in attendance,
- physical distress, nausea, or feelings of panic in such circumstances.
The more specific symptoms of speech anxiety can be grouped into three categories: physical, verbal, and non-verbal. Physical symptoms result from the sympathetic part of the autonomic nervous system (ANS) responding to the situation with a "fight-or-flight" reaction.
During the phobic response, adrenaline secretion produces a wide array of symptoms which enhances the "fight or flight" response. As Garcia-Lopez (2013) has noted, symptoms can include acute hearing, increased heart rate and blood pressure, dilated pupils, increased perspiration and oxygen intake, stiffening of neck/upper back muscles, and dry mouth. Uncontrollable shaking is also common and often occurs prior to the phobia-eliciting stimulus. Symptoms may sometimes be alleviated or mitigated by medications such as beta-blockers.
Verbal symptoms of the fight or flight response include (but are not limited to) a tense or quivering voice, and vocalized pauses (which tend to comfort anxious speakers). One form of speech anxiety is dysfunctional speech anxiety in which the intensity of the fight-or-flight response prevents an individual from performing effectively.
According to the fourth revision of the "Diagnostic and Statistical Manual of Mental Disorders", phobias can be classified under the following general categories:
- Animal type – Fear of dogs, cats, rats and/or mice, pigs, cows, birds, spiders, or snakes.
- Natural environment type – Fear of water (aquaphobia), heights (acrophobia), lightning and thunderstorms (astraphobia), or aging (gerascophobia).
- Situational type – Fear of small confined spaces (claustrophobia), or the dark (nyctophobia).
- Blood/injection/injury type – this includes fear of medical procedures, including needles and injections (trypanophobia), fear of blood (hemophobia) and fear of getting injured.
- Other – children's fears of loud sounds or costumed characters.
Phobophobia is the fear of phobia(s) and, more specifically, of the internal sensations associated with that phobia and anxiety, which binds it closely to other anxiety disorders, especially with generalized anxiety disorders (free floating fears) and panic attacks. It is a condition in which anxiety disorders are maintained in an extended way, which combined with the psychological fear generated by phobophobia of encountering the feared phobia would ultimately lead to the intensifying of the effects of the feared phobia that the patient might have developed, such as agoraphobia, and specially with it, and making them susceptible to having an extreme fear of panicking. Phobophobia comes in between the stress the patient might be experiencing and the phobia that the patient has developed as well as the effects on his life, or in other words, it is a bridge between anxiety/panic the patient might be experiencing and the type of phobia he/she fears, creating an intense and extreme predisposition to the feared phobia. Nevertheless, phobophobia is not necessarily developed as part of other phobias, but can be an important factor for maintaining them.
Phobophobia differentiates itself from other kind of phobias by the fact that there is no environmental stimulus per se, but rather internal dreadful sensations similar to psychological symptoms of panic attacks. The psychological state of the mind creates an anxious response that has itself a conditioned stimuli leading to further anxiety, resulting in a vicious cycle. Phobophobia is a fear experienced before actually experiencing the fear of the feared phobias its somatic sensations that precede it, which is preceded by generalized anxiety disorders and can generate panic attacks. Like all the phobias, the patients avoids the feared phobia in order to avoid the fear of it.
A person may be diagnosed with taijin kyofusho if they feel as if their attitudes, behavior, and physical characteristics are inadequate in social situations. As a result of these feelings, they also experience persistent suffering in the form of emotional distress through shame, embarrassment, anxiety, fear, and other tense feelings that occur when confronted with social circumstances. In addition, individuals also worry about being unable to maintain healthy relationships with others. When it comes to socializing, taijin kyofusho sufferers avoid painful social and interpersonal situations, while simultaneously being averse to doing so. Those likely to develop taijin kyofusho have more of a temperamental characteristic of being hypochondriacal. The balance between introversion and extroversion in hypochondriacal temperament is geared more towards introversion. The introversion causes sufferers to focus on themself and problems they have, and by fixating on their weaknesses they become more anxious and depressed.
Phobophobia is mainly linked with internal predispositions. It is developed by the unconscious mind which is linked to an event in which phobia was experienced with emotional trauma and stress, which are closely linked to anxiety disorders and by forgetting and recalling the initiating trauma. Phobophobia might develop from other phobias, in which the intense anxiety and panic caused by the phobia might lead to fearing the phobia itself, which triggers phobophobia before actually experiencing the other phobia. The extreme fear towards the other phobia can lead the patient to believe that their condition may develop into something worse, intensifying the effects of the other phobia by fearing it. Also, phobophobia can be developed when anxiety disorders are not treated, creating an extreme predisposition to other phobias. The development of phobophobia can also be attributed to characteristics of the patient itself, such as phylogenetic influence, the prepotency of certain stimuli, individual genetic inheritance, age incidence, sex incidence, personality background, cultural influence inside and outside the family, physiological variables and biochemical factors.
Phobophobia shares the symptoms of many other anxiety disorders, more specifically panic attacks and generalized anxiety disorder:
1. Dizziness
2. Heart pounding
3. An excess of perspiration
4. Slight paresthesia
5. Tension
6. Hyperventilation
7. Angst
8. Faintness
9. Avoidance
Hypochondriasis or hypochondria is a condition in which a person is inordinately worried about having a serious illness. An old concept, its meaning has repeatedly changed due to redefinitions in its source metaphors. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.
Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, their concerns are far in excess of what is appropriate for the level of disease. Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal problems, palpitations, or muscle fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least 6 months.
The DSM-IV-TR defines this disorder, "Hypochondriasis", as a somatoform disorder and one study has shown it to affect about 3% of the visitors to primary care settings. The newly published DSM-5 replaces the diagnosis of hypochondriasis with the diagnoses of "somatic symptom disorder" and "illness anxiety disorder".
Hypochondria is often characterized by fears that minor bodily or mental symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one's body. Many individuals with hypochondriasis express doubt and disbelief in the doctors' diagnosis, and report that doctors’ reassurance about an absence of a serious medical condition is unconvincing, or short-lasting. Additionally, many hypochondriacs experience elevated blood pressure, stress, and anxiety in the presence of doctors or while occupying a medical facility, a condition known as "white coat syndrome". Many hypochondriacs require constant reassurance, either from doctors, family, or friends, and the disorder can become a debilitating challenge for the individual with hypochondriasis, as well as his or her family and friends. Some hypochondriacal individuals completely avoid any reminder of illness, whereas others frequently visit medical facilities, sometimes obsessively. Some sufferers may never speak about it.
Studies investigating the relationship between interoception and panic disorder have shown that people with panic disorder feel heartbeat sensations more intensely when stimulated by pharmacological agents, suggesting that they experience heightened interoceptive awareness compared to healthy subjects.