Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, involves worrying excessively about having or being able to develop a serious illness. You may not have physical symptoms. Or, you may believe that normal bodily sensations or minor symptoms are signs of a serious illness, even though a thorough medical exam does not reveal a serious illness.
You may experience extreme anxiety and associate bodily sensations, such as muscle twitching or fatigue, with a specific serious illness. This excessive anxiety, more than the physical symptom itself, causes intense distress that can affect your life.
Illness anxiety disorder is a long-term disorder whose severity can fluctuate. It can increase with age or during times of stress. But psychological counseling (psychotherapy) and sometimes medication can help ease your worries.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, no longer includes hypochondriasis, also called hypochondriasis, as a diagnosis. People previously diagnosed with hypochondriasis may be diagnosed with Illness Anxiety Disorder instead. In this disorder, fear and worry are focused on viewing uncomfortable or unusual physical sensations as an indication of a serious illness.
Somatoform disorder, a related disorder, on the other hand, involves focusing on the disabling nature of physical symptoms, such as pain or dizziness, without concern that these symptoms represent a specific disease.
Illness anxiety disorder symptoms involve preoccupation with the idea of being seriously ill, from normal bodily sensations (such as rumbling in the stomach) or minor symptoms (such as a minor skin rash). Signs and symptoms may include:
Being worried about having or getting a serious disease or disorder
Worrying that minor symptoms or bodily sensations mean you have a serious illness
Worry easily about your state of health
Having a very mild or no sense of calm after seeing your doctor or after getting negative test results
Worrying excessively about a specific disease or the risk of having a disease that runs in your family
Getting too upset about possible diseases in which it is difficult for you to function
Repeatedly examining your body for signs of disease
Attending frequent medical appointments to reassure yourself or avoiding medical attention for fear of being diagnosed with a serious illness
Avoiding people, places, or activities for fear of health risks
Constantly talking about your health and possible illnesses
Constantly search the internet for the causes of symptoms or possible diseases
Since the symptoms can be related to health problems, it’s important to get evaluated by a health care provider if you haven’t been seen yet. If the professional thinks you might have illness anxiety disorder, they may refer you to a mental health professional.
A significant level of anxiety can cause real distress for the person, and reassurance is not always helpful. Sometimes providing comfort can make the situation worse. This can be frustrating and cause stress in families and relationships. Encourage your loved one to consider a referral to a mental health professional to learn ways to cope with illness anxiety disorder.
Illness anxiety disorder usually begins in early or mid-adulthood and can worsen with age. Often in older people, health-related anxiety can center on the fear of losing memory.
Risk factors for illness anxiety disorder may include:
A stressful time in life
Risk of a serious disease that ends up not being serious
History of sexual abuse during childhood
A serious childhood illness or a parent with a serious illness
Personality characteristics, such as a tendency to worry
Excessive use of the internet related to health
To determine a diagnosis, you’ll likely need to have a physical exam and any tests your primary care doctor recommends. Your doctor can help you determine if you have a medical condition that needs treatment and set limits on laboratory tests, imaging, and referrals to specialists.
Your primary care doctor may also refer you to a mental health professional. The professional may do the following:
Get a psychological evaluation to discuss symptoms, stressful situations, family history, fears or concerns, and ways anxiety negatively affects your life
Ask you to fill out a self-assessment or psychological questionnaire
Ask you about the use of alcohol, drugs or other substances
Determine if preoccupation with illness may be caused by another mental disorder, such as somatoform disorder or generalized anxiety disorder.
The goal of treatment is to help you control anxiety about your health and improve your ability to function in everyday situations. Psychotherapy, also called talk therapy, may be helpful for illness anxiety disorder. Sometimes some medications may be included.
Since physical symptoms can be related to emotional distress and health anxiety, psychotherapy, especially cognitive behavioral therapy (CBT), can be an effective treatment. Cognitive-behavioral therapy will help you learn how to manage illness anxiety disorder and find ways to manage worry without excessive medical testing or seeking medical care.
Cognitive behavioral therapy can help you with the following:
Identify your fears and thoughts about serious illnesses
Learn alternative ways to interpret bodily sensations by changing unhelpful thoughts
Being more aware of how worries affect you and your behavior
Changing the way you respond to bodily sensations and symptoms
Learn skills to deal with and tolerate anxiety and stress
Reduce your absence from situations or activities due to physical sensations
Reduce behaviors in which you repeatedly look for signs of illness and reassurance
Improve everyday functionality at home, work, relationships and social situations
Coping with other mental health disorders, such as depression
Other therapies, such as exposure therapy and behavioral stress management, may also be helpful.
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may help you treat an anxiety disorder about illness. Medications to treat mood or anxiety disorders, if present, may also be helpful.
Talk to your doctor about medication options and possible side effects and risks.
