Overcoming Health Anxiety: Can Illness Anxiety Disorder (Hypochondriasis) Be Treated?
Key takeaways:
Illness anxiety disorder is when you have a high level of anxiety about your health even if you have few or no physical symptoms.
Common symptoms of illness anxiety disorder include difficulty accepting you’re healthy, repeatedly seeking out providers or tests to check for signs of an illness, or avoiding healthcare altogether.
Therapy is typically the first line of treatment for illness anxiety disorder. Antidepressant medications may also be used along with therapy.
Have you ever noticed an unexpected body sensation and immediately took to Google to anxiously search for what it could mean? You’re not alone. It can be disconcerting to feel something off or different in your body.
Usually, the jolt of anxiety we feel wears off once we realize that our thoughts are exaggerated or we learn that everything’s OK. But for people with illness anxiety disorder — previously called hypochondriasis — the fear doesn’t go away. Let’s talk more about what illness anxiety disorder looks like and how it’s managed.
What is illness anxiety disorder?
Illness anxiety disorder (also called health anxiety) is excessive fear that you have or will develop a serious medical condition.
People with illness anxiety disorder usually do not have physical symptoms of an illness. If they do have symptoms, they are very minimal. Illness anxiety disorder often leads people to seek out many providers and tests to try and find a diagnosis.
Can illness anxiety disorder be treated?
Treatment for illness anxiety disorder usually starts with psychotherapy. But medications may also be prescribed depending on your symptoms. The goal of treatment is to reduce your excessive health concerns and the distress they cause.
It’s possible to live a functional life with illness anxiety disorder when it’s managed. That’s why it’s important to be open with your healthcare providers about your concerns. It’s also helpful to see them regularly for checkups — not just when you’re really worried.
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Psychotherapy
The two most common forms of therapy to treat illness anxiety disorder are cognitive behavioral therapy and acceptance and commitment therapy.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a research-backed approach to treat illness anxiety. It’s considered a first-choice option for treatment.
CBT works by helping you identify and challenge unhelpful ways you think about your health. Part of this can include education, such as learning to recognize when physical sensations are normal. It also helps change your behavior — such as not acting on urges to check for symptoms.
Acceptance and commitment therapy
Acceptance and commitment therapy (ACT) is another therapy approach for illness anxiety disorder. While it’s not as common as CBT, research suggests it can be effective for some people.
ACT helps you learn that you don’t need to respond to distressing thoughts or urges to act on your illness anxiety. You learn to accept that addressing your health fears may lead to uncomfortable emotions. But those uncomfortable emotions don’t need to dictate your actions. In other words, you learn that illness anxiety doesn’t need to run your life.
Medications
Antidepressants are most commonly prescribed medications for illness anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) are typically the first-choice antidepressants.
SSRIs include medications like:
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Escitalopram (Lexapro)
Common SNRIs include:
Duloxetine (Cymbalta)
Venlafaxine (Effexor)
If you don’t see an improvement after 6 to 8 weeks, your provider may suggest trying a different SSRI or SNRI.
Your specific circumstances will dictate how long you need to take medication. Most people take medication for illness anxiety disorder for at least 6 months to a year.
What are the symptoms of illness anxiety disorder?
Worrying about your health is normal. But there’s a difference between mild worries and having an anxiety disorder. People diagnosed with illness anxiety disorder have severe anxiety about their health, which can interfere with everyday life.
Below are some common signs of illness anxiety disorder. However, keep in mind that other mental health disorders — like generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD) — can share similar symptoms.
Excessively worrying about health
Someone with illness anxiety disorder will worry a significant amount about having or developing an illness. This worry may cause them to:
Constantly check their body for changes
Go to providers repeatedly to be examined
Frequently search the internet for causes of possible symptoms
Mistake normal sensations like twitching as symptoms of a health condition
Believe that minor symptoms are signs of a serious illness
Worry that they’ll develop an illness because someone in their family had it
Become preoccupied with fears of developing a specific health condition
Worrying about your health for at least 6 months
If concerns about your health consume you and interfere with your life, then you may have an anxiety disorder. To be diagnosed with illness anxiety disorder, your health anxiety must last at least 6 months.
Difficulty accepting you’re healthy
Those with illness anxiety disorder may know they are overly anxious. But they often believe that their anxiety will go away if they can just confirm they are healthy. However, their worry doesn’t go away even after getting normal test results or reassurance from a provider. This could lead to going to several doctors with the expectation of getting diagnosed with a health condition or in an effort to make the anxiety finally go away.
Avoiding healthcare providers
People with illness anxiety disorder may act in different ways in response to their anxiety. Some people may make lots of healthcare appointments or request tests to make sure they’re healthy. Others may completely avoid seeing healthcare providers because they fear that they will find out they have a serious illness. This avoidance can lead to even more anxiety, creating a vicious cycle of anxiety and avoidance.
How common is illness anxiety disorder?
Illness anxiety disorder and health anxiety are relatively common. So if you’re struggling with excessive health fears, know you’re not alone. Based on available information, it’s estimated that up to 13% of the general population has experienced illness anxiety disorder at some point in their lives.
Is illness anxiety disorder the same as somatic symptom disorder?
No, but the difference is subtle. Somatic symptom disorder is when you have excessive anxiety and fear about real physical symptoms. “Somatic” refers to physical symptoms.
In somatic symptom disorder, you may or may not know what is causing those symptoms, but they exist. Illness anxiety disorder is different in that the person is overly focused on and worried about their health, and they have no (or very minimal) physical symptoms.
Similar to people with illness anxiety disorder, people with somatic symptom disorder might see a lot of healthcare providers and request tests to be run. However, they always have at least one physical symptom.
What can cause illness anxiety disorder?
It’s not clear what causes someone to have illness anxiety disorder. But experts believe that a few different factors may contribute to your risk for developing the condition, such as:
Having overly worried or anxious parents
Witnessing parents who have a serious health condition
Being abused or neglected in childhood
Experiencing a serious illness in the past
Being overly concerned about body sensations or changes to the body
Having a general tendency to worry
Having a habit of looking for health-related information on the internet
A common theme among people with illness anxiety disorder is a misunderstanding of illness and good health. For example, if you had a rare childhood illness, you might believe that it’s more common than it is. And you may not fully know how you got it or how it was treated. This could lead to a false belief that you can easily contract a serious disease.
Or, you may think that good health means never having symptoms or unpleasant sensations. So, if you ever have a common sensation or symptom like a headache, you might fear that you have a very serious condition.
When should I see a healthcare provider?
You should see your healthcare provider whenever you’re concerned about your health. Your provider will be able to discuss your concerns and order any tests that may be necessary. They will tell you if your symptoms are concerning or serious. Don’t avoid going to a provider if you ever feel like there is something off about your health.
And if you notice your fears about your health and body sensations are starting to take over, reach out for help. A mental health professional in particular can help you determine if you have illness anxiety disorder. They can also offer guidance on your treatment options to reduce your anxiety and worry.
The bottom line
Illness anxiety disorder is an excessive concern about a person’s health with minimal or no actual physical symptoms. People with this condition may have a hard time coping with their worries and may seek out multiple providers or appointments. Or they may avoid healthcare providers altogether.
Illness anxiety disorder is treatable with therapy and medication. If you are struggling with health anxiety, talk to your healthcare provider.
Why trust our experts?
References
American Psychiatric Association. (2021). What is somatic symptom disorder?
Arnaez, S., et al. (2020). Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behavioural and Cognitive Psychotherapy.
Barsky, A. J., et al. (1993). Hypochondriacal patients’ beliefs about good health. American Journal of Psychiatry.
Cambridge University Press. (2018). Health anxiety: Detection and treatment. BJPsych Advances.
Eilenberg, T., et al. (2016). Acceptance and commitment group therapy (ACT-G) for health anxiety: A randomized controlled trial. Psychological Medicine.
French, J. H., et al. (2022). Illness anxiety disorder. StatPearls.
Higgins-Chen, A. T., et al. (2019). Severe illness anxiety treated by integrating inpatient psychotherapy with medical care and minimizing reassurance. Frontiers in Psychiatry.
Marcus, D. K., et al. (2007). Cognitive and perceptual variables in hypochondriasis and health anxiety: A systematic review. Clinical Psychology Review.
Scarella, T. M., et al. (2019). Illness anxiety disorder: Psychopathology, epidemiology, clinical characteristics, and treatment. Psychosomatic Medicine.
Substance Abuse and Mental Health Services Administration. (2016). Table 3.32 DSM-IV to DSM-5 illness anxiety disorder comparison. Impact of the DSM-IV to DSM-5 Change on the National Survey on Drug Use and Health.
Swoboda, C. M., et al. (2018). Odds of talking to healthcare providers as the initial source of healthcare information: Updated cross-sectional results from the Health Information National Trends Survey (HINTS). BMC Family Practice.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
