Illness anxiety disorder: What is hypochondria?

How many of us have felt suddenly unwell for a time, and out of concern, googled our symptoms? Later on, when we’re better, we might feel a little bit embarrassed that we were so concerned—maybe our mysterious symptoms were all in our heads. 

Experiencing this fear of illness or disease is quite common, but for some folks, it’s a constant mental battle. Illness anxiety disorder (also known as hypochondria) is the perpetual fear of being seriously sick, hurt, or otherwise unhealthy.

Hypochondria presents itself as an obstructive and psychologically damaging condition to cope with long-term. It’s a disorder that can be extremely frustrating; the health-based anxiety it creates can convince sufferers that they are frequently in need of medical assistance. In order to dissipate the illusions that illness anxiety disorder sufferers can become entangled in, mental health providers look to implement unique, personally-molded treatment plans. 

What Is Illness Anxiety Disorder?

Illness anxiety disorder is the clinical term for hypochondria —the false belief that one is chronically ill, injured, or otherwise in danger from a serious medical condition. Symptoms may entail:

• Constantly researching potential illnesses, or making frequent doctor’s visits out of concern for non-existent health conditions
• Constantly asking loved ones whether what they’re feeling is normal
• Avoiding public spaces or people for fear of being hurt or exposed to illness
• Experiencing abnormally high anxiety about their personal health
• Obsessively monitoring their vital signs 
• Oversharing their physical health status with other people

People suffering from the condition may also shift their concern to a new medical condition or concern, once their fears about a previous ailment have been quelled or forgotten about. Those with illness anxiety disorder may suffer great psychological harm when they do become seriously ill or injured. 

There’s currently no known cure; however, a therapist or psychiatrist’s guidance has been shown to offer remarkable improvements and the possibility of symptom remission.  

What Is an Example of Illness Anxiety Disorder?

A prime example of illness anxiety disorder is when an individual experiences excessive worry and preoccupation toward having one or more medical conditions, despite having little or no medical evidence to support their belief(s). 

This preoccupation often leads to persistent anxiety, distress, and a significant impairment in daily functioning. The person may frequently seek medical reassurance, visit doctors or specialists, undergo unnecessary medical tests, or constantly research medical information online. 

Even when medical professionals provide reassurance that there is no evidence of a serious illness, individuals with illness anxiety disorder may remain unconvinced and continue to worry excessively about their health.

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What Does Illness Anxiety Disorder Feel Like?

Hypochondria is based on the unique experiences and obstacles that those with illness anxiety face (or have faced); their journey toward wellness will be shaped by their negative thought patterns and their ability to manage them.

That being said, it’s still possible for those who think they may have illness anxiety disorder (or who are curious about this anxiety disorder) to understand an approximation of what illness anxiety disorder feels like. Hypochondriacs often, but not always, experience: 

• Debilitating fear related to their death or pain as a result of an undiagnosed health condition  
• Frustration when others disregard their worries
• Significant detriments to their social, professional, or romantic lives as a result of their irrational thoughts and their effects on their behavior
• Self-doubt, as they wrestle with illness anxiety disorder, wondering if they are overthinking—or if they indeed have a serious health condition 

Many online platforms and social groups have found outlets and communities through which to share personal battles and triumphs related to illness anxiety disorder. These hubs serve as enriching and informative vehicles for insight.

What Causes Illness Anxiety Disorder?

According to current psychological understanding, illness anxiety disorder isn’t caused by a single event or factor but is more likely to arise from a group of comorbid events or circumstances. Some of these events or circumstances include: 

• Childhood trauma, including neglectful parents, sibling rivalries, or even custody battles
• Extreme stress
• A history of anxiety disorders in your family, or severe/chronic illness
• Suffering from an illness or injury in childhood illness 
• Witnessing a family member suffer from a chronic illness or debilitating injury during childhood
• Pre-existing mental health conditions, like anxiety, depression, or schizophrenia
• Recent or past history of trauma, including sexual assault, physical and emotional abuse

The causes of Illness anxiety disorder all function as a gateway toward an increased risk of health-related anxiety. But to be diagnosed requires a mental health evaluation from a psychotherapist or psychiatric professional. 

What Triggers Illness Anxiety Disorder?

Hypochondria can initially be triggered by adverse childhood events, as explained previously, but other triggers in day-to-day life can be: 

• High blood pressure (which can be worsened or caused by their anxiety) 
• Rapid heart rate (which can also be caused by their illness anxiety) 
• Concerns related to contracting COVID-19, or from being in close proximity to someone with a COVID variant
• Public spaces, such as transportation systems, airplanes, bars, and other heavily trafficked areas 
• Allergies, sunburns, hangovers, and other minor ailments 
• Autoimmune issues, which have been shown to be linked with long-term anxiety

Triggers are highly specific, more so to each individual, who may struggle to contain the stress and emotional overwhelm that springs forth from whatever has triggered their illness anxiety disorder. 

When Does Illness Anxiety Disorder Typically Develop?

This condition typically develops in early adulthood. At this point in life, the sufferer may have experienced a chronic illness or injury; perhaps a family member, friend, or someone else became unwell. 

Additionally, media exposure can increase as we age, and becoming overloaded with information or marketing related to certain health conditions may contribute in part to illness anxiety disorder.

How Is Illness Anxiety Disorder Diagnosed?

Being diagnosed involves a mental health evaluation from a qualified mental health professional. The first step is to reach out for help. 

From there, the provider will follow the DSM-5 criteria for illness anxiety disorder, and throughout the evaluation will take care to observe the following symptoms or signs: 

• The individual has an intense fear or strong belief that they will develop (or have developed) a serious mental health condition.
• Somatic symptoms (anxiety-based physical responses, like upset stomach, headaches, etc) are not present or are only mild. Even if the person in mind runs the risk of developing a medical condition, their level of concern is clearly excessive.
• The client indicates a high level of anxiety about their personal health,
• The client exhibits excessive health-related behaviors (like checking their vitals) or has maladaptive avoidant behaviors (avoiding hospitals or doctor’s appointments).
• The client has been overly concerned about their health for at least 6 months, even if the focal point of their anxiety has shifted since then.
• The client’s illness-related preoccupation is not better explained by another mental disorder.

Illness anxiety disorder sufferers are further divided by whether they are care-seeking or care-avoidant in coping with the symptoms of their condition. Care-seeking individuals with illness anxiety disorder prioritize medical care, while care-avoidant types go out of their way to avoid medical appointments, hospitals, and talking with physicians.

Illness Anxiety Disorder vs. Somatic Symptom Disorder: How Do They Differ? 

When comparing illness anxiety disorder vs. somatic symptom disorder, we see those with illness anxiety disorder assuming the worst, while somatic symptom sufferers typically complain of generalized issues. Let’s further discern the differences between the two:

Somatic symptom disorder is less specific in nature, meaning that someone suffering from this disorder might complain of back pain—and despite these physical symptoms feeling real, they are only being manifested by their thoughts. 

This differs greatly from illness anxiety disorder, which is dominated by anxiety about having or acquiring a serious medical illness, that the sufferer doesn’t actually have. To use the “back pain” example again, though they might feel back pain, they go a step further than typically seen in somatic symptom disorder presentions. 

Someone with illness anxiety disorder might assume that perhaps they’ve broken a vertebrae, are leaking spinal fluid, or have another serious back condition, with or without the input of a medical professional.

How Can I Stop My Fear of Illness?

Confronting illness anxiety disorder can be at first difficult, especially if you aren’t fully aware of the extent of your condition. The best way to stop illness anxiety disorder-related thoughts is to team up with a therapist or psychiatrist who has a thorough understanding of the disorder and other anxiety-based conditions. 

Therapists typically employ a cognitive behavioral therapy (CBT) approach to illness anxiety disorder, which among other key points, helps clients recognize and successfully counteract negative thought patterns. 

Still, other therapeutic methods include:

• Group therapy: This treatment method may help those with illness anxiety disorder to better recognize intrusive and irrational health-related thoughts, as they connect and communicate with others who share similar symptoms. Seeing the unbalanced behaviors of other sufferers may help them self-reflect and address their own symptoms. 
• Behavioral stress management: This treatment involves reinforcing helpful behaviors and learning to eliminate unhelpful behaviors. Those who are struggling to cope with the symptoms of illness anxiety disorder may more effectively learn to counteract the stress and anxiety of imagined health concerns when they arise.
• Exposure therapy: This form of treatment can be highly subjective, as each individual with illness anxiety disorder may face a unique set of triggers that activate their tendency to overthink. However, exposure therapy may involve scheduling and attending doctor’s appointments, coping with real illness (such as a cold or flu), or spending time in a setting that has previously caused health-based anxiety, such as a theater, public park, or medical clinic.

Psychiatrists routinely prescribe anti-depressant medication to help treat illness anxiety disorder, specifically selective serotonin reuptake inhibitors (SSRIs), such as sertraline, fluoxetine (perhaps the most popular), fluvoxamine, and paroxetine. 

Your treatment will depend on the severity of your illness anxiety disorder symptoms, your chosen provider’s background, and your personal preferences.