Hypochondria (Illness Anxiety): Signs, Symptoms and Treatment

It’s normal to worry about our health. Health issues are often sensationalized in the news, and we all know people who have been afflicted with illnesses and conditions we hope never to experience.

Furthermore, with the Internet, it’s tempting to turn to Dr. Google to look up all our aches and pains, resulting in an—often unnerving—self-diagnosis.

Some degree of concern over our health can keep you up to date with doctors, help you make healthy decisions about diet and lifestyle, and provide motivation to get to the gym or a yoga class when all we want to do is sink into the couch with a gallon of ice cream.

However, if worrying over your health becomes obsessive, drives you to your doctor’s office requesting tests to rule out diseases you have no symptoms for, or impedes your ability to enjoy your life, you might be experiencing illness anxiety disorder, also called health anxiety disorder or somatic symptom disorder, but most widely known as hypochondriasis or hypochondria. 

It is estimated that about 0.1% of Americans live with hypochondria, which is considered a long-term condition that can get better or worse at various times throughout someone’s life.

It can be treated through therapy, at-home exercise, and prescribed medication. 

What Is Hypochondria or Illness Anxiety?

Hypochondria has “three common presentations: disease conviction, disease fear, and bodily preoccupation.”

A clinical level of illness anxiety is defined as a mental disorder in which the affected person has excessive and constant fear of having a serious medical condition despite receiving a clean bill of health and reassurances from health care providers.

People with illness anxiety—also known as a hypochondriac—tend to focus on normal bodily sensations and interpret them as dangerous.

Someone with hypochondria might have a stomach ache, for example, and rather than understand it as a reaction to something they ate or a bug, fear that they have stomach cancer or appendicitis.

They tend to fear severe illnesses like cancer or HIV, rather than more common health ailments like strep throat or a cold.

It’s also common for an affected person to regularly scan their body for any feelings or sensations that could be worrisome. 

Illness anxiety can appear in people who are physically healthy, as well as those with medical problems either in the past or present.

Illness anxiety is defined as excessive worry over symptoms and conditions, in ways that are harmful to well-being, relationships, and ability to function in daily life. 

Their fear of having a serious illness can cause a person to repeatedly visit their doctors for tests and examinations.

They are often not reassured by the positive outcomes of these tests, though. Instead, they fear that the tests missed something or that their doctors are mistaken.

Others with illness anxiety may avoid the doctor completely, for fear they will find they have something very wrong.

Causes of Hypochondria

Illness anxiety usually starts in early adulthood. It is often triggered by the illness or death of someone you know, or your own health scare or bad experience with an illness or hospitalization.

Roughly two-thirds of those with illness anxiety have a coexisting psychiatric disorder, most commonly an anxiety disorder like panic disorder or obsessive-compulsive disorder (OCD).

Depression also co-exists with illness anxiety in about half of documented cases.

Some people who are more prone to develop illness anxiety are those with a history of abuse, who had a serious childhood illness, whose parents were very ill, and with a high-stress lifestyle.

Many people with illness anxiety often have a family member who is also very worried about health, so it can sometimes be a learned behavior.

Hypochondria Symptoms

It can be hard to tell if you or a loved one has a normal level of anxiety about health, or traits and behaviors that could be classified as illness anxiety.

Knowing what to look for can help you determine if you have more than a normal level of illness anxiety.

Some symptoms include:

• You have no symptoms, but fear that you’re sick. Or, you consider normal functioning of the body to be signs that you have a serious illness.

• You do not feel comforted or secured when tests show you’re healthy or when a doctor reassures you that you don’t have an illness you fear you do.

• You spend a lot of time researching health conditions and symptoms online.

• You worry about getting a serious disease when you hear about it in the news or find out someone you know is sick.

• Your worries about your health prevent you from enjoying regular activities. 

• You constantly check yourself for any signs of illness.

• You make frequent visits to your doctor requesting tests or exams for conditions you fear you have. Or, you avoid going to the doctor for fear of serious diagnosis.

Can hypochondria cause physical symptoms?

Because hypochondria can activate the “fight or flight” system of the body, having excessive worries about your health can cause some physical symptoms.

Some common symptoms of anxiety that hypochondria can trigger include:

• Stomachaches and conditions like irritable bowel syndrome (IBS)
• Dizziness
• Headache
• Dry mouth
• Muscle tension
• Fatigue
• Increased heart rate
• Sweating
• Shortness of breath
• Frequent urge to use the bathroom

When people with illness anxiety experience the symptoms above, they may interpret them to mean they have a serious illness.

But their symptoms are actually caused by an onslaught of adrenaline.

Hypochondria Triggers

This may sound obvious, but the same things that would make any other person worry about their health could trigger an episode of hypochondria.

These episodes become a larger issue when these triggers are combined with a set of inflexible and inaccurate health rules or assumptions. A trigger can be something internal (within you) or external in your environment.

Internal triggers

The body is always gurgling, shifting, and producing strange sensations, so for those looking for sounds and sensations, they’re easy to find.

This can include anything from stomach discomfort to variations in energy levels. Regular living may even produce unusual sensations, such as developing a strange taste in your mouth or a muscular twitch under one of the eyes.

For a hypochondriac, even normal symptoms and sensations can trigger a heightened level of anxiety. 

External triggers

Besides things happening within your body, a number of external factors can draw your attention towards possible health problems and therefore trigger illness anxiety.

These risk factors include: 

• Health scares in the news
• Upcoming medical appointments
• Contact with someone who is sick
• Hearing about someone who has been diagnosed with an illness
• Receiving inconclusive results on a medical test
• Being told you do have a health condition
• Being away from known health-care systems or your primary care physician 

How Is Health Anxiety Diagnosed?

If you are worried about your health, it’s important to consult with your doctor to rule out any health conditions.

If your doctor rules out all health conditions and you continue to worry, he or she may diagnose you with illness anxiety, or hypochondria.

In order to receive this diagnosis, you must satisfy several of the following symptoms:

• Persistent worry about having or developing a serious illness, or having major health concerns for six consecutive months.

• Worry about disease in the absence of physical symptoms, or very minimal symptoms.

• Interpreting normal bodily sensations to mean you have a serious health condition.

• Avoiding people or places you think might get you sick.

• Avoiding doctor’s appointments so as not to receive a feared diagnosis of serious illness.

• Worrying about your health to the point that it disrupts your job, relationships, and enjoyment of your life.

• Not feeling reassured by doctors when they tell you that you’re healthy, or not being reassured by results that show you do not have a feared health condition.

• Repeatedly checking your body for disease.

• Repeatedly researching disease symptoms online.

• Intense worry about an existing medical condition or a medical condition that runs in your family.

Related Conditions

It’s common for people with illness anxiety to have other mental and physical health conditions as well, like:

• Depression
• Generalized anxiety disorder
• Panic disorder
• Phobias
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Schizophrenia

Illness anxiety does not correlate with having any particular physical disease.

Treatment Options

Current Psychiatry states that, “a doctor-patient relationship based on mutual trust and respect is vital” when treating a patient with health anxiety.

If a patient feels comfortable with and truly trusts their doctor, they are more likely to accept reassurance and a clean bill of health when it comes from them. Once a trusted doctor has ruled out serious ailments with tests and examinations, treatment includes:

• Cognitive Behavioral Therapy (CBT): CBT is the most effective treatment for anxiety disorders, including health anxiety. In CBT, patients learn to recognize and disbelieve their excessive fears about their health. CBT can also help patients cope with anxiety symptoms that health anxiety can trigger. CBT is effective for those with health anxiety with co-occurring depression, although less so than for those with co-occurring anxiety.
  
  K Health offers K Therapy, a text-based therapy program that includes unlimited messaging with a licensed therapist, plus free resources designed by mental health experts to use on your own.
  
• Medication: Psychiatric medications, like anti-depressants and anti-anxiety medications, often selective serotonin reuptake inhibitors (SSRIs), can be used in conjunction with therapy to treat health anxiety.

What You Can Do at Home

In addition to communicating and working with your doctor, a mental health professional, and possibly a psychiatrist, there are some stress management and relaxation techniques that may be helpful for easing health anxiety that you can practice at home.

These include:

• Keeping a CBT journal about recurring health related fears and beliefs and writing exercise aimed at dismantling unhelpful beliefs with more healthy thoughts and behaviors.
• Limiting the amount of time spent on online searches for health conditions and symptoms.
• Focusing on hobbies and relationships that bring you joy and distract you from focusing on health concerns.
• Self-talk that normal bodily sensations are not signs of something harmful, but just the body working as it should.
• Keeping regular appointments with mental health providers and taking psychiatric medication if prescribed.
• With your doctor, setting and sticking to a limit on doctor visits, tests, and referrals to specialists you request.

When to See a Doctor

If you have concerns about your health, it’s always a good idea to speak to your doctor.

They can give you the proper tests to make sure you are healthy and well. It is possible to have both health anxiety and a medical condition, so just because you may have health anxiety, it is important to check on new symptoms that worry you.

If your symptoms are found not to be related to a medical problem, it can be a good idea to get a referral to a mental health professional they know and trust, and to discuss how to proceed with scheduling visits for future health concerns.

If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free 24/7 support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.

How K Health Can Help

Anxiety and depression are among the most under-reported and under-treated diseases in America. Nearly 20% of adults in the US have a mental health condition and fewer than half receive treatment. Our mission is to increase access to treatment.

You can start controlling your anxiety and depression and get access to the treatment you need with K Health. Starting at $49/month get prescriptions for mental health medications plus unlimited doctor visits through the K Health app.

Start your free assessment to see if you’re eligible.