What is Illness Anxiety Disorder?

Illness anxiety disorder, previously referred to as hypochondria or health anxiety, involves excessive worry that you are or will become seriously ill. This can involve having no physical symptoms, or believing normal sensations of the body, or even minor symptoms, are signs of serious illness. This can be present even if medical examinations do not reveal any conditions of concern. The severity of this condition can fluctuate over time and is a long-term condition1. It is worth noting that Illness Anxiety Disorder is a common condition, which may affect up to 10% of the general adult population2.

Hypochondria

Hypochondria, or hypochondriasis, was previously utilized in earlier editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent edition, DSM-5, no longer utilizes this term and those who previously were diagnosed with hypochondria may not be diagnosed with Illness Anxiety Disorder or Somatic Symptom Disorder1.

Illness Anxiety vs. Somatic Symptom

Illness Anxiety Disorder is specifically utilized to diagnose individuals whose focus of the fear and the worry is related to unusual physical sensations, which they then relate to an indication of something more serious or even life-threatening occuring. Somatic Symptom Disorder, while related, involves focus on the disabling of physical symptoms, typically pain, dizziness, nausea, with the absence of concern that these symptoms relate to a more serious illness1.

Supporting Loved Ones with Illness Anxiety Disorder

While individuals who are experiencing this condition may not show significant symptoms related to their suspected illness, it is necessary to note that they are not faking it, but rather their beliefs related to their illness are incredibly real to them. There are a number of things to consider when supporting a loved one with Illness Anxiety Disorder:

  • Listen & Talk: Be available to your loved one in order to provide a safe space for them to discuss their fears and concerns with you. Keep in mind you do not always have the answers and you are not expected to give them solutions.
  • Set Boundaries: Think of what you can and cannot do in order to support your loved one, while also keeping your own mental well-being in check. This may involve things like limiting conversations regarding their health anxiety, setting specific times during the day that are set for discussing this anxiety and/or checking symptoms of concern. Remember that it is absolutely fine to have these boundaries and ensure you communicate it with the individual.
  • Accept their Thoughts & Emotions: Instead of making them feel uncomfortable or unintelligent for their concerns, validate that their fears are real for them, regardless of how it may look from an outside perspective.
  • Support them to Stay Engaged in Activities: Anxiety can often be all-consuming when we let it, so encourage your loved one to stay distracted. This may involve day-to-day tasks, such as going to work, cleaning the house, etc. This also may involve things that bring the person joy, such as spending time with their children, participating in a hobby, or spending time with friends. While individuals sometimes feel that their anxiety is too encompassing to do these things, in reality once they start concentrating on other things, this assists in alleviating the anxiety.
  • Seek Support when Needed: Make sure that you are caring for yourself, as you will not be able to fully support someone else, if you are not mentally well yourself. If you need additional support, do not be afraid to seek out a therapist for yourself, or even kindly suggest this option to the loved one in need3.

Symptoms of Illness Anxiety Disorder

Illness Anxiety Disorder is characterized by the following criteria:

  • Preoccupation with having or acquiring a serious medical illness, which has been present for a minimum of six months.
  • Intense anxiety regarding having a serious, undiagnosed medical condition. This can involve spending excessive amounts of time and energy focusing on these health concerns and researching these conditions obsessively.
  • Physical symptoms that are mild or absent entirely.
  • Inability to take reassurance when given evidence that these medical conditions are not present.
  • Disruption in daily life and great deal of mental distress, attributed to worries regarding physical health4.

Causes of Illness Anxiety

While the specific cause of this anxiety may differ from one person to the next, the following factors may play a role:

  • Belief Systems: Sensations in the body that may be uncomfortable or unusual to an individual can lead to misinterpretations that any such sensation is negative and serious, leading to research to confirm these fears. This can be incredibly distressing, as online research can lead to incorrect self-diagnosing.
  • Support System: If you had parents who often worried about their own health or your health, this can lead to a higher chance of your personal distress with health anxiety.
  • Past Experiences: If you had serious illness during childhood or at an earlier time in your life, these physical sensations may be frightening to deal with1.

Persisting Fear Regardless of Reassurance

Some individuals find they are unwilling to go to see their medical provider, regardless of health anxiety, due to fear that they will discover there is something truly wrong with their health. However, more often, individuals with Illness Anxiety Disorder find themselves seeking reassurance from their providers, repeated appointments with little or nothing found to be treated, and requesting specific and repetitive medical tests. Occasionally, reassurance from the practitioner can assist for a short period of time in alleviating anxiety. However, the cycle typically resumes soon after, due to new ideas and sensations. A major concern with regard to this diagnosis is repeated Google searches and self-diagnosing, which typically only perpetuates the anxiety5.

Importance of CBT in Finding Relief

Due to the potential for a true medical condition, it is always best to rule out a medical condition through a physical exam. However, once a health assessment reveals nothing of concern, CBT is found to be the most effective treatment for any form of anxiety. CBT helps us to focus on behaviors, personal actions, and the way we think. This allows us to evaluate our thoughts and the power we are placing on them. It also gives you the opportunity to overcome irrational thoughts, as well as changing unproductive behaviors5.

Finding Ways to Cope

  • Become an Expert at Illness Anxiety Disorder: As someone with Illness Anxiety, you likely spend long-periods of time searching for answers regarding the symptoms you are experiencing. Instead of spending time searching for answers on this, search for information regarding Illness Anxiety Disorder. This allows you to understand what you are dealing with more comfortably and may assist in alleviating some of the anxiety experienced.
  • Find What Works for You: No matter what you are dealing with, people are going to have their two cents to contribute regarding their own experiences and what did or did not help for them. While some people may need to avoid their sensations in order to deal with the anxiety, others may need to limit their ability to check their symptoms at certain times of day only. Finding what does and does not work for you will help to find a better balance in daily life.
  • Stop Self-Blaming: Rather than feeling angry with yourself for the state of your mental health, recognize that many factors led to this mental state. It is okay to acknowledge that you have dealt with things beyond your control that contributed to your present mental health, while also working towards a better mental state going forward.
  • Find Support of Your Own: Sometimes we are unable to find relief on our own. Therefore, finding a therapist to provide support and assist in the treatment process can help to deal with Illness Anxiety symptoms6.

Finding Help

If you are dealing with anxiety related to health concerns, our therapists through Online-Therapy.com provide Cognitive Behavioral Therapy (CBT) and can assist in overcoming symptoms of concern.

Our platform offers a complete online therapy toolbox which includes time with a personal therapist who can support you throughout your journey. If this is something you have interest in, we would love to hear from you.

References

Anxiety & Depression Association of America. Health Anxiety: What it is and How to Beat it. (https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/health-anxiety-what-it-and-how-beat-it). Accessed on 08/08/22.

Happiful. 5 Ways to Support a Loved One with Health Anxiety. (https://happiful.com/how-to-support-a-loved-one-with-health-anxiety/). Accessed 08/07/22.

Mayo Clinic. Illness Anxiety Disorder. (https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782). Accessed on 08/02/22.

National Alliance on Mental Illness. How I Cope with Health Anxiety. (https://nami.org/Blogs/NAMI-Blog/January-2019-How-I-Cope-with-Health-Anxiety). 

National Library of Medicine. Illness Anxiety Disorder. (https://www.ncbi.nlm.nih.gov/books/NBK554399/). Accessed on 08/04/22.

Very Well Health. What is Illness Anxiety Disorder? (https://www.verywellhealth.com/hypochondriac-5095939). Accessed on 08/03/22.