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Health Anxiety (Hypochondria)

• Causes
• Diagnosis
• Treatment
• Outlook

What is health anxiety?

Health anxiety is an obsessive and irrational worry about having a serious medical condition. It’s also called illness anxiety, and was formerly called hypochondria. This condition is marked by a person’s imagination of physical symptoms of illness.

Or in other cases, it’s a person’s misinterpretation of minor or normal body sensations as serious disease symptoms despite reassurance by medical professionals that they don’t have an illness.

What’s the difference between concern for your health and health anxiety?

If your body is sending you signs that you’re ill, it’s normal to be concerned. Health anxiety is marked by constant belief that you have a symptom or symptoms of a severe illness. You may become so consumed by worry that the distress becomes disabling.

If you’re concerned about your health, the rational thing to do is see your doctor. With health anxiety, you’ll feel extreme distress about your real or imagined symptoms even after medical test results come back negative and doctors reassure you that you’re healthy.

This condition goes beyond having a normal concern for one’s health. It has the potential to interfere with a person’s quality of life, including their abilities to:

• work in a professional or academic setting
• function on a daily basis
• create and maintain meaningful relationships

What causes people to develop health anxiety?

Experts aren’t sure of the exact causes of health anxiety, but they think the following factors may be involved:

• You have a poor understanding of body sensations, diseases, or both of these things. You may think that a serious disease is causing your body’s sensations. This leads you to look for evidence that confirms that you actually have a serious disease.
• You have a family member or members who worried excessively about their health or your health.
• You’ve had past experiences dealing with real serious illness in childhood. So as an adult, the physical sensations you experience are frightening to you.

Health anxiety most often occurs in early or middle adulthood and can worsen with age. For older people, health anxiety may focus on a fear of developing memory problems. Other risk factors for health anxiety include:

• a stressful event or situation
• the possibility of a serious illness that turns out to not be serious
• being abused as a child
• having had a serious childhood illness or a parent with a serious illness
• having a worrying personality
• excessively checking your health on the internet

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How is health anxiety diagnosed?

Health anxiety is no longer included in the American Psychological Association Diagnostic and Statistical Manual of Mental Disorders. It was previously called hypochondriasis (better known as hypochondria).

Now, people who had been diagnosed with hypochondria might instead be classified as having:

• illness anxiety disorder, if the person has no physical symptoms or only mild symptoms
• somatic symptom disorder, particularly when the person has symptoms that are perceived as distressing to them or if they have multiple symptoms

To arrive at a health anxiety disorder diagnosis, your doctor will perform a physical exam to rule out any health conditions you’re concerned about. If you’re healthy, your doctor may refer you to a mental healthcare professional. They will likely proceed by:

• performing a psychological evaluation, which involves questions about your symptoms, stressful situations, family history, worries, and issues affecting your life
• asking you to complete a psychological self-assessment or questionnaire
• ask about your use of drugs, alcohol, or other substances

According to the American Psychiatric Association, illness anxiety disorder is marked by:

• preoccupation with having or coming down with a serious illness
• not having physical symptoms, or having symptoms that are very mild
• excessive preoccupation about an existing medical condition or a family history about a medical condition
• performing unreasonable health-related behaviors, which may include:
  • screening your body for disease over and over
  • checking what you think are disease symptoms online
  • avoiding doctor’s appointments to avoid diagnosis with a serious illness
  • preoccupation with having an illness for at least six months (The illness you’re worried about might change during that period.

How is health anxiety treated?

Treatment for health anxiety focuses on improving your symptoms and ability to function in daily life. Typically, treatment involves psychotherapy, with medications sometimes added.

Psychotherapy

The most common treatment for health anxiety is psychotherapy, particularly cognitive behavioral therapy (CBT). CBT can be very effective in treating health anxiety because it teaches you skills that can help you manage your disorder. You can participate in CBT individually or in a group. Some of the benefits of CBT include:

• identifying your health anxiety worries and beliefs
• learning other ways to look at your body sensations by changing unhelpful thoughts
• raising your awareness of how your worries affect you and your behavior
• responding to your body sensations and symptoms differently
• learning to better cope with your anxiety and stress
• learning to stop avoiding situations and activities because of physical sensations
• avoiding examining your body for signs of illness and repeatedly looking for reassurance that you’re healthy
• boosting your functioning at home, work, or school, in social settings, and in relationships with others
• checking whether or not you’re suffering from other mental health disorders, like depression or bipolar disorder

Other forms of psychotherapy are also sometimes used to treat health anxiety. This may include behavioral stress management and exposure therapy. If your symptoms are severe, your doctor may recommend medication in addition to your other treatments.

Medication

If your health anxiety is improving with psychotherapy alone, that is generally all that will be used to treat your condition. Some people don’t respond to psychotherapy, however. If this applies to you, your doctor may recommend medications.

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are frequently used for this condition. If you have a mood or anxiety disorder in addition to your anxiety, medications used to treat those conditions may also help.

Some medications for health anxiety come with serious risks and side effects. It’s important to review your treatment options with your doctors thoroughly.

What is the outlook for health anxiety?

Health anxiety is a long-term medical condition that can vary in severity over time. In many people, it seems to worsen with age or during times of stress. However, if you seek help and stick to your treatment plan, it’s possible to reduce your health anxiety symptoms so you can improve your daily functioning and decrease your worries.

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