Health Anxiety: Signs of Hypochondria

The word “hypochondriac” is an outdated term for someone who thinks that their physical symptoms indicate a serious health condition even though there may not be any medical proof.



Hypochondria is now known as either “illness anxiety disorder” (IAD) or “somatic symptom disorder,” depending on an individual’s symptoms. This form of health anxiety affects up to 13% of people, occurring in men and women equally.

Although IAD can feel distressing, you can seek help and learn some skills to manage your condition. In this article, learn about treatment options and how IAD might manifest.

The symptoms of IAD tend to revolve around a fixation on normal bodily functions or mild symptoms. If you have IAD, you might experience the following:

• frequent worry about having or developing a serious illness despite not having any physical symptoms
• constantly paying attention to what is happening in your body, such as pain, sweating, or tingling
• wanting reassurance from others that you are not sick
• concern that your healthcare professional missed something 
• a constant need to check the internet for health information
• repeatedly checking for lumps on your body or taking your blood pressure, temperature, or pulse
• avoiding going to the doctor or other places where you may get sick

The cause of IAD can vary from person to person. How you think about your symptoms may make you more likely to have IAD. This means that the more you focus on symptoms and worry about what might be happening to you, the harder it can be to break that cycle of symptoms and the ensuing anxiety.

Some factors that increase your likelihood of having IAD include:

• Family history: If you have a family member who spends a lot of time worrying about their health, you may be more likely to have IAD.
• Age: A sense of worry about your health and about developing IAD tends to happen more as you get older. 
• Past experiences: You might be more likely to have IAD if you or a family member had a serious childhood illness or trauma.
• Another mental health condition: If you have another mental health condition — such as an anxiety disorder, depression, or obsessive-compulsive disorder — you may have an increased chance of having IAD. 
• Beliefs about your body: Your bodily sensations or a current health condition might make you think that you have a more severe illness. Therefore, you may look for clues that verify that you have this illness. 

If you have IAD, you will typically see a primary care professional rather than a mental health professional because of your physical symptoms. Your doctor will perform a physical exam and order different tests, depending on what you report for symptoms. 

Your doctor may make a diagnosis of IAD if your tests and exams continue to come back as normal and you have repeatedly been reassured that you do not have anything physical to diagnose.

The concern with this is that if your tests and physical exams come back normal, it might be difficult for you to accept. This might result in you wanting to seek another doctor for a second or third opinion. You may not feel that you have a mental health condition.

It can be difficult to accept that you have IAD because the condition masks how you see your symptoms. Your primary care professional might refer you to a mental health professional so that you can undergo further assessment. 

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, to receive a diagnosis of IAD, you must meet a specific set of criteria, including:

• a preoccupation with having or getting a serious illness for at least 6 months
• an absence of somatic symptoms, which are physical symptoms that a doctor cannot explain
• excessively checking yourself for illness
• mental health symptoms not related to another mental health condition
• either frequently seeking medical care or avoiding it altogether

When it comes to treating IAD, therapy and medications used at the same time can be helpful. However, you may find that your condition is manageable with therapy alone. 

Cognitive behavioral therapy (CBT) can be particularly useful to help you manage your IAD. CBT can help you:

• identify your beliefs about illness and your anxiety
• learn how to respond to your symptoms in a healthier way
• teach yourself to reframe negative thoughts into ones that empower you 

If therapy alone is not working to help with your IAD, your healthcare professional may add medications.

Often, people can manage anxiety disorders using selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft). These medications are called antidepressants, but they can be prescribed to help manage the symptoms of IAD by increasing levels of serotonin in the brain. 

Serotonin-norepinephrine reuptake inhibitors (SNRI) are another type of antidepressant that might be helpful if SSRIs do not seem effective. Some examples are duloxetine (Cymbalta) and venlafaxine (Effexor).

You may need to try more than one medication to find one that is right for you. 

There are ways you can actively work to manage your IAD. Some ideas for coping include the following:

• Practice relaxation exercises, including deep breathing, when you are anxious.
• Build stress management skills into your daily life.
• Distract yourself from thoughts of illness and urges to check your body by leaving the house or reading a book, for example.
• Keep a journal of your thoughts and symptoms and try to replace your anxieties with healthier thoughts or statements.
• Learn new hobbies to put your energy into.
• Work with a therapist who specializes in anxiety disorders or join a support group.

If you have IAD, it might be a good idea to limit the time you spend online researching health conditions and symptoms you may be experiencing. People who are more anxious about their health tend to search for health topics online more than others.

Stress can make your anxiety worse, so when your anxiety is higher, it may be helpful to avoid health research entirely. 

If you want to look up symptoms online, make sure you are getting your information from credible websites, such as the Centers for Disease Control and Prevention (CDC) or World Health Organization (WHO). 

It can be challenging to be there for someone with IAD. Seek information on IAD and tips on how you can best support the person. Organizations such as the National Alliance on Mental Illness can offer support to those who live with someone with a mental health condition such as IAD.