Hypochondria or Hypochondriasis: What Is Illness Anxiety Disorder?

Illness anxiety disorder (IAD) is formerly known as hypochondria or hypochondriasis. Some call this condition “health anxiety,” and it’s a chronic mental illness.

With IAD, you have a persistent and unrealistic fear of having a life-threatening sickness despite having few or no symptoms at all. You assume that you’re at high risk of developing a serious illness because you consider normal body sensations a sign of disease. This feeling continues even after medical test results show that you’re free of any sort of condition.

IAD is a long-term mental health issue that may become severe over time. The disorder could worsen if you’re aging or always stressed out. Though your fears seem unrealistic to some, they’re very real to you. That’s why you’re constantly overly concerned about your health. Your worries may eventually interfere with your personal, social, and work life.

Health anxiety is particularly rare—nearly 0.1% of Americans are affected by it. However, anyone regardless of age or gender can have it, so it’s still a good idea to learn more about the condition.

Hypochondriasis

The term “hypochondriasis” was removed by the American Psychiatric Association (APA) from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because of the stigma attached to it. Hypochondriacs have been wrongly assumed to be faking their condition. Other harmful misconceptions have arisen due to societal stigma, too.

Types of Illness Anxiety Disorder

There are two categories of illness anxiety disorder. Here are the characteristics of a person with either type:

Care-Seeking

They spend most of their time in health care facilities such as health centers or hospitals. There, they seek advice and medical care from different health specialists. The individual may repeatedly ask those medical professionals to give them referrals for medical tests they can undergo. They might also jump from one doctor to another hoping to get a diagnosis coinciding with their supposed symptoms.

Care-Avoidant

This person avoids being in any health care setting. They steer clear of medical practitioners and don’t trust doctors to the point of refusing to receive medical care from them. Because of this, they can become more fearful.

They avoid discussing their health condition even with family members since they’re afraid of being ridiculed or, worse, dismissed. They’re also anxious about their perceived illness. This anxiousness increases once their suspected condition is confirmed by a doctor.

Causes of Illness Anxiety Disorder

The causes of health anxiety are still unknown. However, the following are some possible reasons you could develop it:

• Childhood trauma, child abuse, or neglect during childhood
• Tremendous stress
• Other anxiety disorders in the family
• Struggling to tolerate uncertainties and discomfort brought by ordinary biological processes
• Experiencing serious illness in the family during childhood
• Existing anxiety, depression, or other mental health issues
• Trauma such as rape or psychological or emotional abuse

Risk Factors of Illness Anxiety Disorder

The condition typically starts in early or middle adulthood. It’s possible for it to get worse as you get older, during which some individuals may start worrying about losing their memory. The risk factors for health anxiety include:

• Experiencing a major life stress
• The threat of possibly having a serious sickness (which turns out to be mild)
• Having severe childhood illness or growing up with a seriously ill parent
• The tendency to worry a lot
• Excessive exposure to medical information on the internet

Illness Anxiety Disorder Symptoms

The main symptom of a person with health anxiety is the persistent fear of developing a critical illness. If you have IAD, you have unrealistic health and medical fears.

You may worry about different medical conditions from time to time. The common ones that people with the disorder worry about are cancer, HIV/AIDS, and memory loss. Of course, it’s possible for them to be diagnosed with a disease. However, they feel that their condition is a lot worse than it really is.

You may be preoccupied with the idea that you’re seriously ill due to small issues such as an upset stomach or a minor rash. Some of the symptoms of illness anxiety disorder are:

• Avoidance of people and certain places for fear of catching an illness
• Frequently researching about diseases and symptoms
• Exaggeration of the severity of symptoms (a cough would be taken to possibly indicate lung cancer)
• Being highly anxious about personal health
• Having an obsession or feeling uneasy with ordinary bodily functions like heart rate and sweating
• Excessively sharing your worries and health status with others
• Repeatedly checking for physical symptoms such as taking their body temperature and monitoring their blood pressure
• Constantly getting the same type of medical tests
• Always seeking reassurance about their health condition and symptoms from loved ones
• Not being at ease when given evidence—for example, test results—that they don’t have a serious medical condition

IAD vs. Somatic Symptom Disorder

Individuals who may have either illness anxiety disorder or somatic symptom disorder (SSD) are obsessed about their health. They may be persistently worried about and fearful of having a disease.

However, IAD is different from SSD. Unlike someone with health anxiety, a person who has somatic symptom disorder may have true physical symptoms of a disease. These could include pain or dizziness. Despite that, medical tests are unable to identify the cause of those symptoms.

Diagnosis of Illness Anxiety Disorder

People with IAD may not be aware that they have it. Usually, they would visit a health care provider for diagnosis and treatment of the disease they think they have and not health anxiety.

In diagnosing the disorder, many health care professionals refer to the criteria set by DSM-5. Your doctor needs to do the following to determine your condition:

• Review all your medical records, both current and previous.
• Find out if you’ve had mental health disorders before by looking into your medical history.
• Give you a physical examination.
• Let you take different tests including blood tests and imaging tests such as MRI and CT scans.
• Consider that you may have another mental health condition that needs to be addressed promptly.

The initial diagnosis can be done by your primary health care provider. They may also refer you to a behavioral health care practitioner like a psychologist or psychiatrist if they suspect you have the condition. You may be diagnosed with illness anxiety disorder if you experience health anxiety for six months or longer despite getting negative medical test results.

Complications of Illness Anxiety Disorder

Constantly being fearful and worried can trigger stress. In turn, stress may affect your physical and mental well-being.

If you’re suffering from illness anxiety disorder, you might be afraid of being around other people, even your loved ones. Because of this, you may miss out on social gatherings. Without adequate support, you could become extremely stressed out and even entertain suicidal thoughts.

When health anxiety is left untreated, you’re likely to have:

• Family problems as relatives could get frustrated due to your excessive worrying
• Financial problems because of missed work and medical bills
• Unemployment or school absences
• Test complications and a constant desire to undergo unnecessary medical tests
• Another mental health disorder like somatic symptom disorder, depression, or personality disorder

What Is Illness Anxiety Disorder: Patients’ Prognosis

This mental health disorder is both an ongoing and chronic condition. At one point, you may have little or no health anxiety. But sooner or later, you might find yourself feeling highly anxious about your health again.

Illness Anxiety Disorder and Other Mental Disorders

IAD may develop together with other mental health conditions such as:

• Depression
• Anxiety disorders (e.g., generalized anxiety disorder)
• Obsessive-compulsive disorder (OCD)

Management and Treatment

Health care providers who can help manage your condition are your primary doctor and a mental health professional, specifically a psychologist or psychiatrist. The goals in the management and treatment of IAD include:

• Return to normal function and be able to maintain normalcy as much as possible
• Alleviate mental suffering
• End or prevent the overuse of medical facilities and resources due to frequent requests for medical referrals and testing

A professional mental health provider can offer the following services:

• Set up a doctor’s hub for individuals with illness anxiety disorder. Through this hub, they’ll be able to offer patients consistent and regular care, preventing them from “doctor shopping.”
• Be a gatekeeper, which means they’ll verify which referrals and medical tests are necessary. This can help reduce the unnecessary medical care given to patients with IAD.
• Connect the patient with mental health resources as part of their treatment plan
• Offer regular checkups for each patient. This way, they can discuss symptoms and relieve some of the person’s anxiety.

The treatment of health anxiety focuses on improving your quality of life and minimizing the symptoms you’re experiencing. It may include:

Cognitive Behavioral Therapy (CBT)

CBT is psychotherapy meant to help people learn how to handle their fears and anxieties. The patient receives guidance in identifying negative and destructive thoughts and behaviors. The therapist then integrates techniques on how to transform those ideas and actions into healthier and more productive ones.

For patients with IAD, CBT can aid in the reduction of maladaptive behaviors like body checking and doctor seeking. With the proper stress management methods, the patient could learn to focus and target their anxiety rather than repelling it. CBT is also beneficial to patients dealing with other mental health issues alongside illness anxiety disorder.

Medication

Mental health professionals prescribe medication such as antidepressants to make you less anxious and depressed. The two common types of medicine in treating health anxiety are:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

The side effects of taking medication can range from non-existent to mild to severe. Here are some possible side effects of taking SSRIs:

• Nausea
• Vomiting
• Weight gain
• Diarrhea
• Dry mouth
• Headache
• Sleepiness or sleep difficulties
• Sexual side effects
• Restlessness

Remember that you should avoid abruptly stopping or changing your medication because this can lead to mental withdrawal symptoms. If the side effects are causing you daily inconveniences, inform your health care provider as soon as possible so adjustments in your prescription can be made.

Coping Strategies

Aside from getting therapy and taking medication, carrying out certain coping strategies may help ease your symptoms. Here are some of the methods you can try every day:

• Keep a journal or diary where you can track your symptoms related to illness anxiety disorder.
• Do breathing exercises in order to relax.
• Focus on your hobbies instead of researching your medical condition online.
• Spend time outdoors, eat nutritious meals, exercise, and get enough sleep.
• Avoid alcoholic drinks, smoking, and recreational drugs.
• Join a support group.

Prevention

There’s no surefire way to prevent health anxiety. However, support and understanding from others may help someone with the disorder. Being surrounded by empathetic individuals could give the person more strength to cope with their condition and seek professional treatment as well.

Here are a few suggestions on how to keep illness anxiety disorder in check:

• Seek professional health care advice. You can minimize your symptoms or stop them from getting worse by visiting a mental health expert right away. Don’t wait any longer nor take the risk of reducing your quality of life.
• Learn how to recognize stress. Turn to coping strategies and relaxation techniques whenever needed. Practice them regularly for stress management purposes.
• Follow your treatment plan. Make sure to stick to your doctor’s instructions to avoid relapses and exacerbation of symptoms.

How Can You Live With Illness Anxiety Disorder?

If you think you have the symptoms of health anxiety, it’s best to visit your health care provider. Let them know whether you’re feeling depressed or anxious or experiencing mood changes.

During your doctor’s appointment, you can ask the following questions to better understand your condition:

• Why do you have illness anxiety disorder?
• How can you best manage health anxiety?
• What are the signs or complications?

Final Thoughts

It’s only right for everyone to pay attention to their health and look after their well-being. After all, you’re bound to face more problems if you get sick often or end up with a chronic condition.

Even so, you can go overboard when it comes to being concerned about your health. That’s what characterizes individuals with IAD, which can be challenging to handle.

If you think you have symptoms of illness anxiety disorder, don’t hesitate to contact a health care professional such as one of our experts at Counseling Now. We can diagnose and help address health anxiety through our online services. With our team, you’ll receive quality mental health care right at home.

Counseling Now uses various techniques to guide individuals in managing IAD. Allow us to help reduce your health-related worries. Book an appointment with our professional therapists today.