Illness Anxiety Disorder (Health Anxiety)

Help for anxiety, fears, and obsessions about having a medical condition.

Illness anxiety disorder, also called health anxiety or hypochondriasis, is a condition where the patient suffers from intense fears of having a serious medical condition. The disorder includes persistent, worrisome thoughts regarding physiological health despite appropriate medical assessment and reassurance. People with illness anxiety disorder tend to misinterpret normal bodily discomforts. for example, someone suffering from illness anxiety disorder might ascribe a stomach ache to stomach cancer, or fatigue to Lyme Disease. After onset, it is common for patients to accrue significant medical expenses as they seek ongoing comfort from health professionals.

Did you know that medically unexplained physical symptoms make up 15-30% of PCP appointments?

The disorder was once thought to be resistant to therapy, but thankfully, today we know it is a treatable condition with striking similarities to obsessive-compulsive disorder (OCD). The main difference is that in illness anxiety disorder, the health preoccupations are usually focused on having a disease, whereas in OCD, the thoughts usually focused on fears of getting a disease in the future. Nonetheless, the distressing thoughts, repetitive behaviors, persistent worries, and dysfunctional beliefs that define Illness Anxiety Disorder closely parallel the behaviors and cognitions found in OCD patients. This has led some researchers to assert that they are actually the same condition.

Illness anxiety disorder can develop following a period of major stress, illness, or even after the death of a loved one. in the case of a death due to a health condition, such as cancer, some patients develop near-obsessive thoughts regarding medical conditions similar to the loved one who passed away. Similarly, illness anxiety disorder may develop following exposure to news regarding a disease such like the Ebola media coverage in late 2014. Other ways illness anxiety disorder may develop is through positive behavioral reinforcement for being sick (i.e., increased attention or sympathy from loved ones). Although much more research is needed in this area, empirical evidence suggests biology may also be a risk factor in the onset of illness anxiety. Among those with illness anxiety disorder, 78 percent also have another diagnosable anxiety-related disorder and/or major depression.

Illness anxiety disorder symptoms fall along a spectrum of mild to severe symptoms, and those with the most severe symptoms may be completely debilitated. Illness anxiety can result in impaired social and occupational functioning as individuals find themselves preoccupied with worrisome thoughts and missing work for unnecessary medical visits.

Assessment for illness anxiety disorder begins with ruling out actual medical conditions and other mental health disorders. Another ailment that is similar to illness anxiety disorder is somatic symptom disorder, which also includes misinterpretation of bodily sensations. However, those with somatic symptom disorder are unlikely to consider a psychological cause for their distress.

Following diagnosis of illness anxiety disorder, treatment typically includes psychoeducation to help the patient learn about the disorder, introduction of effective coping strategies, new ways of thinking, stress management, and gradual exposure to their fears. Research indicates Exposure and Response Prevention Therapy (Ex/RP) can be used for treating illness anxiety disorder, and is similar to its effectiveness in treating OCD. Research regarding medication for illness anxiety disorder suggests it may serve as a helpful supplement to therapy.