Truth & Character Thursdays

“After obsessively Googling symptoms for four hours, I discovered 'obsessively Googling symptoms' is a symptom of hypochondria.” ― Stephen Colbert

Overview

What is illness anxiety disorder?

People with illness anxiety disorder, sometimes known as hypochondria or hypochondriasis, fear that they have a serious medical condition or that they’re at high risk of becoming ill. They may also misinterpret typical body functions as signs of illness.

To medical professionals, these fears might look unjustified or unrealistic because there’s no supporting evidence that the provider can find. But for people with illness anxiety disorder, their fears are very real to them. It’s not something they can control.

Even after medical tests show no problems, people with hypochondriasis have trouble focusing on anything other than worrying about being very sick. Their persistent health worries can interfere with their relationships, careers and lives. You may be more familiar with the term hypochondria or health anxiety. Healthcare providers now use the term illness anxiety disorder.

Some people with illness anxiety disorder may actually have a diagnosed physical illness. But because of illness anxiety disorder, you may feel your condition is more severe than it is.

What are the types of illness anxiety disorder?

Someone with illness anxiety disorder generally fits into one of these categories:

• Care-seeking: You spend a lot of time in a healthcare setting. You seek advice from multiple specialists and request medical tests.
• Care-avoidant: You avoid healthcare providers and medical care. You might not trust doctors or you think they don’t take your symptoms seriously. This can create more fear and anxiety.

How common is illness anxiety disorder?

Illness anxiety disorder (hypochondria) is extremely rare. It affects about 0.1% of people in the U.S. It typically appears during early adulthood.

Symptoms and Causes

If you have illness anxiety disorder (hypochondria), you have an ongoing but unrealistic fear about being seriously ill.

What are the symptoms of illness anxiety disorder?

If you have illness anxiety disorder, you have an ongoing but unrealistic fear about being seriously ill. The specific illness(es) that you worry about often changes.

Symptoms of hypochondria include:

• Avoiding people or places due to worry about catching an illness.
• Constantly researching diseases and symptoms.
• Exaggerating symptoms and their severity (for instance, a cough becomes a sign of lung cancer).
• High level of anxiety about personal health.
• Obsession with usual body functions, like your heart rate.
• Oversharing your symptoms and health status with others.
• Repeatedly checking for signs of illness, like taking your blood pressure or temperature.
• Seeking reassurance from loved ones about your symptoms or health.
• Uneasiness with healthy body functions, like gas or sweating.

What causes hypochondria?

Healthcare experts don’t know why some people develop illness anxiety disorder. You may be more prone to illness anxiety disorder if you have a family history of:

• Childhood illness or serious illness in your family during childhood.
• Childhood trauma, like child abuse or neglect.
• Extreme stress.
• Health anxieties or other anxiety disorders in your family.
• Mental health issues like anxiety or depression.
• Trauma, like rape or physical or emotional abuse.

What are the complications of illness anxiety disorder (hypochondria)?

Constant fear and worry can cause stress that impacts your physical and mental well-being. Illness anxiety disorder can disrupt your relationships and life. You may miss out on time with loved ones because you’re concerned about your health. Illness anxiety disorder also puts you at risk for:

• Financial struggles due to medical bills and missed work.
• Medical disability and unemployment.
• Unnecessary medical tests and potential test complications.

Some people feel severely depressed and may even think or act on thoughts of self-harm or suicide. If you have any thoughts about hurting yourself, call or text the Suicide & Crisis Lifeline at 988.

Diagnosis and Tests

What are the criteria for illness anxiety disorder?

To diagnose illness anxiety disorder, healthcare providers refer to the criteria listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (often known simply as the DSM-5. Your provider may make a diagnosis or they may refer you to a behavioral health specialist, like a psychologist or psychiatrist. The six criteria for illness anxiety disorder include:

1. Frequent or constant worrying about being or becoming sick.
2. Having no symptoms or only mild ones. If you do have a medical condition and experience illness anxiety disorder related to it, the worries you experience may seem disproportionate or excessive to others.
3. You feel a high level of anxiety and are easily alarmed when it comes to your health.
4. You frequently do things to check or assess your health like checking for signs and symptoms of illness, or you frequently avoid medical appointments, hospitals, etc.
5. You’ve had these feelings of severe, health-related worry for at least six months. The feelings don’t have to be consistently about just one illness during that time.
6. There isn’t a better condition to explain your symptoms and what you’re experiencing.

A persistent fear about having a serious illness or developing one is the top symptoms of illness anxiety disorder. Your provider may diagnose illness anxiety disorder if you have health anxiety (or other illness anxiety disorder symptoms) for six months or longer even after tests show that you’re not sick.

Management and Treatment

What are the best treatments for illness anxiety disorder?

Your healthcare provider may partner with a mental health professional, like a psychologist or psychiatrist, to help you treat hypochondria. But you’ll also continue to receive regular care from your provider.

Treatment goals focus on improving quality of life by minimizing symptoms. Illness anxiety disorder treatment includes:

• Drugs like antidepressants or antianxiety medications.
• Mental health therapy, such as psychotherapy or cognitive behavioral therapy (CBT) to talk through your fears and anxieties and learn healthy ways to cope.

Outlook / Prognosis

What is the prognosis (outlook) for people who have illness anxiety disorder (hypochondriasis)?

Illness anxiety disorder is a chronic (ongoing) condition. You may go through periods where you have little or no health anxiety — and then it returns. You can take steps to keep illness anxiety disorder symptoms in check.

Prevention

Can illness anxiety disorder be prevented?

Unfortunately, there’s no known prevention against illness anxiety disorder. But getting support from medical and mental health professionals and loved ones (family, friends, etc.) may help reduce the severity of your symptoms and help you cope with the disorder.

Living With

When should I call my healthcare provider?

You might consider seeing a provider if you or others notice signs of illness anxiety disorder. You should call your healthcare provider if you experience depression, anxiety or other mood changes.

If you’re experiencing suicidal thoughts, call or text the Suicide and Crisis Lifeline at 988. This national network of local crisis centers provides 24/7 free, confidential support to people who are feeling emotional distress or having thoughts of self-harm or suicide.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider:

• What are the best ways to manage illness anxiety disorder?
• Should I look out for signs of complications?
• How do I tell the difference between fears that illness anxiety disorder amplifies and fears that are justified and mean I need to get medical care?

Additional Common Questions

What’s the difference between illness anxiety disorder and somatic symptom disorder?

Someone with somatic symptom disorder may obsess and worry about their health — just like someone with illness anxiety disorder. A person with somatic symptom disorder has true physical symptoms. But those symptoms could be normal sensations from how your body works, or medical tests may not be able to pinpoint a cause for the physical symptoms.

A note from Cleveland Clinic

Everyone worries about their health from time to time. But if health anxiety affects your ability to enjoy life, you should talk honestly with your healthcare provider. Your provider can diagnose and treat illness anxiety disorder. Living with illness anxiety disorder can be challenging, but you can learn coping skills to help you enjoy good health again.

Care at Cleveland Clinic

Anxiety disorders can affect your life in many ways. Cleveland Clinic mental health experts can help you manage anxiety so you’re back in control.

Human Nature

Do you ever find yourself self-diagnosing, and what strategies do you use to avoid falling down the rabbit hole of medical anxiety?