Hypochondriasis/Health Anxiety

Resource and assistance for people with anxiety and fears about having a medical condition

Illness anxiety disorder or health anxiety is most commonly known as hypochondriasis; that name was later changed because of its derogatory connotation. A person suffering from this disorder has a persistent, intense fear of having a medical condition despite normal medical assessments. Typical body discomforts are often misattributed to a more severe disease, like when one experience a headache and associate it to a brain tumor or malignant cancer. One of the perils of having health anxiety is spending too much on hospital visits and medical tests to make sure one is free from serious medical conditions.

Physical symptoms without medical explanations make up 15-30% of PCP appointments.

Hypochondriasis used to be extremely difficult to treat. But in the modern world, therapists and researchers have already found ways to treat health anxiety symptoms, more so because of its similarities to obsessive-compulsive disorder. In contrast, contamination OCD patients fear getting a disease in the future while the fears of health anxiety patients are focused on currently having a disease that they are not aware of. Many research studies suggest that Illness Anxiety Disorder should be part of the OCD spectrum disorder because the persistent fears, repetitive behaviors, and unreasonable beliefs suffered by patients are also part of OCD. However, it remains as a type of somatic disorder until now.

Healthy anxiety can arise from a momentary stressful situation or a major difficulty. It could be due to an illness, death of a loved-one, a significant person with a grave disease such as cancer. The patient may develop obsessive thoughts about the medical condition of the person close to him. Being exposed to a headline about a disease outbreak, like the Zika virus and Ebola media coverage in 2014 can likewise trigger patients to develop obsessive thoughts. Another situation that could induce illness anxiety disorder is positive reinforcement for being sick. Someone who wants to get sympathy and attention from their loved-ones may develop imagined physical symptoms. Biology may also play a role in advancing illness anxiety disorder – 78% of patients with IAD also have other anxiety-related disorder or depression.

The symptoms of IAD can be mild to severe; those with severe symptoms may be totally debilitated. IAD impairs the social and occupational functioning of an individual as they find themselves lost in obsessive thoughts and skipping work for unnecessary medical assessment.

Illness Anxiety Disorder must be ruled out from actual medical conditions and other mental disorders. IAD is somewhat similar to Somatic Symptom Disorder (SSD). A person with SSD also misinterprets bodily discomforts, but in contrast with IAD, SSD patients do feel physical symptoms.

Once Illness Anxiety Disorder is diagnosed, psychoeducation can be started to help individuals to be aware of their condition, learn effective coping strategies, management of stress, and gradually exposing them to their fears. Exposure and Response Prevention Therapy (Ex/RP) is very helpful, not just in OCD, but in treating illness anxiety disorder as well. Certain medications may also help augment exposure therapy.