Health anxiety sometimes referred to as ‘hypochondriasis’ is a debilitating mental health condition.
Unfortunately, because of its nature, it can very often be challenging for medical professionals to accurately diagnose (in comparison to other mental health issues).
What is Health Anxiety
Illness anxiety disorder (or health anxiety) is a psychological disorder characterised by excessive preoccupation with one’s health.
Often categorised within the OCD (obsessive Compulsive Disorder) spectrum, health anxious people have an obsessive preoccupation with either being ill (or becoming ill).
The health preoccupation is often so debilitating that it can impact nearly every aspect of a person’s life.
The worries a typical health anxiety sufferer endures are centred around the possibility of them contracting a serious disease such as Cancer, AIDS, Meningitis and Heart Disease.
Essentially, dangerous and life-threatening diseases often feature at the top of the list for all health anxiety sufferers.
The physical symptoms experienced by health anxiety sufferers can be real or imagined. In cases where the symptoms are real, the persons’ misinterpretation of minor body sensations is often way out of scope despite reassurance from a medical professional.
Harmless physical symptoms often become a massive cause of concern for health phobics.
A skin rash can quickly escalate to meningitis, that lump on the arm is most definitely cancer and the stomach ache that’s been lingering all day could never be down to the dodgy takeaway from the night before. No. It must be a sign of a serious intestinal problem. Likely an incurable one.
Why people develop health anxiety
According to research, experts aren’t sure of the exact reason why people develop health anxiety.
However, contributory factors might include:
- Having a family member that was excessively concerned with their health (or yours)
- Going through a serious illness in childhood (or witnessing another person with an illness)
- Having a lack of understanding about diseases and illnesses, leading you to look for evidence by researching on the internet
- The death of someone close to you
Studies show that health anxiety usually develops in early adulthood and often worsens with age.
Other at-risk groups who have a likelihood of developing health anxiety include:
- Someone who was abused as a child
- Having a serious childhood illness
- Experiencing a stressful situation or event
- Possessing a worrying character
- Excessively checking out symptoms on the internet
Some experts believe that health anxiety is prevalent in those who have a natural propensity to worry. Genetic factors also play a role as does each individual’s life experiences.
Interestingly, according to psychologists, an intolerance to uncertainty can also put someone at significant risk of developing a health anxiety disorder, as health itself can often be unpredictable.
This lack of tolerance can often spell disaster as it can be very challenging for health anxiety sufferers to ‘sit with their symptoms’ without excessively worrying or having the compulsion to do something about it, such as constantly checking their body or researching their symptoms on the internet.
Health anxiety may be more common in women and occurs in up to 5% of patients visiting GP surgeries.
The difference between a health problem and health anxiety
Since many anxiety symptoms often replicate that of a serious illness, such as:
- Dizziness
- Fainting
- Palpitations
- Feelings of unreality
- Sweating and shaking
- Numbness in the body such as the hands and face
It’s important for people to discuss their concerns with a doctor.
Your doctor may ask you about any new, changing, persistent and recurrent symptoms. If after examining you, your doctor concludes that the problem is solely anxiety (rather than a physical illness) then it’s likely that they are correct.
Fortunately, most doctors are able to distinguish between anxiety-related symptoms and sensations since many of the symptoms associated with a disease are unlike those caused by anxiety alone.
It’s perfectly plausible to seek a second, or even third opinion if your symptoms persist and you are still worried.
Although you can be confident that if all three medical opinions are the same, then it’s likely that anxiety/stress is the cause of your symptoms and not a medical problem.
The health anxiety trap
There are several aspects experienced in health anxiety that can very quickly spiral into a vicious cycle.
This cycle often lasts a long time, especially if the sufferer is unaware of the thoughts and behaviours that can lead them to become trapped in health anxiety.
Five signs that someone might be suffering from health anxiety include:
Avoidant behaviour or overexposure
Since health anxiety sufferers are in a constant state of worry and preoccupation over their health, they have a tendency to either completely avoid or overly expose themselves to anything health-related (such as doctors, GP surgeries, health documentaries/articles, hospitals, sick people etc).
If someone is worried about having breast cancer, for example, they may avoid being naked and rush through daily routines such as bathing to avoid looking at that part of their body.
When someone is being avoidant, they might experience relief when they are fully clothed since the symptoms of breast cancer are not obvious this way.
However, for someone who is overly exposing themselves, they often feel compelled to constantly examine their breasts for any underlying symptoms. It’s also possible for someone to bounce between being avoidant and overly exposing.
This adds to the point that intolerance to uncertainty is prevalent for individuals experiencing health anxiety.
Reassurance seeking behaviours
Giving reassurance to a health anxiety sufferer is the equivalent of giving drugs to a drug addict.
The way that reassurance typically plays out in illness anxiety disorders is extremely short-term. The sufferer may experience immense relief when given the ‘all clear’ by a doctor. Still, moments, hours, or perhaps even days later, the worry starts to creep back in.
The ‘high’ that most health anxiety sufferers experience when given reassurance is similar to the addictive behavioural patterns found in substance misuse.
Unfortunately, the mania only lasts so long before the same thoughts of worry become invasive again. Hence, the cycle ensues:
Health worry + reassurance-seeking + given appropriate reassurance from a doctor or loved one = temporary relief and the health worry resurfacing.
When someone excessively seeks reassurance, they are raising the bar for future anxiety, as this behaviour feeds into the cycle of future worrying and the sense to seek out even more reassurance!
Health anxiety sufferers may go as far as justifying their reassurance-seeking behaviours with the following statements:
- Not all doctors are right. The diagnosis can be wrong.
- Even though my doctor gave me good news, he/she still looked worried. Perhaps they are keeping important information about my health from me.
- Maybe my results got mixed up with someone else’s.
- I received a call from an unknown number. I’ll just ring the doctor’s office to make sure it wasn’t them.
- I was seen by a junior doctor. The next time, I’ll choose a more senior doctor to take care of me.
Checking the body for signs of disease AKA’ self – diagnosis’.
Self-diagnosis is perhaps one of the biggest commonalities in health anxiety. The person will excessively check their body for:
- Lumps
- Bumps
- Inconspicuous rashes or discolouration of the skin
- Numbness of the limbs and other body parts
- Balding
- Inflammation of the gums
- Bleeding
- Swelling
In the time it takes to have a shower, a person experiencing health anxiety will have diagnosed themselves with a plethora of life-threatening diseases.
This excessive ‘symptom-checking’ also includes searching the internet and (often inaccurately) matching their symptoms to the most monstrous diseases out there.
Similar to how OCD works, examining oneself multiple times throughout the day – is a regular occurrence in health-anxiety disorders.
Feeling guilty when other people around you are sick
Feeling guilty for another’s health misfortune is associated with magical thinking. It is, of course, nobody’s fault when someone around us becomes poorly.
Although overwhelming feelings of guilt can manifest as overly compensating by going ‘above and beyond’ to help those who are unwell, fostering the blame for someone else’s illness often results in the compulsion to excessively take care of the sick.
The preoccupation of having or getting a disease
This is one of the more obvious signs that someone might be suffering from a health-related anxiety disorder. Key signs that someone might have a health preoccupation include:
- Constantly talking to friends and family about a particular disease and the symptoms
- Reading articles or watching shows related to the disease (or avoiding them completely)
- Becoming fascinated with a disease and constantly searching it up online or through other means
- Researching people who have had the disease and excessively checking yourself (and others) for symptoms
- Avoiding people and places to minimise your chances of getting ill
- Constantly worrying that you might have a serious disease
Treatment for health anxiety
There are several effective treatments for health anxiety:
- Psychotherapy
- Cognitive Behavioural Therapy (CBT)
- Medication (to help control the anxiety)
- Other therapies such as counselling
Things that health anxiety sufferers must do if they want to get better:
- Do not seek reassurance from doctors, family members or friends (this includes the internet)
- Reduce the amount of time spent checking the body for symptoms every day
- Do not avoid places or things such as doctor surgeries, hospitals and anything else health-related as this will only fuel the cycle of anxiety. The same goes for over-exposure too.
- Do not neglect self-care. Self-care includes coming to the realisation that you have a problem with worry and not a health worry.
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About Giles Fourie
Giles Fourie is the director and co-founder of White River Manor. He is dedicated to providing the best care for clients seeking recovery from substance abuse, anxiety, depression, or co-occurring disorders.
