Illness Anxiety Disorder (Hypochondria, Hypochondriasis)

Overview

What is illness anxiety disorder?

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

Even after medical tests show no problems, people with hypochondriasis are still preoccupied with the idea that think they’re seriously sick. Their persistent health worries can interfere with their relationships, careers and life.

You may be more familiar with the term hypochondria or health anxiety. Healthcare providers now use the term illness anxiety disorder. People with illness anxiety disorder can’t control how they feel. Their fears are very real to them.

How common is illness anxiety disorder?

Illness anxiety disorder (hypochondria) is extremely rare. It affects about 0.1% of Americans. It typically appears during early adulthood. Illness anxiety disorder can affect all ages and genders.

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 doctors 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.

What is 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 medical tests can’t pinpoint a cause for the physical symptom.

Symptoms and Causes

What causes illness anxiety disorder?

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

What are the symptoms of illness anxiety disorder?

People with illness anxiety disorder have ongoing but unrealistic fear about being seriously ill. The specific illness(es) that they worry about often changes.

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

Symptoms of illness anxiety disorder 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 normal body functions, such as heart rate.
  • Oversharing your symptoms and health status with others.
  • Repeatedly checking for signs of illness, such as 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.

Diagnosis and Tests

How is illness anxiety disorder diagnosed?

To diagnose illness anxiety disorder, healthcare providers refer to the criteria listed in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th edition. Your provider may make a diagnosis or they may refer you to a behavioral health specialist, such as a psychologist or psychiatrist.

A persistent fear about having a serious illness or developing one is the top symptom 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 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 harm your relationships and life. You may miss out on time with loved ones because you’re concerned about your health. Some people become severely depressed and even suicidal.

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.

How is illness anxiety disorder (hypochondriasis) managed or treated?

Your healthcare provider may partner with a mental health professional, such as a psychologist or psychiatrist, to help you manage the disorder. But you will continue to receive regular care from your provider.

Treatment goals focus on improving quality of life by minimizing symptoms. Treatments include:

Prevention

Can illness anxiety disorder be prevented?

Unfortunately, there is no known prevention against illness anxiety disorder. However, providing the illness anxiety disorder patient with support and understanding may help reduce severity of the symptoms, and help the patient cope with the disorder.

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.

Living With

When should I call the doctor?

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 the National Suicide Prevention Lifeline at 1.800.273.8255. This national network of local crisis centers provides 24/7 free, confidential support to people in suicidal crisis or emotional distress.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

  • Why do I have illness anxiety disorder?
  • What are the best ways to manage illness anxiety disorder?
  • Should I look out for signs of complications?

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.

Last reviewed by a Cleveland Clinic medical professional on 02/01/2021.

References

  • American Psychiatric Association. What is Somatic Symptom Disorder? (https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder) Accessed 1/13/2021.
  • Anxiety and Depression Association of America. Health Anxiety. (https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/health-anxiety-what-it-and-how-beat-it-updated) Accessed 1/13/2021.
  • French JH, Hameed S. Illness Anxiety Disorder. (https://www.ncbi.nlm.nih.gov/books/NBK554399/) [Updated 2020 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Accessed 1/13/2021.
  • Merck Manual. Illness Anxiety Disorder. (https://www.merckmanuals.com/home/mental-health-disorders/somatic-symptom-and-related-disorders/illness-anxiety-disorder) Accessed 1/13/2021.
  • National Health Service (UK). Health Anxiety. (https://www.nhs.uk/conditions/health-anxiety/) Accessed 1/13/2021.
  • American Psychiatric Association. DSM 5th edition. Chapter 11.  Somatic Symptom Disorder and Illness Anxiety Disorder. Henningsen P, ed. Accessed 1/13/2021.

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