Hypochondriasis, also known as Illness Anxiety Disorder (IAD) or simply health anxiety, is worrying that you are or will become extremely ill. Accompanying your worries, you may or may not have physical symptoms. Or, you may believe that minor symptoms or typical bodily sensations are cause for concern as they may be signs of a severe illness.
For example, you may associate fatigue with a specific, serious illness rather than the result of a not-so-great night’s rest. The health anxiety you are experiencing, not the physical symptoms, can cause significant distress which impacts your daily life and ability to function. Health anxiety may increase as we age into adulthood and become a senior citizen, and/or it may increase during periods of high stress. Luckily, therapy for health anxiety can help put your mind at ease.
Anchor Therapy is a counseling center in Hoboken, NJ with mental health therapists specialized in helping children, teens, adults, couples, and families with anxiety, depression, relationship issues, trauma, life transitions, and more. Anchor Therapy is accepting new clients and is now providing in-person sessions and teletherapy sessions to residents of New Jersey, New York, and Florida.
What is health anxiety?
Health anxiety is a condition where you are excessively worried about having or developing a serious illness. According to the University of California Los Angeles (UCLA), health anxiety is diagnosed in 4-5% of people; however, many mental health professionals believe that the diagnosis is higher, impacting roughly 10% of the population since the condition often goes undiagnosed.
Illness Anxiety Disorder is defined by a focus of a fear or worry on uncomfortable or atypical physical sensations being a major indicator of a serious illness or medical condition. However, in reality, there may be little to no medical evidence to support your concerns. It is not uncommon for many people to associate a normal bodily function with a sign of severe illness.
Some symptoms of Illness Anxiety Disorder include:
High level of anxiety about health
Excessive health-related behaviors (e.g., checking your body for signs of illness)
Preoccupation with having or obtaining a serious illness
Easily alarmed by minor health concerns or normal bodily functions
Avoiding doctor’s appointments or hospitals
Over-booking appointments at doctor’s appointments or frequently visiting hospitals
Another similar mental health condition is Somatic Symptom Disorder (SSD). This is a condition where you have an intense focus on physical sensations, perhaps shortness of breath or frequent headaches. These physical sensations or symptoms cause much distress and issues with functioning. The symptoms may or may not be related to an actual medication condition, but your response to the sensations would be considered abnormal.
Some symptoms of Somatic Symptom Disorder (SSD) include:
Symptoms can be specific (e.g., localized pain) or general pain (e.g., fatigue, weakness, etc.)
One or more somatic symptoms that are distressing and/or disrupting your ability to live daily life normally
Excessive thoughts, feelings, and behaviors related to your physical symptoms or connected health concerns, such as:
Consistent high level of anxiety about your health and/or symptoms
Excessive time and energy devoted to your symptoms and/or health concerns
Unreasonable, ongoing thoughts about the seriousness of the symptoms you are experiencing
If you have persistent physical symptoms that bring stress and anxiety to your life, it is important to seek the support of a healthcare professional. For example, you may want to visit your doctor so you can rule out any physical health conditions so you know what to focus on in therapy sessions with your health anxiety counselor at Anchor Therapy.
To distinguish your symptoms between Illness Anxiety Disorder and Somatic Symptom Disorder, ask yourself the following questions:
Are you concerned about having a serious illness even if no physical symptoms are present (IAD) or are you focused on physical symptoms that are distressing and disrupt your daily routine (SSD)?
Are your symptoms rooted in thoughts you hold about potential illnesses (IAD) or do you experience noteworthy, ongoing symptoms that cause distress (SSD)?
Do you often check your body for signs of illness or seek reassurance about your health (IAD) or do you spend a lot of time and energy trying to address your physical symptoms (SSD)?
Is your anxiety related to a fear of being diagnosed with a serious illness even if you have medical reassurance that is not what is occuring (IAD) or do you have high levels of anxiety about real physical symptoms (SSD)?
Do you regularly seek reassurance from doctors, family members, and friends about your health status (IAD) or do you mostly seek medical support for persistent physical symptoms you are facing (SSD)?
While a health anxiety therapist will be able to guide you through counseling sessions and provide you with an accurate diagnosis and treatment plan, these questions will give you insight into whether your experience aligns more with IAD or SSD.
For further guidance, check out our blog “Do I Have Anxiety? Take The Quiz and Learn 5 Instant Calming Tips.”
Why do I always think something is wrong with my health?
As human beings, we have been trained to focus on the bad. Generally speaking, it is much easier for us to ruminate on potentially poor or dangerous outcomes rather than thinking about how things could go positively or smoothly. This is due to evolutionary, psychological, and social factors.
From an evolutionary standpoint, being alert to possible dangers and threats is what helped our ancestors survive. The more aware you were, the more likely you were to survive. Human beings also have a negativity bias where we naturally focus more on negative experience or information than positive ones.
Psychologically, negative events often invoke stronger emotions within us than positive events. This makes them inherently more memorable, therefore more likely to be ruminated on. The brain also processes negative information differently and more thoroughly than positive information, leading to a greater recall of negative experiences.
From a social and cultural perspective, we are constantly surrounded by emotion-provoking, often-negative information. Think about every time you turn on the news or go to a media outlet- negative stories are shown because they grab peoples’ attention. Constantly exposing yourself to negative information may teach you to focus on the bad. With loved ones, you may even find yourself only discussing your problems and/or negative experiences instead of sharing the highlights of your life which may create a habit of focusing on the negative. Lastly, many people find themselves comparing their life and accomplishments to that of others, especially in social settings. This can highlight negative aspects of your own life. For support with this, our blog “How to Stop Comparing Yourself to Other People” is a must-read.
Additionally, anxiety is often about trying to predict the future. It will fill your head with a lot of “what if” questions.
For example, you may be asking yourself…
What if this headache means I have a brain tumor?
What if I do not go to the doctor and I miss a serious illness?
What if I ignore these symptoms and they get worse?
What if I lose my job because I am constantly worried about my health?
What if I do not seek a second opinion and the first doctor was wrong?
What if I cannot control my anxiety without constantly checking my symptoms?
All of these questions involve worrying about potential negative outcomes. Your brain creates these “what-if” scenarios in an effort to protect you by anticipating negative outcomes but, when these thoughts become overwhelming and persistent, your thoughts can cause more harm than good. Your anxious thoughts may cause you to have a low tolerance for uncertainty, needing you to constantly seek reassurance and predictability from other people.
Another common theme with health anxiety-related thoughts is a loss of control. While of course you can maintain good health by eating a well-balanced diet, exercising regularly, managing stress levels successfully, and getting good sleep, there are also many health factors outside of your control.
You may be overwhelmed, as if you are losing control over your body, mind, and general health. From a fear of developing a serious illness that cannot be anticipated or managed to minor symptoms triggering intense worries about health conditions that are unpredictable, you may experience increased anxiety or stress.
Anxiety about your health often creates a loop of worry and checking (e.g., checking your body daily for signs of deteriorating health, asking opinions from family members/friends, seeking support from a medical professional, etc.). This cycle reiterates a sense that you are losing control. Constant worry and avoidance of certain activities will deteriorate your quality of life and enjoyment. For support, read our blog “5 Ways to Nurture Your Mind-Body Connection.”
Can health anxiety cause fake symptoms?
Health anxiety goes beyond just the mental, stress and anxiety can impact our physical bodies as well. Your symptoms of health anxiety feel real because they are real. Yes, you may really experience a headache, fatigue, stomachache, etc. due to health anxiety. However, the stomachache, for example, is not caused by food that you ate, it is triggered by your mind.
Many people are familiar with the emotional and mental discomfort of anxiety, but did you know that health anxiety can also cause physical symptoms as well?
When you become anxious, your sympathetic nervous system becomes activated. Our nervous system scans for threats and, when we are in this state, our fight-or-flight response gets triggered. This is the ability to fight off our threat or run away from it to seek safety. The sole purpose of this system or response is to keep us alive. While the fight-or-flight response was useful in a time when we lived amongst animals in nature for instance, it can be triggered by relatively normal life occurrences in today’s age.
Our fight-or-flight response causes our body to pump with stress hormones, such as cortisol, and adrenaline. Think about when you are nervous or anxious what happens. Perhaps your heart begins to beat fast, your palms sweat, and so on. A host of physical changes can occur.
While these physical sensations may feel uncomfortable, it is all about keeping you safe. Back in the time of our ancestors, this bodily response would save many lives!
All of this is to say that it may not be your mind (or a perceived illness) producing the symptoms in real time, but it is our body’s process or reaction to stress and anxiety.
The following is a list of physical symptoms commonly associated with health anxiety:
Headaches
Dizziness
Chest pain or discomfort
Muscle tension or pain
Shortness of breath
Heart palpitations
Sweating
Shaking or trembling
Frequent urination
Nausea or digestive issues
Sensations of tingling or numbness
Fatigue
Sleep disturbances (Read our blog “Unlocking the Secrets of Quality Sleep: A Therapist’s Perspective on Sleep Hygiene and Insomnia”)
Dry mouth or throat
Feeling cold or hot
Changes in appetite
Fatigue and weakness
Feeling detached or unreal
Frequent headaches
For support, check out our blog “3 Ways to Manage Your Physical Anxiety Symptoms.”
What is the most effective treatment for health anxiety?
Cognitive-Behavioral Therapy (CBT) for health anxiety is a successful treatment modality. CBT is a structured, time-restricted type of counseling where you will make a conscious effort to identify and change your negative thoughts surrounding your health. You will not only work on your thought patterns, but any behaviors as well that are contributing to your health anxiety. Read our blog “How You Can Treat Your Anxiety Using CBT.”
Acceptance and Commitment Therapy (ACT) for health anxiety may also be used. This form of counseling focuses on accepting your anxious thoughts and feelings instead of trying to control or avoid them. You will also commit yourself to taking actions that align with your personal values. You will be encouraged to accept your anxiety with zero judgment attached which will naturally reduce the impact of anxious thoughts on your behavior.
Something that many people who struggle with physical symptoms of health anxiety find helpful is mindfulness and other relaxation techniques. A mindfulness meditation or activity can help you stay grounded in the present while accepting your feelings and thoughts as they are. Deep breathing exercises can promote relaxation and offer immediate relief from physical symptoms of anxiety. For more information, read our blogs “How Meditation Can Lead to Stress Reduction” and “5 Breathwork Techniques to Decrease Anxiety.”
If your body is sending you signals that you are ill, it is normal to be worried. But, it is also important to distinguish whether these are symptoms related to a medical condition or symptoms associated with stress and anxiety. If you are struggling with health anxiety, it is recommended to seek the support of an anxiety therapist.
Victoria Scala
is the Social Media Manager, Intake Coordinator, and Community Engagement Director at Anchor Therapy in Hoboken, New Jersey. She is a graduate of the Honors College of Rutgers University-Newark and is currently studying Clinical Mental Health Counseling at the graduate level. In her roles, Victoria is committed to managing the office’s social media/community presence and prioritizing clients' needs.
IF YOU’RE LOOKING FOR HELP FROM A PROFESSIONAL COUNSELOR TO ASSIST YOU IN MAKING POSITIVE CHANGES IN YOUR LIFE, CONTACT US
WORKING WITH US IS EASY
Fill out the contact form below.
Our intake coordinator will get back to you with more information on how we can help and to schedule an appointment. We will set you up with an experienced licensed therapist who specializes in what you're seeking help with and who understands your needs.
You’ll rest easy tonight knowing you made the first step to improve your life.
