What Is Illness Anxiety Disorder? (Formerly Hypochondriasis)

Symptoms, Dangers, and Treatment

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What Is Illness Anxiety Disorder?

Illness anxiety disorder (IAD), formerly known as hypochondriasis, is a condition marked by an excessive fear of having a serious medical condition despite having few or no symptoms. People who have IAD often go to doctors about symptoms they believe are linked to a medical problem or may believe that mild symptoms are more serious than they really are.

While there may not be a medical illness present, the concerns that people with IAD have are very real, and the anxiety they feel can cause serious disruptions in normal daily functioning.

Hypochondriasis

Hypochondriasis, or hypochondria, was eliminated in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Hypochondria was eliminated from the DSM-5 because the term has negative connotations and is stigmatizing.

Instead, most people who would have previously been diagnosed with hypochondriasis now receive a diagnosis of illness anxiety disorder or somatic symptom disorder. However, there are some who feel that hypochondriasis should be reclassified as a phobia since it represents a specific fear.

Symptoms

Symptoms of illness anxiety disorder center primarily on a preoccupation with the possibility of being ill, often based on normal body functions or mild physical complaints. Common symptoms include:

  • Avoiding people or places out of a fear of contracting an illness
  • Constantly searching the internet for information about symptoms and health conditions
  • Constantly talking to others about health problems
  • Distress that is significant enough to impair normal daily functioning
  • Fear that physical sensations are caused by a serious medical disease
  • Feeling nervous and obsessed with frequently checking health status
  • Heightened awareness of minor bodily symptoms such as headaches, joint pain, or sweating
  • Making doctor's appointments to check up on mild symptoms or normal body functions
  • Significant distress over the possibility of being sick

Diagnosis

Illness anxiety disorder is often diagnosed after physical examinations and lab tests return normal results, but the person remains preoccupied and anxious about an underlying health condition. Diagnosis of IAD is based on the person's symptoms, medical history, exam results, and accompanying mental health symptoms such as severe anxiety

Diagnosis may be complicated by the fact that people with this condition are not reassured by normal exam or lab results and, as a result, may dismiss their doctor's findings and seek another provider.

In order to be diagnosed with illness anxiety disorder, an individual must exhibit the following:

  • Excessive worry about a serious or life-threatening illness
  • Lack of or mild somatic symptoms
  • Excessive worry and anxiety about health issues
  • Repeated checking for illness or indications of disease

Additionally, these symptoms must be present for at least six months and must not be better explained by another psychiatric condition.

Complications

It is easy for illness anxiety disorder to become a self-replicating cycle. Many of the physical symptoms of illness can also be caused by stress. Joint and muscle pain, sweating, nausea, and skin conditions are a few of the more common physical symptoms that people with illness anxiety disorder worry about. That worry can, in turn, cause these symptoms to worsen and cause new symptoms to develop.

Illness anxiety disorder may also lead people to avoid seeking medical treatment altogether, thus jeopardizing their health.

Other Similar Conditions

Illness anxiety disorder is sometimes confused with other conditions or behaviors including:

  • Nosophobia: Both illness anxiety and nosophobia involve a fear of illness. The difference is in the exact nature of the fear. Nosophobia is the fear of developing a specific disease such as cancer or diabetes. Illness anxiety disorder is the fear that existing physical symptoms may be the result of an undiagnosed disease.
  • Malingering: It is important to note the distinction between illness anxiety disorder and what is known as malingering. Malingering involves intentionally feigning an illness in order to gain or avoid something, such as to get financial compensation or avoid legal consequences. Illness anxiety disorder is not the same as people with IAD are not feigning illness and truly believe that they have an illness or are at risk of developing a serious condition.

Causes

The exact causes of illness anxiety disorder are not known, but there are a number of contributing factors that may play a role in the development of this condition. Some of these factors may include:

  • A history of illness during childhood
  • Having another mental health condition such as anxiety, obsessive-compulsive disorder, or major depressive disorder
  • A history of trauma, abuse, or neglect during childhood
  • The presence of a serious symptom that poses a health threat
  • Stress
  • Feeling uncomfortable when experiencing normal body sensations

Some research also suggests that people may have a higher risk of developing IAD if they spend a great deal of time on the internet reviewing the symptoms of different health conditions.

Illness anxiety disorder frequently overlaps with other anxiety disorders. People who have IAD may also have co-occurring conditions such as specific phobias, generalized anxiety disorder, and/or panic disorder with agoraphobia, among other conditions.

Types

There are two types of illness anxiety disorder: care-seeking and care-avoidant.

Care-Seeking Type

Some people with illness anxiety disorder react with a need for constant reassurance. They may visit the doctor regularly despite tests showing that everything is normal. They may also frequently complain of their symptoms to friends and family members.

Care-Avoidant Type

Others with IAD react in the opposite extreme. They may avoid visiting the doctor for fear of learning bad news. They may be reluctant to share their fears with loved ones, either because they are afraid of having their fears confirmed or because they believe that they will not be taken seriously.

Treatment

Research has shown that there are treatments that can be effective for illness anxiety disorder. Treatment often depends on the nature and severity of the condition, as well as any co-occurring mental health conditions.

Psychotherapy

There are different types of psychotherapy that can be useful for treating illness anxiety. Cognitive behavioral therapy (CBT) has become a popular option for treating IAD. This type of therapy helps people learn to manage the anxiety that they feel towards their physical symptoms. In turn, this can help the symptoms themselves diminish.

Medications

In addition to therapy, medication may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are a type of medication that can help to treat illness anxiety disorder. These drugs are generally known as antidepressants and work by affecting the levels of serotonin in the brain. Examples include Zoloft (sertraline), Paxil (paroxetine) and Prozac (fluoxetine).

Coping

In addition to professional treatment for the condition, there are a number of self-help strategies that people might find helpful for reducing feelings of illness anxiety disorder:

  • Manage stress levels. Because stress can contribute to illness anxiety, finding ways to relieve stress may be helpful. Deep breathing, visualization, and progressive muscle relaxation are just a few techniques that you may find helpful for relieving stress.
  • Practice mindfulness. Mindfulness is a technique that involves focusing on your body in the present moment. It may help you better understand the normal sensations that you feel each day so that they feel more normal and less like potential health problems.
  • Avoid unhelpful information. Constantly reading frightening articles online about health conditions can heighten your anxieties. When you do seek information, look for sources that are trustworthy and reassuring, but avoid constantly reading about health conditions or illnesses.

A Word From Verywell

If you constantly worry about physical symptoms, it is important that you seek treatment. It is generally best to visit your family doctor first in order to rule out any possible medical cause for your symptoms. If your doctor does not find an illness, then the next step is to seek help from a mental health professional.

Untreated illness anxiety disorder can eventually cause you to limit your life activities due to your fears. With treatment, however, you can get your symptoms under control and move on with your daily life.

If you or a loved one are struggling with illness anxiety disorder contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Article Sources
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