Hypochondria (Illness Anxiety Disorder)

Updated 06/12/2024

For most people, a sneeze is just a sneeze. But for those living with hypochondria, every sneeze, cough, or ache can spark a cascade of anxious thoughts, leading them down a rabbit hole of fear and uncertainty about having a disease. Imagine a life where a simple sneeze becomes a sinister signal, a benign mole transforms into a harbinger of doom, and every minor ailment is a source of paralyzing dread.

In this article, we dive into the symptoms, causes, and ways to deal with hypochondria, offering insights into this often misunderstood condition.

What is Hypochondria?

Hypochondria, clinically known as Illness Anxiety Disorder (IAD), is a mental health condition characterized by an overwhelming fear of having a serious medical condition, despite medical reassurance and evidence to the contrary. Diagnosis of IAD is confirmed when fears and symptoms persist for longer than six months despite a thorough medical evaluation and reassurance there are no medical issues present. This chronic anxiety-related disorder often presents similarly to obsessive-compulsive disorder and can significantly impact daily life, relationships, and mental well-being. 

Hypochondria: A type of somatoform disorder

Hypochondria falls under the broader category of somatoform disorders. This is a term used for psychiatric disorders that cause any unexplained physical symptoms.

The extreme health anxiety associated with hypochondria can manifest as bodily sensations — such as muscle twitching or fatigue — which, to a hypochondriac, are associated with a specific physical illness, despite the body being healthy. In this scenario, the mental health condition is not about the presence or absence of illness, but the psychological reaction to a specific form of anxiety.

Other somatoform disorders include:

• Somatization disorder
• Undifferentiated somatoform disorder
• Conversion disorder
• Pain disorder
• Body dysmorphic disorder
• Somatoform disorder not otherwise specified

Undiagnosed symptoms of somatoform disorders often lead to inaccurate or exaggerated beliefs about somatic symptoms, difficult encounters with medical professionals (frequent visits, unnecessary lab tests), and resistance to or noncompliance with diagnostic or treatment efforts.

Symptoms of Hypochondria

Broadly, hypochondria involves a preoccupation with the idea that you’re seriously ill based on normal body sensations (a rumbling stomach) or minor symptoms (a scratchy voice). More specifically, signs and symptoms may include:

• Excessive worry over having or getting a serious illness.
• Health concern persists despite appropriate medical evaluation and reassurance.
• The duration of the disturbance lasting at least six months.
• Physical symptoms are not present or if present, only mild. If another illness is present, or there is a risk for developing a physical illness, a hypochondriac’s concern is out of proportion.
• High level of anxiety and alarm over personal health status.
• Repetitive checking of the body for symptoms of an alleged medical condition.
• Excessive health-related behaviors — repeatedly checking body temperature, researching symptoms and checking body for signs of illness — or abnormal avoidance of medical care — avoiding scheduled doctors’ appointments or the need to make them, and hospitals.
• Multiple medical tests, often for the same alleged condition.

Diagnosis of hypochondria usually starts with a primary care physician expressing concern about a patient and recommending they consult a psychiatrist or other mental health professional. Patients, however, sometimes refuse to see a mental health clinician, or express wariness, if  they continue to suspect a health problem.

Causes of Hypochondria

While the cause of hypochondria is not entirely understood, several factors may contribute to the development of this condition:

• Biological factors: Genetics and brain chemistry can play a role. An imbalance of neurotransmitters in the brain might contribute to anxiety-related mental health conditions, including hypochondria.
• Psychological factors: A person’s personality, past experiences, and mental health history can influence the development of hypochondria. Individuals with a history of anxiety or depression are more prone to developing health anxiety.
• Environmental factors: Stressful life events, such as the death of a loved one, can trigger hypochondria. Additionally, individuals who were often sick as children or had parents who were overly concerned about their health may develop health anxiety.
• Cognitive factors: Misinterpreting normal bodily sensations as serious illnesses and having a heightened focus on body functions can contribute to hypochondria. Those with hypochondria often have a low tolerance for uncertainty regarding their health.

How to Deal With Hypochondria

Fortunately, several treatment options are available for people with hypochondria and other forms of health anxiety. Because of their many similarities, the same techniques that are effective in treating OCD are also employed in the treatment of hypochondria. Below are some  examples that are available to people with hypochondria that should be researched further, with the help of a mental health professional, before proceeding.

Psychotherapy for hypochondria

Hypochondria is a psychological problem, even if legitimate physical symptoms exist. Because of this, psychotherapy in a number of forms — cognitive therapy, behavior therapy, or stress management — can be beneficial.

Medication options for hypochondriacs

The symptoms of hypochondriasis may sometimes be relieved by an antidepressant. Experts have noticed this disorder’s similarity to obsessive-compulsive disorder (OCD) and have thus found that it can help to prescribe OCD treatments — serotonin specific reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

Stress management

Stress management techniques, such as mindfulness, meditation, and relaxation exercises, can help teach you how to deal with anxiety and reduce the focus on health concerns. These practices allow individuals to become more aware of their thoughts and feelings without immediately reacting to them, which can reduce the intensity of health-related anxiety.

Healthy routine

Maintaining a healthy routine by balancing diet, regular exercise, and adequate sleep can improve overall well-being and reduce anxiety. Physical activity, in particular, has been shown to have a positive impact on mental health by releasing endorphins, which are natural mood lifters.

Lean on a support system

Building a strong support system of friends, family, or support groups can provide reassurance and reduce feelings of isolation. Having people to talk to and share concerns with can help hypochondriacs feel understood and supported, which can alleviate some of the anxiety associated with their health fears.

It should be noted that some individuals with hypochondria do not consider these options because they do not believe they have a mental health condition or maintain that their challenges are physical.

Changing the Narrative Around Hypochondria

According to the OCD Center of Los Angeles, 4-6 percent of the population has clinically significant hypochondria. Furthermore, they suggest that up to 10 percent of all visits to primary care physicians may be due to hypochondriacal fears.

Like many other mental health issues, hypochondria is a condition that is often tossed around lightly in conversation or used pejoratively. A person might seem worried over a headache and be called a “hypochondriac” in a casual group setting. It’s important to remember, however, that this pejorative term can undermine the potential severity of anxiety. Hypochondria is a real and entirely treatable disorder. If you recognize any of the symptoms listed above, help is available to you. Consider speaking with a therapist to help work through your illness anxiety.