What Is Illness Anxiety Disorder

Misinterpreting sensations in the body to be serious illness can be a sign of illness anxiety disorder.

Illness anxiety disorder, formerly known as hypochondria, is a mental health condition where minor symptoms or normal bodily functions are misinterpreted as indications of a serious illness. It encompasses different types, such as somatic symptom disorder and cyberchondria. 

To delve deeper into illness anxiety disorder and its causes, symptoms, management, diagnosis, risk factors, complications, and frequently asked questions, read on!

Overview

More commonly known as hypochondria before a realignment in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), illness anxiety disorder is a mental health condition in which common symptoms or normal bodily function is interpreted as a symptom of a physical illness.¹ Concern for the individual's health is a norm, however, when it starts to impact livelihood and daily functioning, it is classified as mental illness.

Types of illness anxiety disorder

People previously diagnosed with hypochondria or hypochondriasis as per the DSM-4 may now be diagnosed with illness anxiety since the publication of the DSM-5. This defines a distressing disorder, in which an individual interprets sensations in the body or minor symptoms as an indication of a serious illness or condition.

Related to this is somatic symptom disorder, a condition where an individual may focus on the symptoms and how they are affected by them, but not connect this concern to a specific or serious illness. The distress caused by these symptoms is often disproportionate to their severity causing disruption to daily life.² 

A more recent facet of illness anxiety is cyberchondria. Although not currently defined as a distinct entity, it refers to the excessive and often unwarranted anxiety or preoccupation with having a serious medical condition based on the information obtained from online sources. This usually results in increased self-diagnosis and distress around disorders.³

Causes of illness anxiety disorder

Although the exact cause of illness anxiety disorder is unknown, there are a few factors thought to potentially play a part. 

Family and childhood experiences can play a huge role in illness anxiety disorders. Growing up in an environment where family members are excessively focused on health and illness, whether it relates to their own well-being or that of others, can influence the development of illness anxiety disorder. Experiencing a significant illness during childhood, either personally or through a loved one, can also contribute to the development of illness anxiety disorder. Having these experiences may mean that feeling unknown physical symptoms or sensations can be more concerning or distressing.⁴

There are also many other mental illnesses or psychiatric disorders that overlap with illness anxiety disorder. People with depression, and other types of anxiety like general anxiety disorder, social anxiety disorder, or OCD may have a higher risk of comorbidity with illness anxiety disorder. Conditions like OCD also have many overlapping symptoms, like obsessions and repetitive behaviour or compulsions.⁵

Signs and symptoms of illness anxiety disorder

From a throat tickle to a minor rash, the interpretation of minor symptoms or body sensations as something much more severe is hugely involved in symptoms of illness anxiety disorder. More signs may involve ⁶

• Preoccupation with getting a serious disease or already having a severe health condition
• Persistent fear of having an undiagnosed or unrecognised medical condition
• Reading into minor symptoms and being concerned that they mean you have a serious illness
• Being distressed about an illness to the point where it starts to interfere with day-to-day activities 
• Overuse of medical services, or repetitively going to friends, family, and online health resources for reassurance
• Avoiding certain places, people or events from the fear of illness being spread
• Avoiding medical services out of fear of illness
• Frequently checking the body for signs of illness or seeking reassurance from medical professionals
• Significant impairment in social, occupational, or other important areas of functioning due to illness-related fears
• Frequent seeking of medical tests or medical procedures, often finding little to no reassurance from negative test results or medical professional opinion

Management and treatment for illness anxiety disorder

Treatments are generally focused on coping with anxiety. Management is essential to improving overall health and the ability to participate in society. Psychotherapy can be used to help treat illness anxiety disorder. Therapy types such as cognitive behavioural disorder (CBT) are commonly used, aiming to help individuals challenge and modify their anxious thoughts and behaviours related to health concerns. This may be coupled with medications, to help manage anxiety symptoms.⁷

It can also be helpful to keep a journal of how often you review your body for symptoms, research symptoms on the internet or ask healthcare professionals or family for reassurance. Not only can this help in the management of the condition but can also aid in the diagnosis and progress tracking.⁹  

Diagnosis

As part of diagnosis, a physical examination as well as referral to a mental health professional can take place.⁶ 

With the physical examination, the healthcare professional can conduct any tests to determine the presence of any medical conditions.

In some cases, psychological assessment is also required, this could include asking about any symptoms, family history and concerns, as well as discussing any substance use, and filling out some self-assessment reports. 

Risk factors

Illness anxiety disorder typically emerges during early to middle adulthood and may worsen as the individual gets older,⁶ as concern turns to memory decline and cognitive disorders. Other factors can consist of:

• History of childhood abuse
• Significant life stressors
• Experiencing threat of a severe illness that ultimately turns out to be non-serious
• Possessing personality traits surrounding anxiety

Complications

There are some associations with illness anxiety disorder. Here are some examples ⁹

• Strained or dysfunctional relationships with family or loved ones
• Absence from work or performance issues
• Development or presence of other mental illnesses, like other types of anxiety disorders
• Financial issues due to extensive and regular health check-ups or medical appointments

FAQs

How can I prevent illness anxiety disorder

Although there are currently no established prevention methods, seek professional advice if anxiety issues are present before they begin to develop further. Recognising the moments of distress or worry also can help target which areas of anxiety are disrupting daily functioning.

How common is illness anxiety disorder

1.3-10% of the population are estimated to have some level of illness anxiety. It’s rare, but not as uncommon as you might first think!⁸

What can I expect if I have illness anxiety disorder

If you have illness anxiety disorder, you may experience excessive worry or fear about having a serious or fatal medical condition, despite there being no symptoms to suggest so, or only mild symptoms being present. It might mean that you constantly seek reassurance, monitor your health excessively and interpret minor symptoms with more severity.⁸ 

When should I see a doctor

If self-help efforts are not helping to alleviate distress, and concerns about your health are getting in the way of normal life, it might be time to speak to a healthcare professional or primary care provider. This way, if they find a diagnosis, treatment options can be discussed.⁹

Summary

Illness anxiety disorder is a mental health condition characterized by excessive worry about having a serious medical illness. People with this disorder often misinterpret minor symptoms as signs of a severe disease, causing persistent anxiety. Treatment usually involves psychotherapy and, in some cases, medication. Supportive healthcare professionals play a vital role in helping individuals manage their anxiety and improve their overall well-being.