Healthy Worry or Health Anxiety?
You spend hours researching your health symptoms on the internet. You check your heart rate on your smart watch frequently to make sure it’s normal. You’re tempted to buy that pulse oximeter to ease your mind. Your doctor tells you you’re healthy, but it only provides temporary relief.
If this sounds like you, it may be health anxiety.
Health anxiety is clinically known as Illness Anxiety Disorder (IAD), formerly called Hypochondriasis. It causes healthy people to fear they are sick or will get sick, even when they have no symptoms, or mild symptoms. Illness anxiety is relatively common, with lifetime prevalence of 2-13% of the general population.
Healthy Worry
Not all concern about health indicates health anxiety.
I suspect most would admit they have conducted a google deep dive about their physical symptoms. If the group is comprised of Millennials, 83% would raise their hand for doing their own health research, and 69% would say they used Dr. Google rather than visiting a doctor (interesting data here).
Concern about physical symptoms is arguably healthy. I frequently encourage my clients to retain your critical thinking. Find the line between critical thinking and anxious rumination.
Signs of Health Anxiety
Your mind is preoccupied with your health status, and you are easily alarmed about health symptoms
You have no symptoms, or mild symptoms, but still fear you have a serious illness
You excessively engage in “checking” behaviors, like scanning your body for symptoms, researching symptoms online, or using tools to check your health (e.g., pulse ox, blood pressure cuff)
When your doctor reassures you that you are healthy or that your test results are normal, you may feel temporary relief, but the anxiety persists that maybe you really do have some illness
You go to the doctor repeatedly to get reassurance you are healthy (care-seeking). Alternatively, you might avoid going to the doctor for fear of bad news (care-avoidance)
This anxiety has lasted for greater than 6 months and is interfering with your daily life, including hobbies, work, or relationships.
Health Anxiety is Not Malingering
Individuals with health anxiety may experience real physical symptoms which they are not “making up.” The concern is when preoccupation of having a serious illness continues even after medical evaluations clearly rule-out an illness.
Some individuals with health anxiety have a history of medical diagnosis or medical trauma personally or within their family. Prevalence of Illness Anxiety for those with medical comorbidities is between 5 - 30%.
If the medical issue is resolved, a sign of Illness Anxiety is excessive engagement in “checking” behavior mentally or physically to ensure the condition has not recurred. Individuals might avoid activities they have been medically cleared to engage in for fear or recurrence of illness. Preoccupation with the symptom causes anxiety and disrupts daily functioning.
Therapy for Health Anxiety
The idea of seeking therapy for health anxiety can elicit conflicting emotions. On one hand, you might think you have a serious or debilitating disease. But on the other hand, there is likely part of you that recognizes your worrisome thoughts are lacking credibility and the anxiety is limiting your life.
I cannot emphasize how many times I have heard my clients with health anxiety say: “I know it sounds stupid” or “I know it’s not rational, but I just keep thinking I have _______(enter a myriad of illnesses).”
You are not ‘stupid,’ or unintelligent, or an irrational person. Rather, you may be caught in the “IAD cycle” of thoughts and reinforcing behaviors that perpetuates health anxiety. If you have continue to struggle with health anxiety despite independent efforts, it may be time to explore therapy.
Cognitive Behavioral Therapy (CBT) is an effective treatment for Illness Anxiety. CBT will help identify patterns of behavior and thought that keep you in this reinforcing loop. We will explore avoidance and safety-seeking behaviors, unhelpful thinking patterns, underlying assumptions and fears, and take actionable steps to disrupt the anxiety cycle.
If you are ready to take the next steps, please reach out to a mental health professional in your area who specializes in health psychology or anxiety disorders to explore your options. If you’re unsure where to start, your primary care doctor can provide you with a referral. You are also invited to contact me to inquire about working together. I provide therapy for health anxiety in the St. Louis area, and virtually to 28 states (and growing).
