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Am I a Hypochondriac? Living with Illness Anxiety Disorder

If you have ever openly questioned your health status or worried aloud about a medical condition, it is possible that a family member or friend will have asked whether you have hypochondriasis. If you have recurring concerns about your health, you may also start to question whether you are a hypochondriac.


While hypochondria is sometimes made the center of humorous dialogues on television and media, it is really considered a genuine and serious condition.


Today, the condition is formally known as illness anxiety disorder. Learn more about this condition and what you can do to reduce your health anxiety:


Illness Anxiety Disorder: What Does It Mean to have Hypochondriasis?


Most generally, individuals who have illness anxiety disorder or what is formerly known as Hypochondriasis, will experience concern and worry about their health status. Any physical symptom or minor illness will increase the feeling of anxiety as they are concerned that their health is at great risk.


Hypochondriac Definition


In the past, the terms hypochondriasis and hypochondriac were used to describe those individuals who were frequently concerned about any physical symptoms and their overall health. These people might demonstrate their hypochondria by talking about their physical symptoms, visiting the doctor often, and being overly cautious about avoiding any health risks.


Unfortunately, those terms of hypochondriasis and hypochondria took on a negative stigma and even a humorous connotation in the media, that minimized the severity of the condition.


In the field of psychology, terms are sometimes changed and updated for various reasons. To better relay the nature of health anxiety and eliminate some of the stigma associated with it, an updated term was developed—illness anxiety disorder. Not only does this term more clearly define the condition as one marked by anxiety, it is also generally a better viewpoint of the symptoms.


Stats: How Many Suffer from This Disorder?


Although hypochondriasis is frequently presented in the media as a common occurrence among people, the incidence of such characters does not match the likelihood of this disorder actually occurring in the general population. Illness anxiety disorder (or IAD) as it is now known, is a relatively rare disorder.

Prevalence rates estimate the occurrence is approximately 1.3 to 10 percent in the general population. The disorder is equally likely to occur in males and females as there is no significant gender difference.


What Causes Hypochondria?


Hypochondriasis or what is now referred to as illness anxiety disorder typically emerges from a compilation of several factors. Childhood factors such as illness, abuse, or trauma may contribute to it emerging even later in life.


Experiencing an actual and severe physical symptom that was perceived as a threat to one’s health may be a cause, as the person then begins to fear that any small physical sensation or symptom may indicate a bigger problem.


Major life stressors can also contribute to the development and may exacerbate the appearance of the disorder. Finally, having another mental disorder, such as depression, anxiety, OCD, or even some form of psychosis can also increase the risk.


Signs and Symptoms of IAD


As noted, individuals who have illness anxiety disorder are often concerned about their physical health. They believe any physical symptoms could indicate some more serious illness.


In some cases, there might not be any particularly concerning physical symptoms and instead, the person may be really tuned into typical body sensations, misinterpreting them as an unusual symptom, when in fact they are not.


It is key that individuals with illness anxiety disorder do not actually have a diagnosable medical illness or at the least there are no active symptoms causing the anxiety. This can be assessed with a medical evaluation.


If someone does have an actual illness and verifiable medical symptoms, then there may be some anxiety associated with that, but it is not necessarily illness anxiety disorder.


What are the Common Behaviors/Characteristics?


The most common characteristic of illness anxiety disorder is the tendency to be very attuned to one’s body sensations and to interpret (often misinterpreting) them as a sign of some serious illness.


The anxiety that is felt will be associated with worry about the physical sensations, intrusive thoughts about physical symptoms, and being physically keyed up when thinking about physical health. The physical signs of this anxiety may include racing heartbeat and rapid breathing. Such physical symptoms can themselves be misinterpreted as signs of illness.


Behaviorally, individuals with illness anxiety disorder will appear fixated on their physical sensations and health. They may frequently discuss their symptoms and concerns with family and friends. They may visit the doctor often. It may be hard for them to accept that nothing significant is wrong even after medical tests. Sometimes they may continue to worry about their health and may want another opinion before they can try to accept that things are okay.


Testing: What are the Diagnostic Criteria Per the DSM-5


If you are excessively worried about your health, find that there is no actual medical condition to explain your symptoms, and remained overly concerned, then you may have illness anxiety disorder.


To determine if this is the case, you will need to visit a psychologist, psychiatrist, or some other mental health specialist. They will assess your symptoms and determine your diagnosis. To do this, mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5).


The DSM presents the following criteria to define illness anxiety disorder:

  •       Preoccupation with the possibility of having or acquiring a serious illness.
  •       Lack of somatic symptoms or mild somatic symptoms.
  •       If there is a verifiable medical condition or the individual is in a high-risk category, but there are no current indicators of a disease, the anxiety is out of proportion to the objective reality.
  •       High anxiety about health and easily alarmed about health issues.
  •       Frequently monitoring for sign of illness.
  •       Frequently checking health status or maladaptively avoiding doctor appointments and evaluation due to anxiety about what they fear will be found.
  •       The anxiety and preoccupation with illness has persisted for at least six months, although the specific fears may change during that time.
  •       The preoccupation with symptoms is not better accounted for by another mental disorder.


Illness Anxiety Disorder and Other Conditions


As seen in the DSM-5 diagnostic criteria, mental health professionals must rule out other similar conditions before they can officially diagnose illness anxiety disorder. Similar conditions might include other forms of anxiety disorder and other forms of somatic (health and body) related disorders.      


Illness Anxiety Disorder vs Hypochondria


As noted, psychologists use the DSM to assist in diagnosing mental health conditions. When the DSM-5 was published in 2013, the older diagnostic label of hypochondriasis was replaced with the newer diagnostic label of illness anxiety disorder.


Regardless of the label, the core diagnostic criteria of this condition is the same—the person has worry about physical sensations and fears that those symptoms may indicate significant health problems.


Illness Anxiety Disorder vs Somatic Symptom Disorder


Another mental health condition related to physical health is somatic symptom disorder. In this condition, the individual has actual physical (somatic) symptoms that are typically caused by emotional and mental causes rather than physical causes.


The presence of physical symptoms distinguishes somatic symptom disorder from illness anxiety disorder (in which individuals are most often overly attuned to normal body sensations). Such symptoms are also distressing.


Related Conditions


In the DSM-5, there are other several other conditions that might appear similar to illness anxiety disorder. These occur largely in the category of somatic symptom and related disorders. This category includes somatic symptom disorder (as described above) along with conversion disorder.


Others occur in the category of Anxiety Disorders, including generalized anxiety disorder and panic disorder. To be diagnosed with illness anxiety disorder, each of these other mental health conditions needs to be ruled out.


Illness Anxiety Disorder in Adults/Children


Both adults and children can experience symptoms of illness anxiety disorder, although the disorder usually emerges in early to middle adulthood. Once the symptoms emerge, there can be increases and decreases in the severity, depending on other life stressors.  


Example Case of Illness Anxiety Disorder


Bob becomes anxious and upset whenever he has a cough or a sneeze. He is usually convinced that it indicates an upcoming cold or flu. Recently he had an earache and he was certain it indicated signs of brain cancer. He quickly visited a doctor who diagnosed him with a mild inner ear infection that could be easily treated.

Bob insisted on tests and scans to rule out the chance of cancer. Every test came back with no signs for concern. Bob continues to worry that the doctor missed something. His worries disrupt his sleep and he continues to monitor his health.


Illness Anxiety Disorder


How to Deal/Coping with Illness Anxiety Disorder


Individuals with illness anxiety disorder most often initially visit medical providers as they are worried about their physical health. Once it is determined that there is no medical condition, they may be recommended to visit a mental health provider, such as a therapist, psychologist, or psychiatrist. Along with attending therapy and receiving mental health treatment, there are steps the individual can take themselves to help manage and reduce their psychological/emotional symptoms.


Look Out for These Complications/Risk Factors


It is probably not possible to completely prevent illness anxiety disorder. However, some factors can increase the risk of developing this disorder and could exacerbate the symptoms, including major stressors and substance use.


Hypochondria Treatment


If you choose to visit a mental health provider for treatment of your illness anxiety disorder, there are many different approaches they may choose to use. The treatment options include medications, therapy, and at-home, self-care approaches.


Possible Medications for Illness Anxiety Disorder


If medication appears appropriate, a psychiatrist or medical provider can prescribe an anti-depressant. This class of medication, known as a Selective Serotonin Reuptake Inhibitors (SSRIs), are also used to treat anxiety disorders, including illness anxiety disorder.


Home Remedies to Help Illness Anxiety Disorder


In conjunction with therapy, and possibly medication, you will also want to use home remedies to manage your symptoms of illness anxiety disorder. These approaches may include stress management and relaxation techniques, which can help to settle your mind and reduce your symptoms of anxiety. Getting physically active and engaged in activities can also be helpful, as these distract the mind and improve physical functioning in ways that can help mental health.


Living with Illness Anxiety Disorder


Having illness anxiety disorder can make life difficult at times, however, it is still possible to live a full life. By seeking professional help and then integrating self-care approaches into your daily life, you can manage the condition. Use the home remedies described above.


Insurance Coverage for Illness Anxiety Disorder


Psychologists and medical providers consider illness anxiety disorder a serious mental health condition. If you suspect you have this condition, it is likely that your health insurance will cover any treatment you may need. You can call your insurance company to inquire about this. Your doctors’ office may also be able to assist with it.


How to Find a Therapist


As you think about getting help to address illness anxiety disorder, it may initially seem daunting. However, with today’s online resources, it can be relatively easy. You can search online for therapists in your area, using the name of your city/state. With online resources, you can research the potential providers and even read reviews to find the person that seems like the right fit for you. Alternatively, ask your medical providers and friends/family for any recommendations that they might have.


What Should I be Looking for in an LMHP?


When seeking out a therapist or mental health provider, you want to make sure that they are trained and licensed in their field. You may also want to ask about their experiences working with illness anxiety disorder. Ideally, you will want to work with someone trained and experienced with this specific condition to ensure the best possible care.


Questions to Ask a Potential Therapist


When you meet with a potential therapist, not only should you ask about their training and experience, you may also want to know about their approach to therapy. You can ask them about the following topics to learn more about what you can expect from working with them:

  •       Recommended treatment approaches
  •       Anticipated frequency and duration of therapy
  •       How success in therapy will be monitored

Illness anxiety disorder Resources and Support Helpline


There are many resources online that may be helpful to anyone dealing with illness anxiety disorder:


  •      Psychology Today is a website where you can search for mental health providers.
  •      SAMSHA has a treatment locator where you can find low-cost treatment options.
  •       The Anxiety and Depression Association of America (ADAA) has information on anxiety disorders, depression, and related conditions.


If you want support or have questions about your mental health, you can call the National Alliance on Mental Illness Helpline or the SAMSHA Helpline. If your symptoms are causing or include suicidal thoughts, you can use the Suicide Prevention Lifeline.


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