Health Anxiety

When I and others refer to ourselves as “anxiety specialists,” health anxiety is one of the problem areas we treat. Technically, however, health anxiety has been moved out of the anxiety disorders section of the DSM-5 to a separate category of “Somatic Symptom and Related Disorders.” What previously was called “hypochondriasis” is now Illness Anxiety Disorder. There are also diagnoses to cover people who either have excessive worry about a diagnosed health condition or mysterious physical symptoms that have not yet been given a label.

People with Illness Anxiety Disorder do not have a diagnosed medical condition but may worry that they have a brain tumor, cancer, HIV/AIDS, or sometimes even psychiatric diagnoses. They tend to either avoid medical assessment and treatment or seek it excessively. For example, some might consult with 10 different doctors about the same non-existent condition. Others may avoid even routine care such as their annual physical for years out of fear they will be diagnosed with a medical condition. Both of these approaches, of course, are unhelpful and fuel the anxiety.

Most of us hate being sick and prefer to be as healthy as possible. It is not unusual to become anxious at the thought of having an illness, especially one that would negatively impact someone’s quality of life. Health anxiety is a tricky thing to deal with because people can be diagnosed with an illness they worry about and they can become ill at any time, even when they have been healthy. The point is not to avoid ever having a medical condition, but to learn to tolerate anxiety about ill health while engaging in appropriate healthy habits and avoiding unnecessary compulsive health-related behaviors.

Whether someone has anxiety and is in peak health, has some unexplained physical symptoms, or has a diagnosed chronic illness, thinking about illness over and over is not helpful to them and can only make them feel worse overall. In therapy, people learn to better manage their thoughts, emotions, and behaviors related to illness in order to live their best lives, regardless of their medical status.