What is Health Anxiety (Hypochondria)?

What's the definition of health anxiety, or hypochondria?

Health anxiety, hypochondria, or hypochondriasis, is defined as an overwhelming anxiety over one’s health, especially with an irrational fear that one has (or may develop) a serious physical illness.

Are health anxiety and hypochondria the same thing?

Hypochondria (and hypochondriac, someone who has hypochondria) is a label that comes with a stigma. As a result, it’s common for people challenged by health anxiety to feel medical practitioners, family members and others are dismissive of their concerns.

Google search interest in health anxiety (blue) vs. hypochondria (red).
Source: Google Trends.

It’s no wonder Google search interest in health anxiety surpassed hypochondria about a decade ago, and continues to rise.

Times are changing.

In the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association in 2013, hypochondria (hypocondriasis) was redefined as two new, but related disorders: Illness anxiety disorder, and somatic symptom disorder.

What is illness anxiety disorder?

With illness anxiety disorder, a preoccupation with the possibility an undiagnosed, serious illness, is the patient’s primary focus.

They:

  • May or may not have a physical illness.
  • Are perpetually concerned they may have an undiagnosed illness.
  • Are extremely sensitive to (and misinterpret) uncomfortable body sensations.
  • Dedicate excessive time and energy to health concerns.
  • Feel little-to-no relief from medical evidence or reassurance.
health-anxiety-hypochondria-definition.jpg

What is somatic symptom disorder?

With somatic symptom disorder, physical symptom(s) are the patient’s primary focus.

They:

  • Have one or more persistent physical symptoms that cause excessive anxiety.
  • Dedicate excessive time and energy to health concerns.
  • Feel little-to-no relief from medical evidence or reassurance.
“Health anxiety and body vigilance are much more understandable to patients when they realize they can have these things despite what their medical doctor finds. During the field trials, we found it much easier to engage patients if we identified what the problem was instead of what it was not... now we can identify these symptoms in a positive way.”
Dr. Jeffrey P. Staab, MD (Mayo Clinic)

Health anxiety, while not an official diagnosis, is a more modern term used to describe hypochondria, including both illness anxiety disorder and/or somatic symptom disorder.

Health anxiety is irrational

It’s normal to worry about your health from time to time. Everybody does - but for someone challenged by health anxiety, it’s much more than your average worry.

The average person responds rationally to their health concerns or new, uncomfortable body sensations.

  1. They feel initial, manageable anxiety.
  2. They mention it to a doctor at their next appointment, if it persists. If it worsens, they may make an appointment sooner.
  3. Meanwhile, life goes on.
  4. They see the doctor, obtain a remedy or reassurance, and the anxiety quickly disappears.

People challenged by health anxiety interpret, and respond to, their health concerns irrationally:

  • Minor symptoms or abnormalities lead them to believe they’re seriously ill, even when they receive medical evidence and reassurances to the contrary. 
  • They respond with anxious “safety” behaviours that, ironically, exacerbate their fears and symptoms, and promote new symptoms.
  • They research, check and seek reassurance for their worsening and new symptoms.
  • The vicious cycle spins faster and faster.

It comes as no surprise that people challenged by health anxiety find it difficult, at times impossible, to meet the demands of their careers, relationships, self-care, social lives, and more.

It’s not a healthy way to live.

“Don’t spend a lot of time imagining the worst-case scenario. It rarely goes down as you imagine it will, and if by some fluke it does, you will have lived it twice.”
- Michael J. Fox

Health anxiety is overwhelming

With health anxiety, the average ache, pain or abnormality can be perceived as imminently dangerous, immediately overwhelming the patient with worry and an unhealthy preoccupation that reduces their quality of life.

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Career

Focus and concentration are impaired. The patient may take excessive time off for (scheduled and unscheduled) medical appointments. In addition to the cost of medical appointments and time away from work, the patient may jeopardize their entire career as a result of phobias they develop (such as fear of driving, elevators, flying, or even leaving their home).

Diet

The patient may obsess over, or ignore their diet completely - and will often swing between these two extremes with as they desperately search for dietary culprits to eliminate, or experiment with new diets and herbs or dietary supplements to relieve their symptoms.

Exercise

Ironically, given the proven and widely-accepted health benefits of regular exercise, the patient avoid physical activity, fearful they may exacerbate (especially cardiovascular) health anxiety or hypochondria symptoms - or even cause a heart attack and die.

Leisure

The patient will prioritize health concerns and anxious “safety” behaviours over worthwhile activities they enjoy doing.

Relationships

The patient will prioritize health concerns over activities with family, friends, colleagues and other important people in their lives - including their relationship with themselves.

Language

The patient will engage in negative self-talk and dwell upon their symptoms, illness or anxiety during conversations with others - reinforcing their fears and feeding health anxiety further. They may also exhibit a more fearful, anxious tone and physiology (including breathing, posture and body language), or even avoid interpersonal communication or social gatherings altogether.

Mindfulness

Health, symptoms and fear take dominate their thoughts, taking their mind away from worthwhile activities even when they do engage in them.

Health anxiety can lead to other mental health disorders

While health may be the primary focus of your anxiety, you may recognize similar patterns in other situations and areas of your life.

Left unchecked, this can promote development of other mental health disorders, including but not limited to:

Generalized Anxiety Disorder (GAD)

If your mind has learned to think, feel and respond anxiously to your health, chances are it does so in other situations, too. Do you experience anxious thoughts and engage in anxious "safety" behaviours related to life at home, work, or school?

Social Anxiety Disorder

Some people challenged by health anxiety may find themselves anxious or uncomfortable in social settings, fearing they may be embarrassed, humiliated or ridiculed or looked down upon.

Phobias

A phobia is an extreme or irrational fear or avoidance of something, taking away joy and opportunities from multiple areas of one's life.

Some common phobias include:

Agoraphobia

Fear and avoidance of places or situations that may cause you to panic, may not be able to escape or get help (with health anxiety, most commonly in case of a medical emergency). In severe cases, one may not even be able to leave their own home without feeling intense anxiety.

Aerophobia

Fear of flying, and the potential inability to escape or get help  - most commonly on an airplane.

Claustrophobia

Fear of enclosed spaces, such as an elevator - again, where you may not be able to escape or get help.

Panic Disorder

As anxiety takes over one’s thoughts, feelings and daily life, and the frequency and severity of panic attack symptoms rises, patients may have sudden episodes of intense fear or terror that strike repeatedly, without warning.

Obsessive Compulsive Disorder (OCD)

Health anxiety can lead to repeated checking (compulsions), routines (rituals) and thoughts (obsessions).

Depression (Major Depressive Disorder)

With constant fear of illness, dying and frustration when no answers are found to explain their physical symptoms, it’s no wonder patients challenged by health anxiety can at times become depressed (in a state of sadness, worthlessness and/or loss of interest in activities they once enjoyed).

How you can overcome health anxiety

Anxiety over your health is normal - but unchecked, it can lead to unhealthy, self-destructive thoughts, behaviours and beliefs in all areas of your life.

With a holistic plan, relentless action, and practice you can transform your life into a healthy, fearless one, free of anxiety.

Stage 1: Accept.

Completely accept health anxiety as the cause of your suffering, and take sole responsibility for your recovery.

Stage 2: Learn.

Identify and understand the thoughts, behaviours, beliefs and risk factors that led to health anxiety.

Stage 3: Apply.

Take relentless action, eliminating risk factors and transforming unhealthy beliefs, thoughts and behaviours into healthy ones.

Stage 4: Grow.

Perfect your practice and apply a positive, growth-mindset to every area of your life.

A successful journey begins by knowing exactly where you start... so if you've already taken steps toward overcoming health anxiety, but aren't getting the results you need, find out what stage you're on right now, and your exact next steps using the free resource at the bottom of this post.

“Nothing diminishes anxiety faster than action.”
- Walter Anderson

Now, Apply.

📗 If you don't have a journal, get one. Documenting what you learn, and your progress, is critical to your recovery. I recommend Day One (iPhone or iPad | Android) because it's easy to use and I can take it with me everywhere I go. If you prefer pen and paper, that's fine - any journal will do.

💡 Ask yourself: 

  • Self, do I respond irrationally to concerns about my health? 
  • Am I experiencing multiple symptoms of health anxiety that aren’t otherwise medically explained?
  • Do I engage in anxious “safety” behaviours? 
  • How has health anxiety impacted my career, diet, exercise, leisure, relationships, language and mindfulness?
  • Do I exhibit signs of generalized anxiety? Panic disorder? Or Depression? 

💬 Talk to your doctor about whether your symptoms can be explained by health anxiety (illness anxiety disorder or somatic symptom disorder).

✏️ Take this 90-second health anxiety (hypochondria) quiz to determine what stage you’re at in your recovery, and find out your next steps to overcoming health anxiety.

🙏🏼 Share this post - it may help a loved one or friend finally begin a healthy, fearless life, free of anxiety.

Free resource!

📊 You'll get a personalized report based on your progress, and enable access to my best tips, tools & resources to live a healthy, fearless life, free of anxiety.