Understanding hypochondria: Causes, symptoms, and treatments

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Medically reviewed by Melissa Guarnaccia, LCSW
Updated May 14, 2024
by BetterHelp Editorial Team

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“Hypochondria” is often seen as a somewhat outdated term used to describe health anxiety disorders. In the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the term “hypochondriasis” was replaced with two diagnoses: illness anxiety disorder and somatic symptom disorder.
Although the term “hypochondriac” might be used to reference anyone who worries about their health, only 4% to 5% of people may be diagnosed with a health anxiety disorder, although some professionals believe that it may often go undiagnosed. This type of anxiety can often be effectively treated with online or in-office cognitive behavioral therapy.
What is hypochondria?
As previously mentioned, hypochondria is often used to describe health anxiety disorders, such as illness anxiety disorder and somatic symptom disorder. There might be a significant overlap between the two conditions, as both tend to involve extreme concern over one’s health. However, there may be a few key differences.
Illness anxiety disorder
Illness anxiety disorder typically describes a mental health disorder involving significant anxiety over one’s own health, often accompanied by mild symptoms or no symptoms at all. For example, someone with illness anxiety disorder may believe developing a slight cough is a sign that they have lung cancer.
Somatic symptom disorder
Somatic symptom disorder often involves similar levels of anxious thoughts and behaviors, but this disorder is typically accompanied by at least one physical symptom as well. However, although there often isn’t a serious medical condition associated with the physical symptoms, the related anxiety might be debilitating or reduce a person’s quality of life.
Care-seeking vs. care-avoidant health anxiety
Health anxiety disorders can affect different people in different ways, even if they share similar symptoms. In most cases, someone with a health anxiety disorder falls into one of two categories:
Care-seeking: Someone who constantly contacts medical professionals to discuss their symptoms, receive medical tests, and request treatment
Care-avoidant: Someone who avoids seeing a medical professional for fear of being diagnosed with a serious illness or who doesn’t trust doctors to take their symptoms seriously and give an accurate diagnosis
Triggers
For someone living with these conditions, health anxiety can be triggered by a number of situations, some of which include:
Watching a movie or TV show where someone has a serious illness
Reading about or researching an illness (this can be especially prevalent in students studying health sciences)
Seeing someone else experience a serious illness
Being diagnosed with a less serious medical condition
Finding out your diagnosis is much less serious than originally thought
Potential causes of health anxiety disorders
The reasons someone might develop health anxiety disorders can vary. However, researchers have identified several potential causes.
Childhood illness
If you experienced a serious or long-term illness during childhood, you could be more likely to develop a health anxiety disorder. This could involve worrying that the illness is returning or that you are developing symptoms of a different illness.
Family illness or illnesses
Although regular monitoring might be beneficial for genetic conditions that run in the family, watching family members experience serious illnesses could cause a person to develop unnecessary anxiety regarding their own health.
Health anxiety in family members
Growing up around people with illness anxiety disorder or somatic symptom disorder can increase a child’s risk of developing health anxiety disorders later in life. A 2017 study discovered that children raised by mothers living with extreme health anxiety, including health anxiety by proxy, tend to be more likely to experience symptoms of health anxiety later in life as well.
Stress
External stressors or having a personality that generally causes you to worry could contribute to health anxieties. You might have a difficult time accepting uncertainties within your own body, potentially leading you to believe you have a serious condition.
Trauma or abuse in childhood
Health anxiety disorder could be caused by traumatic experiences in childhood, including abuse and neglect. Research supports the theory that adverse experiences in childhood can increase the likelihood of developing health anxiety later in life.
If you or a loved one is witnessing or experiencing any form of abuse, please know that help is available. You can call the National Domestic Violence Hotline anytime at 1-800-799-SAFE (7233).
Mental health conditions
Having a mental health disorder can contribute to a person’s development of health anxiety disorders. Conditions that commonly contribute to health anxiety can include depression, obsessive-compulsive disorder (OCD), and other anxiety disorders.
Symptoms of health anxiety disorders
Although they usually come with their own risks and complications, illness anxiety disorder, somatic symptom disorder, and other health anxiety disorders often share similar symptoms. Some signs that you or someone you love might be experiencing a health anxiety disorder might include the following:
Constant or extreme worry about your health
Being easily alarmed by potential symptoms of illnesses
Believing the worst-case scenario for any symptom or sign of illness
Frequently checking yourself for signs of illness
Fearing that serious health conditions could be the cause of normal body sensations or mild symptoms
Constantly researching illnesses, symptoms, and conditions
Avoiding people, places, or activities due to potential health risks or fear of contracting an illness
Tracking and obsessing over normal bodily functions, such as heart rate or blood pressure
Frequently talking to others about your health and health worries
Seeking reassurance from others about your health
Making frequent doctor’s visits and requesting medical tests and examinations
Finding little to no comfort from doctor’s visits or test results
Avoiding doctor’s visits for fear of being diagnosed with a serious illness
Believing that your doctor isn’t taking your symptoms seriously or isn’t properly diagnosing your condition
Risks associated with health anxiety disorders
At a clinical level, the health anxiety disorders commonly referred to as hypochondria can present several risks. If a health anxiety disorder goes untreated or unmanaged, you might experience the following:
Unnecessary medical tests and procedures, which can put unnecessary stress on your body
Strain on personal relationships due to friends and family no longer wanting to hear about your medical worries
Frequent absences from school or work, which can impact performance or future prospects
Financial troubles due to frequent and expensive medical appointments, tests, or procedures
Mental health conditions, including depression and anxiety disorders
Decreased quality of life from spending so much time and energy worrying about your health
Treating and managing health anxiety
If you believe you are experiencing symptoms of hypochondria and its associated health anxiety disorders, there are ways to manage your condition and relieve yourself of some of your health concerns.
Although you might make frequent visits to physical health doctors regarding your health, a mental health professional might be able to provide you with the support you need to manage your health anxieties and begin living life to the fullest.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a form of therapeutic treatment that can be used to treat a variety of mental health conditions, including anxiety disorders. CBT is primarily based on the idea that mental health conditions can develop due to unhelpful ways of thinking and resulting behavior patterns. By learning to identify these unhelpful thoughts and behaviors and taking steps to change the way you think, you may be able to relieve symptoms of mental health conditions.
CBT is often the first line of defense for treating health anxiety, as there is significant research to support its effectiveness. In a 2017 study, for example, patients experiencing health anxiety participated in several sessions of CBT and were then evaluated over a period of five years to monitor symptoms and improvement. Researchers concluded that CBT could be considered “a highly effective treatment for pathological health anxiety with lasting benefit over 5 years.”
In some cases, psychiatrists may pair CBT with an antidepressant or anti-anxiety medication as well. Always consult your doctor before beginning, changing, or discontinuing any medications.
Benefits of online therapy
For those experiencing health anxiety, it may be difficult to have regular in-person sessions with a therapist. Fear of contracting an illness might make you wary or prevent you from leaving the house altogether. Additionally, being in close contact with a therapist face-to-face might contribute to health anxieties. In those cases, online therapy can be a helpful alternative for those looking to receive treatment, as sessions can be completed from the comfort of your own home.
Effectiveness of online therapy
A randomized noninferiority clinical trial compared internet CBT to face-to-face CBT for those living with health anxiety. After 12 weeks of CBT treatment delivered either over the internet or face-to-face, researchers concluded that there seemed to be no significant differences between the two formats. The study also noted that being able to deliver internet-based CBT “has potential to increase access to evidence-based treatment for health anxiety.”
Takeaway
Health anxiety disorders, also known as hypochondria, can involve symptoms like worrying about your health or convincing yourself you have a serious illness. These conditions may be caused by childhood or family illnesses, childhood trauma, or other mental health conditions. If you’re experiencing symptoms of a health anxiety disorder, you might consider seeking professional help, as research suggests that cognitive behavioral therapy in-person or online can effectively reduce this type of anxiety.
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