Hypochondria: Understanding and Overcoming Health Anxiety

What Is Hypochondria?

Hypochondria -- formally known as health anxiety disorder -- is a mental health condition that belongs to the OCD and anxiety spectrum.

The core feature of hypochondria is the sufferer's persistent fear that they have a serious medical condition or are about to develop a life-threatening illness.

People with hypochondria latch onto minor symptoms or ordinary bodily sensations -- and sometimes there are no symptoms at all -- yet they become convinced something is seriously wrong.

A person with health anxiety focuses their entire attention on their body and their well-being. Even completely normal changes or sensations that happen in everyone's body immediately set off alarm bells: a birthmark might become a sign of a severe skin disease; a nagging headache triggers intense anxiety that it might be caused by a brain tumor.

People with hypochondria visit doctors frequently about their symptoms. Their worry and distress intensify because they believe they have a serious problem that doctors simply can't find.

Even when medical tests come back completely clear, people with health anxiety struggle to accept the results or to rule out the presence of disease. Instead, they ask for the tests to be repeated.

Research shows that 4-6% of the population suffers from hypochondria. Surprisingly, there is no common physical, social, or other denominator among sufferers -- the disorder appears at these rates across the board, in both men and women.

The most common age of onset is typically between 20 and 30, though health anxiety can first appear at other ages as well.

While they may not have a physical problem, hypochondria takes a heavy toll: living in constant fear of a terrible illness disrupts daily routines and damages quality of life for the sufferer and their family.

Unfortunately, many people with health anxiety refuse to seek mental health help because they believe they have a real medical problem that simply hasn't been diagnosed yet.

What Causes Health Anxiety?

No single clear cause has been identified, and several theories exist.

The Cognitive-Behavioral Explanation

Hypochondria involves a distorted perception of oneself and the world on multiple levels: misinterpreting physical sensations (amplified by fear of serious illness), a distorted sense of existential threat, and a self-perception of being unable to cope or to get help from one's environment.

Negative self-perception, internal fears, and a lack of trust in the environment's ability to help all contribute to a cognitive-behavioral pattern that typically leads to anxiety.

When the anxiety centers around physical health, it may originate in a past event related to serious illness or medical settings -- either the person's own experience or that of someone close to them.

The Social-Behavioral Explanation

Another theory suggests the motivation behind hypochondria is social-behavioral. Focusing on aches or bodily symptoms indicates avoidance of challenging situations or conflicts, justified by the fact that the person is "sick."

A related hypothesis, based on social learning theory, holds that preoccupation with physical symptoms reflects a desire to occupy the "sick role" and avoid conflicts, tasks, and obligations.

Along the same lines, some explain the obsessive focus on bodily symptoms as a cover for deep feelings of insecurity or low self-esteem. The fact that symptoms remain unresolved leaves the person in constant disappointment at the environment's inability to help.

The Genetic Explanation

Some argue that there is a genetic component -- that anxious tendencies are inherited.

Research has shown that people with hypochondria often have a low tolerance threshold for physical sensations. That is, a low pain threshold or heightened bodily interpretation of physical symptoms. For example, abdominal discomfort may be interpreted as real pain by someone with a low tolerance threshold. The same goes for pressure in the head, muscle aches, and so on.

This low tolerance threshold causes hypersensitivity, making the person highly aware of bodily symptoms and, ultimately, developing excessive worry -- hence, health anxiety.

Symptoms of Hypochondria

The hallmark of a hypochondria diagnosis is anxiety and distress about one's health. This anxiety disrupts normal life and daily functioning at work and at home, sometimes to the point of genuine paralysis from persistent fear.

Health anxiety leads to two main behaviors: repeated visits to various doctors with referrals for numerous tests, and obsessive searching for written or other materials about different diseases.

People with health anxiety interpret physical signs such as skin redness, headaches, stomach discomfort, or even heartbeat and breathing as symptoms of a serious illness and immediately take steps to investigate using various means.

Health Anxiety and Co-occurring Disorders

People with health anxiety often also suffer from other anxiety disorders and even depression.

In certain cases, hypochondria may manifest in actual physical symptoms, such as chronic pain syndrome -- what is called a conversion disorder (so-called "hysterical" blindness or paralysis).

In severe cases, Munchausen syndrome ("hospital addiction syndrome") can develop, where the person with health anxiety may cause themselves various physical symptoms in order to obtain treatment and hospitalization.

Diagnostic Checklist for Health Anxiety

Health anxiety can be diagnosed by a psychologist or psychiatrist. The following criteria must be met:

• The person is intensely worried or frightened by the belief that they have a serious illness, based on misinterpretation of physical symptoms
• The worry persists despite normal medical findings
• The person cannot acknowledge that their concern about their physical condition is excessive and irrational in most cases
• Avoidance of places or people out of fear of contracting diseases
• Intensive searching for information about symptoms and health conditions
• Conversations with others almost always revolve around health problems
• Heightened awareness of minor changes in bodily functions (headaches, sweating)
• Significant distress from the possibility of being ill

Treatment for Health Anxiety

Hypochondria is, at its core, an anxiety disorder -- with all that entails. And like other anxiety disorders, effective treatment exists that can significantly reduce symptoms and markedly improve quality of life.

Treating someone with hypochondria can be complex because the person clings to physical complaints and doesn't perceive the problem as psychological distress, so they have no desire to treat it as such. That's why the support of close, caring people is invaluable in helping the person decide to seek treatment.

Group Psychotherapy

Individual psychotherapy has been found less effective due to low willingness in the patient to explore their mental state. However, group psychotherapy can help. A group treatment setting provides support and social interaction, which helps relieve the ongoing stress and anxiety.

Medication

Medication has been found effective in cases where the person with hypochondria also has additional anxiety disorders or depression. The most common treatment involves anti-anxiety and antidepressant medications from the SSRI class.

CBT -- Cognitive Behavioral Therapy

CBT has been proven highly effective for treating hypochondria. This approach focuses on changing the behavioral and thought patterns of the person with health anxiety.

Research has shown that even six months to a year after short, focused CBT treatment, patients experienced significantly fewer symptoms of hypochondria, health anxiety, and somatic complaints, compared to control groups.

If health anxiety is controlling your life -- the constant checking, the doctor visits, the endless Googling -- you don't have to stay stuck. Our free mini-course uses proven CBT techniques to help you understand and manage anxious thought patterns, so you can start breaking the cycle today.