Is Health Anxiety (Hypochondria) Making You Sick?

Do you constantly worry about having a serious health issue. Do you frequently check your body for signs of illness, such as lumps, skin changes, numbness, tingling, irregular heart palpitations, or pain? Do you often call or see your primary doctor due to these concerns? Or, alternatively, do you avoid your doctor, afraid of what he or she might discover? If so, you may have a condition called health anxiety disorder. Patients with health anxiety will use health care services frequently, sometimes seeking treatment from multiple providers at once. However, they don’t often feel reassured and more commonly doubt that their medical care is adequate.

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Health anxiety can be debilitating—negatively impacting work, personal relationships, basic daily functioning, mental health, and even longevity. Actress/producer Tish Cyrus, mother of pop singer/songwriter Miley Cyrus, suffered for many years from health anxiety. In a segment of Scan My Brain with Dr. Daniel Amen, Cyrus opened up about her experience.

“I was just always worried about my health,” she says. “And that happened for a long time until my mom literally forced me to go see a doctor and get on some medication.”

Indeed, health anxiety can be managed by medication, different types of therapy, and actions that reduce anxiety. Here’s what you need to know about health anxiety and how to manage it.

WHAT IS HEALTH ANXIETY?

Health anxiety is a mental health condition that involves excessive worry about specific symptoms or fears that you are or may experience a serious illness. This condition was formerly known as hypochondriasis, or hypochondria. If you’ve ever expressed worry about a symptom, injury, or illness being something bigger or more serious than it actually was, you may have been called a “hypochondriac.” This casual term is dismissive and borders on disparaging. That’s one reason the diagnosis hypochondriasis was replaced with the two new, more specific diagnostic terms:

• Somatic symptom disorder (SSD) affects about 5% to 7% of the population.
• Illness anxiety disorder (IAD) affects roughly .1% of people.

The terms hypochondria and hypochondria symptoms may still be used, but not diagnostically. They are both forms of health anxiety.

WHAT IS SOMATIC SYMPTOM DISORDER?

SSD involves one or more chronic somatic (bodily) symptoms that cause excessive concern, preoccupation, or fear. This can lead to significant distress and trouble functioning in daily life. Usually, one symptom remains constant, but other symptoms may come and go. People with SSD feel concerned that their mild symptoms (such as minor pains, weakness, shortness of breath, etc.) are signs of serious conditions. Patients with SSD will use health care services frequently, sometimes seeking treatment from multiple providers at once. However, they don’t often feel reassured and more commonly doubt that their medical care is adequate. These individuals can spend exorbitant amounts of time and energy dealing with health worries. Sometimes they may be unusually sensitive to drug side effects. They may become demanding or dependent on others for help and emotional support. And they may feel angry when they feel unsupported.

WHAT IS ILLNESS ANXIETY DISORDER?

IAD is a mental health disorder characterized by excessive worry about having or developing a debilitating life-threatening illness, such as cancer, stroke, or heart disease. People with IAD may have no symptoms or only mild symptoms, which are not overly distressing. However, if an individual with IAD has a medical condition or an increased risk for developing a medical condition (due to family history), the anxiety surrounding the medical condition or potential medical condition is abnormally high. Even when physical examination and laboratory testing results are normal, people with IAD continue to have intense anxiety or fear of having or developing a serious medical issue. Their health anxiety symptoms may include repetitive behaviors related to their fears like compulsively checking their body for bumps or other signs of disease. For a clinical diagnosis of IAD, the preoccupation with illness must last for 6 months or longer and cannot be better explained by another mental health condition. Other signs of IAD may include:

• Worry about specific organs (such as the brain or heart) or a disease one has read or heard about.
• Avoiding people, places, or activities out of anxiety about health risks.
• Incessant talking about one’s health and possible illnesses.
• Frequently or compulsively searching the internet for causes of symptoms or possible illnesses.

• Compulsively checking for signs of illness, such as taking blood pressure or temperature.
• Anxious feelings around everyday healthy body functions like passing gas or perspiring.

Although it’s common for people with any type of health anxiety to see their doctors frequently, some individuals may be completely care avoidant. This may be due to fear that seeing a doctor will reveal a life-threatening illness.

THE NEGATIVE IMPACT OF UNTREATED HEALTH ANXIETY

Untreated health anxiety can impact an individual in profoundly destructive ways. As mentioned, it can significantly interfere with a patient’s personal life and relationships, as well as normal functioning in their daily life. It can also cause severe psychological disability, according to the latest research. People with health anxiety are at greater risk of other psychiatric disorders, such as:

• Major depressive disorder
• Alcohol or substance abuse disorders
• Other anxiety disorders
• Personality disorders

But there’s more. A 2023 Swedish study has found that people with illness anxiety disorder tend to die earlier than individuals who don’t obsess about their health. People with IAD die at a mean age of 70 while those without the condition pass away at a mean age of 75. In this study, having health anxiety was linked to increased risk of death from both natural and unnatural causes, such as suicide. Data from this study indicate that those with IAD are four times more likely to die by suicide compared to the general population. In short, one’s overall quality of life—and even longevity—can be dramatically decreased.

WHAT CAUSES HEALTH ANXIETY?

Experts are not entirely clear about what causes health anxiety, but there are a number of factors associated with SSD and IAD. Contributing factors may include:

• Physical or sexual abuse in childhood
• Poor emotional awareness or emotional development in childhood (often from parental neglect or lack of closeness)

• Having a poor understanding of body sensations, diseases, or both
• Having a difficult time tolerating uncertainty over unusual or uncomfortable body sensations
• Having a family member or members who worried excessively about their health or your health
• Having had a serious illness in childhood or a parent with a serious health issue
• Having a tendency to worry in general
• A stressful event or situation

For Cyrus, a few of these causes likely played a role in her health anxiety. While growing up, she was faced with the traumatic experience of slowly losing her father to throat cancer.

“Between 7 and 19, I saw a lot. He had his voice box removed, and he couldn’t talk for a year and a half before he died,” she says. “And he was also diabetic.”

Although medication initially helped with her symptoms, its effectiveness diminished over time. Her health anxiety resurfaced after a number of stressful life circumstances occurred, including the passing of her mother.

“I always knew when something happened to my mom, it would probably be the hardest day of my life,” she says.

She eventually visited Amen Clinics for help. As part of her evaluation, Cyrus underwent brain SPECT imaging, which measures blood flow and activity in the brain. Her SPECT scan revealed overactivity in the region of the brain known to control anxiety and body sensations. This may, in part, explain her health anxiety.

11 WAYS TO MANAGE HEALTH ANXIETY

If you believe you may have health anxiety, it’s important to reach out to a mental health professional for an evaluation. Here are 11 ways to manage health anxiety: 

1. Consider psychotherapy, especially cognitive behavioral therapy (CBT).
2. Talk to your doctor about antidepressant medication, such as SSRIs and SNRIs, which have been shown to help the condition in research.
3. Get tested (and treated if tests are positive) for hypoglycemia, anemia, and hyperthyroidism, which are associated with increased anxiety.
4. Try prayer, meditation, and hypnosis, which are associated with stress and anxiety reduction.
5. Practice diaphragmatic breathing, which may reduce anxiety.
6. Learn to eliminate automatic negative thoughts (ANTS).
7. Practice calming exercises such as yoga, qi gong, or tai chi.
8. Take calming nutritional supplements such as l-theanine, GABA, and magnesium (glycinate, citrate, or malate) with vitamin B6.
9. Take probiotics. Gut health is important to keeping stress and anxiety levels low.
10. Try neurofeedback which can alleviate anxiety, according to research.
11. Consider eye movement desensitization and reprocessing (EMDR), which involves moving the eyes in a specific way. EMDR has been shown to be an effective trauma therapy in You can watch Tish Cyrus engage in EMDR with Dr. Amen in this video segment.

By putting one or more of these strategies into practice, you will be better able to get health anxiety under control. This can be beneficial in your daily life and can help you achieve a greater sense of calm and happiness. Healthy anxiety and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 855-508-1316 or visit our contact page here.