How To Recognize Illness Anxiety Disorder
Illness anxiety disorder or IAD generally involves anxious feelings regarding potential illnesses or diagnoses. It may be accompanied by a variety of mental and physical anxiety symptoms, such as hypervigilance regarding health, an unrealistic fear of medical assistance, intense overwhelm regarding past illnesses, and even headaches, stomach discomfort, and other potentially psychosomatic symptoms. In general, it can be helpful to see a doctor to rule out any possible physical illnesses. Therapy is generally viewed as the best way to treat IAD, and cognitive behavioral therapy is often particularly effective. You can start cognitive behavioral therapy by seeking out a licensed therapist in your area or by connecting with one through an online therapy platform.
Illness anxiety disorder can be defined as a condition in which patients may experience anxious feelings or behaviors about their potential to become ill. The condition may or may not accompany physical or psychosomatic symptoms, and it may be unrelated to any previously diagnosed physical condition (if any).
When experiencing illness anxiety disorder, patients may experience physical effects of anxiety, including chest tightening, pain, shortness of breath, and dizziness. They may also experience other forms of anxiety disorder manifestations, potentially including dissociation, feelings of overwhelm, or emotional responses.
Illness anxiety disorder typically develops during early adulthood, though it may also arise during childhood, adolescence, or later adulthood. The condition can significantly impact well-being and affect social and occupational functioning, among other complications. Illness anxiety disorder was previously named in the DSM-5 as hypochondriasis, which is generally classified as a form of anxiety disorder. While the name of the condition has changed, the IAD is typically still classified as an anxiety disorder.
The feelings and symptoms that you experience may differ in severity and manifestation due to various contributing factors, which can include a family history of IAD or anxiety disorders, the presence or lack of resources for the management of your anxiety disorder symptoms, prescribed medications, and previous procedures or prognoses.
In general, illness anxiety disorder is clinically different from somatic symptom disorder. An individual with IAD may experience concern and cyclical thinking about a potential for illness or for a specific diagnosis. They may or may not experience physical symptoms of illness.
Somatic symptom disorder (SSD), while often similar to IAD, is typically classified as a condition in which you may experience a range of physical symptoms alongside anxious thoughts or behaviors. Symptoms or feelings of anxiety in this condition may or may not be tied to the potential for illness or a specific diagnosis.
Several symptoms may be commonly associated with IAD. Mayo Clinic notes that those who live with IAD may experience the following:
- Anxious thoughts about contracting an illness, with or without a history of diagnosis
- Mild physical symptoms, or no symptoms at all
- Concern that normal bodily functions are signs of illnesses
- Significant symptoms of anxiety or anxious thoughts about any current diagnoses, even if the illness or condition has been previously managed
- Consistently seeking reassurance from professionals, including utilizing testing facilities, specialist referrals, and imaging exams
- Feelings of hypervigilance about your health, physical sensations, or experiences with illness and injury
- Feelings of avoidance or fear about medical assistance regarding a potential diagnosis or to address symptoms
- Feelings of anxiety about serious illness that aren’t a part of a previously diagnosed mental disorder, like generalized anxiety disorder or obsessive-compulsive disorder (OCD)
- Feelings of self-pity or intense overwhelm regarding past illnesses that have since resolved
If you suspect you have illness anxiety disorder, you may choose to seek a formal diagnosis from a psychiatrist. You may be asked to complete a medical interview to rule out any undiagnosed medical condition and to find out if you meet the DSM-5 criteria for illness anxiety disorder.
Your psychiatrist may also choose to speak to you about your history, potentially including topics about your family history and personal health habits. You may also be asked about symptoms you’re experiencing, any previous diagnoses in your medical history, potential stressors in your life, and your overall lifestyle.
A psychiatrist is generally educated and trained as a medical doctor. They may make preliminary diagnoses based on your clinical presentation and interview, which may further assist you in determining the next right step in your health journey. If there is concern or supposition of another underlying cause to your symptoms, they may choose to recommend supplementary appointments, further medical evaluation, or diagnostic support with other professionals in your care team.
For a mental health professional to diagnose illness anxiety disorder, according to the DSM-5, an individual must experience persistent fear regarding the presence of a severe illness for a period of six months, despite having minimal somatic symptoms. If an illness exists—or the individual is at high risk of developing one—their concerns must be disproportionate to the danger posed. Elevated anxiety must be present, evidenced by avoidant behavior (e.g., declining to seek care) or extreme wellness-related actions (e.g., regularly checking for the presence of a physical symptom).
Though emotional distress and impairments to social and occupational functioning were criteria under the DSM-4, they are no longer required for a diagnosis. There are two potential specifiers that can be used: care-seeking type and care-avoidant type. Someone with care-seeking type IAD may frequently visit health care providers and otherwise utilize the medical system, while someone with care-avoidant type may avoid doctor’s appointments and similar forms of care.
If your primary doctor or psychiatrist diagnoses you with illness anxiety disorder, you might consider seeking professional treatment to enhance your quality of life. The primary methods of treatment used to manage illness anxiety disorder symptoms are therapy and medication. Though treatment experiences can range for many, courses of treatment often focus on shifting attitudes and thought processes around anxious thoughts or triggers, and they may provide you with additional resources to help you thrive.
Cognitive behavioral therapy
An empirically supported treatment method for anxiety disorders is cognitive behavioral therapy (CBT), which can support patients in realigning their thought processes around mental wellness and anxious thought patterns.
For many, one of the main goals of cognitive behavioral therapy is usually to identify unhelpful thoughts and replace them with more helpful thoughts. Experiences with anxiety may stem from unconscious or turbulent reactions to events, which can further perpetuate the cycle.
Cognitive behavioral therapists can identify this in patients and may offer support through CBT techniques, such as thought evaluation and mental wellness problem-solving skills.
Other types of therapy
CBT may not be the only way to address illness anxiety disorder. Your cognitive behavioral therapist may also recommend other types of therapy or therapeutic techniques to help you find success on your healing journey. These may include:
Medication
Pharmacological solutions are considered secondary treatments for illness anxiety disorder, after therapy. Antidepressants, like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), may be used to minimize the disorder’s impacts on daily life. These medications can alleviate the symptoms of IAD and underlying anxiety disorders or comorbid conditions. Always seek advice from your primary care provider or another professional prior to starting or stopping any medication.
How online therapy can help
Online therapy may be a preferable solution if you’re experiencing difficulty or inconvenience leaving the home. Additional benefits of online therapy may include more flexible therapist messaging options and the ability to hold sessions in a familiar space, such as your home or office space.
Online therapy can be effective in managing anxiety disorders in many patients, and it has generally become a common course of treatment for many patients looking for flexible therapy options. A recent systematic review of online CBT showed that many patients in the test group found significant improvement in their health outcomes, which may suggest that online therapy can be a strong choice for those looking for alternative therapeutic solutions.
If you think mental health disorders may be affecting your life, contact a therapist or mental health specialist who can treat illness anxiety disorder.
Takeaway
Mental disorders like illness anxiety disorder typically won’t resolve on their own, which is why seeking professional treatment is recommended. Treatment usually consists of some form of therapy, such as cognitive behavioral therapy, to help an individual learn to question and shift distorted thoughts associated with the disorder and/or any other anxiety disorders that may be co-occurring. Medication may also be recommended in some cases to help ease common symptoms, such as debilitating fears or anxious thoughts related to fearing one has a life-threatening illness.
The goals of treatment are generally to avoid complications of illness anxiety disorder—such as getting unnecessary medical tests from primary care providers or specialists and racking up medical bills from unnecessary medical care—and allow the person to improve their daily functioning and overall well-being.
Someone with illness anxiety disorder may experience physical symptoms of anxiety as a result of their fears, which can further fuel fears about their health status, such as that they may have a serious medical condition or serious disease. Anxiety-related symptoms like stomach aches, rapid heartbeat, dizziness, muscle tension, pressure in the chest, and tingling in the extremities could all be experienced by someone with an anxiety disorder like illness anxiety disorder.
According to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), illness anxiety disorder is classified as a mental illness in the category of “Somatic Symptom and Related Disorder.” Diagnosis criteria in the statistical manual include the existence of illness preoccupation for six months or more, excessive health-checking behaviors, and related avoidance behaviors.
As the American Psychiatric Association notes, this disorder differs from somatic symptom disorder in that the individual typically does not experience physical sensations or symptoms of any specific illness aside from those caused by the experience of the anxiety itself.
A person with illness anxiety disorder or a tendency toward health-related anxiety in general may experience symptoms (or more severe symptoms) as a result of certain triggers. Stress, for example, could cause them to be more likely to interpret normal body sensations as warning signs of an illness. Having a loved one diagnosed with a serious illness and spending large amounts of time researching health conditions online are two other situations that could also trigger increased health anxiety.
What trauma causes hypochondria?
The causes of illness anxiety disorder, formerly known as hypochondriasis, aren’t well understood, but it is thought that past trauma could represent a risk factor for developing it. Someone who experienced neglect or abuse in childhood, for instance, may be at higher risk of this type of disorder, as may someone whose parent or caregiver was diagnosed with a serious illness when they were young or who experienced a serious childhood illness themselves.
If you or someone you know is experiencing abuse in any form, you can contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233) for immediate support, advice, and assistance.
Health-related anxiety of all types is considered to be treatable. Treatment typically takes the form of therapy, sometimes in combination with medication.
According to a review of research on the topic, “pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus” and the prefrontal cortex. It also notes, however, that it may be possible to reverse some of this damage through interventions like therapy and medication.
Anxiety can manifest as physical symptoms that may vary based on the individual and the intensity of their anxious feelings. Some examples include headache, stomachache, dizziness, muscle tension, sweating, trembling, and a racing heartbeat.
The first-line treatment for illness anxiety disorder is psychotherapy, typically cognitive behavioral therapy. The second is medication, typically some type of antidepressant like an SSRI. Speak to your doctor or psychiatrist before stopping, starting, or changing any medication.
Therapy is currently considered to be the first-line treatment for many mental disorders, symptoms, and challenges, including health anxiety. Cognitive behavioral therapy (CBT) is one of the most common types. It aims to help clients learn how to recognize and shift distorted thought patterns that may be causing or contributing to distress.
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