Health anxiety: Is it possible to worry too much about health?

Health anxiety is a condition that may cause people to think they are sick despite minor or no symptoms. Fears of a severe illness can interfere with their daily lives, whether they’re spending their time consumed with worry or going to appointments at multiple doctor’s offices for extensive testing.

Being concerned about your health is one thing, but can you worry too much? Read on to learn more about what distinguishes health anxiety from general health concerns and what you can do if your health worries affect your life.

What is health anxiety?

There’s a difference between health anxiety and being concerned about health. People concerned about new or worsening symptoms or conditions from the past do not necessarily have health anxiety. 

Other symptoms or behaviors people with this type of anxiety may experience include:

• Spending hours researching health information online
• Reading a news story about a disease or condition and then worrying that they have it
• Thinking something is wrong with their health after medical tests appear “normal”
• Misinterpreting or attributing specific physical symptoms to something serious

People with this condition also experience common signs and symptoms of anxiety, which can heighten their worries about their health. These symptoms can include: 

• Being easily fatigued, often due to sleep trouble 
• Having difficulty concentrating
• Having headaches, stomach aches, muscle aches, chest pains, or other unexplained pain
• Experiencing stress responses like sweating or racing heart
• Feeling tingling or trembling sensations

Somatic symptom disorder and illness anxiety disorder

Two conditions are similar to health anxiety: somatic symptom disorder and illness anxiety disorder.

Somatic symptom disorder (SSD) occurs when someone experiences physical symptoms like pain, shortness of breath, or weakness to the point that it causes challenges in daily functioning. These symptoms are real. The person does experience them and believes they are sick, but a physical cause of the symptoms can’t be found.

Someone may receive an SSD diagnosis when their behaviors, thoughts, and feelings are disproportionate to their symptoms. 

They may see a primary care physician rather than a mental health professional and may have difficulty understanding when the doctor tells them that they are too concerned about their symptoms despite medical testing showing that they do not have a serious illness.

Illness anxiety disorder (IAD) used to be called hypochondriasis, a psychiatric disorder that causes excessive worry about having or developing a medical condition. People with IAD may constantly worry about getting sick despite having a clear physical exam and lab tests. They may focus on typical body functions, like sweating or digestion, and interpret them as symptoms or believe their doctors were incompetent for not finding anything wrong. 

People with this condition may seek care from medical doctors who may speculate that they have IAD when they continue to have anxiety about and a preoccupation with illness. The most significant difference between someone with IAD and someone with SSD may be that those with IAD often do not have somatic symptoms. If they do, they are mild, and the anxiety the person experiences may be disproportionate to their symptoms.

Prevalence and risk factors for health anxiety

Having health anxiety can cause someone to feel alone and like no one understands what they’re going through. They may feel embarrassed to share their experiences without medical assessments or diagnoses to support their feelings. They may wonder, “How common is health anxiety?”

Health anxiety may be relatively common, particularly in the wake of the COVID-19 pandemic, which was associated with greater awareness of one’s physical symptoms and those of others around them. 

Approximately 4-5% of people experience health anxiety, though the condition may frequently go undiagnosed. In reality, up to 10% of the population could experience health anxiety at some point.

It can be common for people with health anxiety to have co-occurring mental health conditions, such as another form of anxiety, depression, or post-traumatic stress disorder (PTSD). SSD risk factors include a history of a personality disorder, a disorganized lifestyle, childhood neglect, sexual abuse, or a history of substance use.

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There may be an increased risk of developing IAD if the person experienced a serious illness during childhood or if their parents or siblings had a major medical condition. People with underlying anxiety disorders or who spend much time researching health-related information online may also be more likely to develop IAD.

Treating health anxiety and related disorders

Treatment for health anxiety depends on the symptoms the person may be experiencing. People with SSD may have difficulty accepting that their medical doctor cannot diagnose or treat their symptoms. And they may be unwilling to talk to a mental health professional because they’re convinced they have a physical illness. 

It can benefit the person if their medical doctor works with a mental health professional to continue monitoring the physical symptoms and help them cope with their frustration about not receiving a precise diagnosis. Treatment from a mental health professional can help reduce symptoms, improving their quality of life. 

For IAD, treatment primarily focuses on helping people cope with their anxiety. Psychotherapy with a mental health expert can help and cognitive behavioral therapy (CBT) may be the first-line treatment, which focuses on assisting people to reframe their thoughts into empowered versions of previously disempowered patterns.

According to the Anxiety and Depression Association, CBT can be a highly effective, long-lasting, well-established treatment. It may also be an effective treatment for health anxiety. 

CBT can help people learn other ways to interpret the signals they are getting from their bodies, cope with their anxiety, and stop looking for signs of illness. These things can help someone with this type of anxiety improve their functioning at work, school, or home.

Online treatment can help

If you’re experiencing health anxiety, talking to an online therapist can help. Most people who complete the initial questionnaire on BetterHelp, for example, are matched with a qualified, vetted professional within 48 hours of signing up so they can start treatment as soon as possible. 

With online treatment, you attend therapy sessions from the comfort of your home, or anywhere you have an internet connection, which can allow many the opportunity to prioritize their mental health. With BetterHelp, you can choose the communication format that feels most comfortable, such as video, voice chat, or text messages. 

Research shows that online CBT can be effective at treating health anxiety. One review of 19 studies found no significant difference between face-to-face and internet-delivered treatment for health anxiety.