What is health anxiety disorder and how can it be managed?

Health anxiety disorder is a mental health condition where an individual experiences persistent and excessive worry about their health that goes beyond typical self-awareness, interfering with daily life, relationships, and overall wellbeing.

Dr Catherine Sykes, highly-regarded chartered psychologist, explores what health anxiety disorder is, its symptoms, causes, and progression, as well as how it is diagnosed and treated.

What is health anxiety disorder?

Health anxiety disorder, also known as illness anxiety disorder or hypochondriasis, is a mental health condition characterised by persistent fears of having or developing a serious illness. These fears are often disproportionate and persistent despite reassurance from healthcare professionals and negative test results.

Symptoms can manifest both emotionally and physically. People with this condition often experience intrusive thoughts about their health, compulsive behaviours such as repeatedly checking their body for signs of illness, and difficulty focusing on anything other than their health concerns. In some cases, people may also experience tension headaches or stomach pain caused by the stress and anxiety.

What causes health anxiety disorder?

The exact causes of health anxiety disorder remain unclear, but it’s believed to result from a combination of psychological, environmental, and biological factors.

A history of illness - either personal or in a loved one - can leave a lasting psychological impact and heighten sensitivity to health concerns. Additionally, personality traits such as a tendency towards perfectionism or a predisposition to anxiety can increase the likelihood of health anxiety disorder.

Access to health information online can also amplify these fears, leading to "cyberchondria," where excessive symptom-checking on the Internet fuels anxiety and creates a fixation on worst-case scenarios.

Furthermore, health anxiety disorder often co-occurs with other mental health conditions, including generalised anxiety disorder, obsessive-compulsive disorder, and depression. This overlap can compound the symptoms of health anxiety disorder and make diagnosis and treatment more complex.

Can health anxiety disorder worsen over time?

Yes, health anxiety disorder can worsen if left untreated. Over time, the persistent worry and focus on health concerns can escalate into avoidance behaviours, such as avoiding medical appointments out of fear of receiving a diagnosis or refraining from social activities associated with illness risk, creating a vicious cycle that perpetuates anxiety.

Chronic stress caused by ongoing anxiety can also contribute to physical health problems, including tension headaches, hypertension, or gastrointestinal issues. Without intervention, the disorder can then start to significantly impact quality of life and interfere with relationships, further isolating people with this condition and exacerbating their symptoms.

How is health anxiety disorder clinically diagnosed?

Health anxiety disorder is diagnosed by a qualified mental health professional, such as a psychologist. The diagnostic process typically involves a comprehensive mental health assessment of the patient's medical history, psychological symptoms, and behavioural patterns. To rule out any underlying medical conditions, the psychologist may order specific diagnostic tests as well.

Health anxiety disorder is clinically diagnosed when an individual's health-related anxiety persists for six months or more and causes significant distress or impairment in daily functioning. Psychologists also assess whether the anxiety is disproportionate to the actual risk of illness and whether it involves behaviours such as excessive checking or avoidance of health-related situations.

What psychological techniques are effective for health anxiety disorder?

Cognitive behavioural therapy (CBT) is the most widely used approach for health anxiety disorder and has been proven effective, helping patients identify and challenge negative thought patterns related to their health, such as catastrophic thinking, and replacing them with more balanced perspectives. Through CBT, patients can also learn to gradually confront feared situations about their health, reducing their reliance on reassurance-seeking behaviours.

Mindfulness is also another effective technique that focuses on cultivating awareness of the present moment, helping patients reduce rumination on health fears and providing relief from intrusive thoughts about future illnesses or worst-case scenarios.

In some cases, exposure therapy may be used to address avoidance behaviours. This therapy involves gradually exposing patients to feared stimuli, such as attending a medical appointment, in a controlled and supportive manner. Over time, exposure therapy can reduce the patient's anxiety triggers associated with such experiences.

For patients with severe symptoms or co-occurring conditions, medication such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed alongside therapy. Medication can help alleviate the underlying anxiety, making therapy more effective.

If you or a loved one is struggling with persistent health concerns, reaching out to a mental health professional is the first step toward recovery. Health anxiety disorder is manageable, and with the right treatment plan, you can regain control of your thoughts and lead a fulfilling life.

If you would like to book an appointment with Dr Catherine Sykes, head on over to her Top Doctors profile today.