We’ve all heard about how mental illness can often be stigmatised.
However, it’s one thing to know something and another to grasp the reality of someone else’s suffering.
Even with all the advancements of the modern world, our collective understanding of mental health may still have some way to go.
Of course, some mental health conditions have become more widely accepted and openly talked about than others, such as depression, anxiety, and in more recent years, borderline personality disorder.
However, there are still many disorders such as substance abuse, narcissistic personality disorder, and health anxiety that remain highly stigmatised, with sufferers often feeling judged and misunderstood. They also receive much less compassion, understanding, and support from their loved ones, peers, and sometimes even the medical community.
Health anxiety sufferers know this reality all too well.
These individuals are often the butt of many jokes and may be labelled ‘hypochondriacs’, ‘fakers’, ‘attention seekers’, ‘drama queens’, and ‘time wasters’.
Yet, they live in constant, crippling fear that they have or will, in the future, contract a severe physical illness that will eventually take them away from their families and loved ones.
Health anxiety can be so debilitating that it interferes with a person’s functioning.
Sufferers can find it challenging to eat, sleep or socialise due to the insurmountable worry that whatever symptoms they are experiencing (real or imagined) may indicate something sinister like cancer, AIDS, multiple sclerosis, or meningitis.
According to the latest research, approximately 9% of the broader population has experienced health anxiety.
However, many people with the condition may not seek support and treatment due to the shame and fear of being judged or ridiculed by those around them.
Some may even worry they will be shunned by medical practitioners or dismissed as a ‘time waster’ or ‘hypochondriac’.
These terms are profoundly unhelpful and can hinder a person’s recovery or spiral them further into isolation.
This article explores why health anxiety isn’t discussed as much as it should be and will outline some common symptoms along with treatments that can help.
What is health anxiety?
Health anxiety is an irrational and obsessive fear about having a severe medical condition. It is also called illness anxiety disorder and was formerly called hypochondriasis. (Health Anxiety (Hypochondria), Healthline, Erica Cirino, 29 September 2018.)
We all tend to worry about our health from time to time. When we experience physical symptoms, it makes sense to feel concerned, and this worry may prompt us to make an appointment to see our doctor or health physician.
This is all just good sense. Being ignorant about one’s health or ignoring physical symptoms is never a good idea, particularly when symptoms worsen or crop up out of nowhere.
A thorough medical check-up with a healthcare professional can rule out any underlying conditions that may be causing your symptoms and may quash something before it becomes more serious.
However, there is a marked difference between taking precautions over your health and having the constant belief that a life-threatening illness or disease is causing your symptoms.
Health worries often consume health anxiety sufferers, and this distress can be disabling.
With health anxiety, individuals feel extreme concern about their real or imagined symptoms even after medical test results come back negative and doctors reassure them that they’re perfectly healthy. (Health Anxiety (Hypochondria), Healthline, Erica Cirino, 29 September 2018.)
Health anxiety can erode a person’s quality of life, sucking the joy out of experiences that were once fulfilling, exciting, and meaningful.
During a health anxious episode, the individual may feel like a dark cloud is hovering permanently above them, the world may seem daunting and colourless, and the sense of isolation and loneliness can be crushing.
Health anxiety is a lonely experience
Many people with health anxiety often do not feel understood by those around them, spiralling individuals further into hopelessness and despair.
One woman described her experiences with health anxiety, saying, “You feel really alone in it… At first, I wouldn’t recognise any of it as health anxiety; I’d believed in it fully. But even when you know yourself, you still have all these feelings. I couldn’t turn it off.”
Health anxiety can create feelings of isolation and potentially interfere with an individual’s quality of life, including their ability to function daily, maintain meaningful relationships, and work in a professional or academic setting. (Health Anxiety (Hypochondria), Healthline, Erica Cirino, 29 September 2018.)
Why health anxiety isn’t talked about enough
There are various reasons why health anxiety may not be discussed as openly as many other mental illnesses.
Let’s explore these reasons further.
1. Stigmatisation
Sometimes called the ‘well worried’, individuals with health anxiety often receive a bad rap from those who do not take the time to understand the deeper mechanics that underlie the disorder.
This lack of understanding may go back to historical roots, where health anxiety was previously called ‘hypochondriasis’ and not really taken seriously.
As time passed, this label spread across various cultures and communities, and the familiar insult, “You’re just being a hypochondriac”, emerged into broader society.
Unfortunately, the stigma associated with this term has meant that health anxiety as a disorder is frequently ignored, brushed aside, or treated as a personality trait rather than the reality of its debilitating symptoms. (Improving our understanding of health anxiety, Counselling Directory, Michael Swift, Integrative Psychotherapist, 19 July 2021.)
2. Shame and embarrassment
For many health anxiety sufferers, a cough isn’t just a cough. It’s a death sentence. Innocuous symptoms are a drumroll of death, and no diagnostic reassurance can convince sufferers otherwise. (Hypochondria: The Impossible Illness, Psychology Today, Jeff Pearlman, January 2010.)
When your stomach cramps have lingered on for four days, and it’s all your family can do but respond to your health concerns with a series of eye rolls or resigned sighs; when all you can feel is uncontrollable fear and anxiety that your life is about to end due to a killer stomach bug or fatal disease – this experience can induce much shame and embarrassment on top of the primary concerns. You may wonder:
Why isn’t anyone else as worried about my symptoms as I am?
Why are these stomach cramps getting worse?
What if it’s cancer?
Why do I feel so alone and scared?
A visit to the doctor can be just as frustrating as the following scenario illustrates:
Doctor: “You’re fine. It’s just a bit of indigestion. It’ll probably clear up in a few days.”
Health anxiety sufferer: “But the pain has been there for four days already and seems to be worsening. Do you think it could be something more serious?”
Doctor: “It’s unlikely to be anything serious. These things are usually related to wind or indigestion. I’ll prescribe some medication, and that should clear things up.”
Health anxiety sufferer: “But I’m really worried. Could it be appendicitis? Or cancer?”
Doctor: “It’s unlikely. But if you think your symptoms are worsening in a few days, call the surgery again, and I’ll reevaluate.”
Health anxiety sufferer: “So, it’s nothing serious?”
Doctor: “It’s unlikely, but we can never be 100% sure. As I’ve already said, if your symptoms worsen, book another appointment, and we can investigate further.”
At this point, the individual feels rushed and may leave the doctor’s office feeling mildly reassured, albeit profoundly embarrassed and ashamed to have wasted the doctor’s time.
On the way home from the doctor’s office, the dreaded sentence circles around the individual’s mind, “It’s unlikely to be anything serious, but we can never be 100% sure.“
The latter part of that sentence keeps the person with health anxiety awake at night, robbing them of their appetite, concentration, and focus, silencing them into more shame and embarrassment.
These feelings can result in a person not wanting to discuss their health anxiety issues, particularly with those closest to them. They may not want to worry others or don’t want to experience more shame or relational pain.
For many, avoiding bringing up their struggles and talking about their health anxiety feels like the easiest option, as doing so can either make the anxiety worse or add to the shame and embarrassment they may already be experiencing.
3. Individuals don’t always talk about their health anxiety out of fear their worries may come true
People with health anxiety don’t often talk about their health anxiety out of fear that whatever illness or disease they dread may actually come to fruition.
Loved ones who are not health anxiety savvy may unintentionally exacerbate the situation by saying things like, “You should get that mole checked out as soon as possible,” or “You look pale. Have you lost weight recently?”
If someone comments negatively about your weight or physical appearance, you may take this as a testament that you are sick. All your worst fears are compounded, and it’s all you can do but paste a smile on your face and head to the nearest bathroom to check your body for symptoms.
These innocuous statements can spiral someone with health anxiety into a full-blown episode – where they may silently obsess over symptoms and search the internet for illnesses that match how they look and/or feel.
However, many health anxiety sufferers won’t share their fears with others and will actively avoid seeking reassurance or visiting a health professional, as they are too scared of the answers or diagnosis they might receive.
4. Health anxiety is a relatively unknown condition compared to other mental illnesses
Finding helpful information on health anxiety takes some digging around on the internet.
This is not to say there is no information or insights on health anxiety, just that other anxiety disorders, such as generalised anxiety disorder or social anxiety, often take precedence.
Fortunately, compared to decades ago, resources on health anxiety have drastically improved. Sufferers who grew up pre-millennia may have endured insurmountable worry over their health compared to today’s generation.
However, even with all the technological advancements, health anxiety sufferers are still more likely to stumble across social media posts about social anxiety or GAD on their newsfeeds than illness anxiety disorder or health anxiety.
Health anxiety is a condition that silently circles within individuals, communities, and cultures. Information is more readily available, but the stigma remains, which often presents a double-edged sword, particularly when talking about the disorder and/or seeking treatment.
Due to the lack of awareness around health anxiety (compared to other mental health disorders), individuals with the condition may avoid discussing their anxiety struggles with their loved ones, friends, and peers due to fear of being judged, laughed at, or dismissed.
They may also feel guilty about constantly worrying about their health, and concerned that others will think them selfish for spending so much time preoccupied with their health, when appearing to be perfectly fine.
However, by not sharing their experience of health anxiety and avoiding seeking treatment and support, the disorder remains relatively unknown, under-researched and underfunded compared to other mental health issues.
Risk factors for developing health anxiety
Like any mental illness, health anxiety can have many causes and these will vary from person to person, depending on an individual’s medical, family, and life history.
However, researchers have noted some factors that may put someone at higher risk of developing health anxiety.
These include:
- A family history of health anxiety or other mental health conditions.
- Having a severe illness during childhood or exposure to a loved one’s serious illness. These experiences may cause you to fear any physical sensations or symptoms in your body as an adult.
- Having a limited understanding of diseases and body sensations. This lack of knowledge may mean you misinterpret your body’s sensations, which can lead to health anxiety developing.
- Traumatic experiences such as experiencing trauma in your childhood (childhood abuse, household dysfunction, etc.).
- Hormonal changes – studies have shown that many women experience health anxiety as part of menopause (and perimenopause). Anxiety can be a hallmark symptom of menopause, and specific types of anxiety are common during this phase of a woman’s life. The symptoms experienced during menopause, such as hot flashes, palpitations and joint pain, can induce health anxiety, where a person may start to believe their menopause symptoms indicate something more sinister. It’s also common for women to experience existential dread during menopause, where their mortality becomes more of a focus, which may cause them to worry more about their health (and the health of their loved ones).
Diagnostic criteria for health anxiety
According to the latest research, health anxiety is no longer included in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders. (Health Anxiety (Hypochondria), Healthline, Erica Cirino, 29 September 2018.)
Individuals who may have been diagnosed with health anxiety or hypochondriasis in the past are now classified as having:
- Somatic symptom disorder – involves an individual having symptoms that cause distress (or multiple symptoms).
- Illness anxiety disorder – includes a person having no physical symptoms or only mild symptoms but still worrying excessively that they may be seriously ill.
Your doctor will likely perform various examinations and tests to rule out any serious physical health conditions.
Once you get a clean bill of health, they will likely refer you to a mental health professional for treatment for your anxiety.
Symptoms of health anxiety
Symptoms of health anxiety vary from person to person. However, typically, individuals with health anxiety present with the following symptoms:
- Not having any physical symptoms or only having symptoms that are very mild, but still worrying excessively that they’re seriously ill.
- Excessive anxiety and preoccupation about an existing medical condition or a family history of a specific medical condition.
- Preoccupation about having or contracting a severe medical condition.
- Checking for symptoms and performing unreasonable health-related behaviours, such as checking or screening your body for disease.
- Avoiding doctor appointments out of fear that you’ll be diagnosed with a severe illness.
- Obsessively checking for disease symptoms online or completely avoiding all reminders of sickness and disease.
- Seeking reassurance about your symptoms from family members, loved ones, and healthcare professionals. Any comfort you receive from others may not work or only last temporarily, and your worries may come back with a vengeance.
- Repeatedly requesting scans, blood tests, and other medical examinations to rule out your worst fears about having a severe illness.
- Inability to concentrate on work, social activities, or other vital areas of your life due to excessive worry about your health.
- Mistrust towards doctors and believing your doctor may have missed something crucial or misdiagnosed you as being healthy.
- Experiencing problems in your interpersonal relationships due to excessive preoccupation with your health.
- Missing time off work due to your health concerns.
Treatment options for health anxiety
Health anxiety can be debilitating, but fortunately, various treatment options are available.
Treatment for health anxiety usually involves reducing and improving your symptoms and daily functioning.
The most common treatments for health anxiety include a combination of psychotherapy (such as cognitive behavioural therapy) and medication.
Cognitive behavioural therapy
The most popular treatment for health anxiety is cognitive behavioural therapy (CBT).
This therapy is the most effective as it helps individuals understand and better manage their condition. CBT often occurs through individual (one-to-one) therapy but can also be facilitated in a group setting.
CBT helps those with health anxiety in the following ways:
- It helps raise awareness of how your worries may affect you and your behaviour.
- It allows you to respond to and interpret body symptoms and sensations differently.
- It teaches you to refrain from examining your body for symptoms or signs of illness and avoid seeking reassurance from others, as this only worsens your anxiety in the long run.
- It helps you to identify your health worries and concerns, allowing you to get curious about your health anxiety instead of feeling anxious or afraid of it.
- It teaches you how to look at bodily sensations in a different way by changing unhelpful thoughts.
- It teaches you to stop avoiding situations or activities because of physical symptoms or sensations.
- It helps to improve your daily functioning, including your work, home, and personal relationships.
Other treatments
Research shows that treatments such as exposure therapy and behavioural stress management are also effective for health anxiety.
Moreover, doctors may recommend specific medication and other treatments for those with severe health anxiety to help them manage their condition.
Finding recovery at Centres for Health and Healing
Centres for Health and Healing provide personalised addiction and mental health treatment to clients in Toronto and surrounding areas.
Whatever issues an individual might face, our personalised approach to treatment aims to treat the ‘whole’ person, not just their symptoms, giving people the best chance at lasting recovery.
We treat various mental health conditions, including substance addiction, depression, and anxiety disorders, to name a few.
Our experienced team of professionals come from a variety of backgrounds and experiences and provide a warm, compassionate space for individuals to begin their journey to lasting healing and well-being.
Worrying about your health from time to time is normal, particularly when you have symptoms that may require further investigation by a doctor.
However, if your worries are persistent and last for six months or more, you may be experiencing health anxiety and require treatment to help you manage your condition and live the fulfilling life you deserve.
Living with health anxiety can be challenging, but your daily functioning and anxiety symptoms can be improved with proper care, support, and treatment.
Contact our friendly team today for further advice and support and to discuss your treatment options.
We are here and ready to help.
Additional resources
- Health Anxiety (Hypochondria) Healthline, Erica Cirino, September 29, 2018.
- Hypochondria: The Impossible Illness Psychology Today, Jeff Pearlman, January 2010.
- Improving our understanding of health anxiety Counselling Directory, Michael Swift, Integrative Psychotherapist, July 19, 2021.
