Illness Anxiety Disorder (Hypochondria) Explained

Depending on the symptoms, hypochondria is now known as either illness anxiety disorder (IAD) or somatic symptom disorder. Hypochondria refers to someone who believes their physical symptoms indicate a serious health condition despite the lack of medical evidence. This article discusses the symptoms, causes, and treatment of illness anxiety disorder (IAD). It also gives tips for living with IAD.

The symptoms of IAD revolve around a fixation on typical bodily functions or mild symptoms. You might experience any of the following symptoms:

• frequent worry about having or developing a serious illness despite not having any physical symptoms
• constantly paying attention to what is happening in your body, such as pain, sweating, or tingling
• wanting reassurance from others that you are not sick
• concern that your healthcare professional missed something 
• a constant need to check the internet for health information
• repeatedly checking for lumps on your body or taking your blood pressure, temperature, or pulse
• avoiding going to the doctor or other places where you may get sick

Read about a similar condition, somatic symptom disorder.

The cause of IAD can vary from person to person. How you think about your symptoms may make you more likely to have IAD. This means that the more you focus on symptoms and worry about what might be happening to you, the harder it can be to break that cycle of symptoms and the ensuing anxiety.

Some factors that increase your likelihood of having IAD include:

• Family history: If you have a family member who spends much time worrying about their health, you may be more likely to develop IAD.
• Age: A sense of worry about your health and about developing IAD tends to happen more as you get older. 
• Past experiences: You might be more likely to develop IAD if you or a family member had a serious childhood illness.
• Another mental health condition: If you have another mental health condition — such as an anxiety disorder, depression, or obsessive-compulsive disorder — you may have an increased chance of developing IAD. 
• Beliefs about your body: Your bodily sensations or a current health condition might make you think you have a more severe illness. Therefore, you may look for clues that verify that you have this illness. 

A person with IAD will typically see a primary care professional rather than a mental health professional because of their physical symptoms. The doctor will perform a physical exam and order tests depending on the reported symptoms.

Your doctor may diagnose IAD if you are convinced that you need a medical diagnosis despite the return of normal test results and continued reassurance that there is no reason for a medical diagnosis.

The concern with this is that if tests and physical exams come back normal, it might be difficult for the individual to accept. This may make them want to seek another doctor for a second or third opinion. They may not believe that they have a mental health condition.

It can be difficult for someone to accept they have IAD because the condition masks how they see their symptoms. A primary care professional might recommend a referral to a mental health professional for further assessment.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), for a diagnosis of IAD to be given, the following criteria must be met:

• a preoccupation with having or getting a serious illness for at least 6 months
• an absence of somatic symptoms or physical symptoms that a doctor cannot explain
• excessively checking yourself for illness
• mental health symptoms not related to another mental health condition
• either frequently seeking medical care or avoiding it altogether

Treatment for IAD typically involves a combination of cognitive behavioral therapy (CBT) and medication. However, some individuals may find therapy is enough to manage their symptoms.  

CBT can be useful to help you manage your IAD. CBT can help you:

• identify your beliefs about illness and your anxiety
• learn how to respond to your symptoms in a healthier way
• teach yourself to reframe negative thoughts into ones that empower you 

If therapy alone is ineffective in managing IAD, your mental health professional may recommend adding medications to your treatment plan.

Often, people can manage anxiety disorders using selective serotonin reuptake inhibitors (SSRIs). These medications are called antidepressants. However, they can be prescribed to help manage the symptoms of IAD by increasing serotonin levels in the brain. 

Serotonin-norepinephrine reuptake inhibitors (SNRI) are another type of antidepressant that might be helpful if SSRIs are ineffective.

You may need to try more than one medication to find the most effective one. 

There are ways you can actively work to manage your IAD. Some ideas for coping include the following:

• Practice relaxation exercises, including deep breathing, when you are anxious.
• Build stress management skills into your daily life.
• Distract yourself from thoughts of illness and urges to check your body by participating in an activity or hobby you find enjoyable or meaningful.
• Keep a journal of your thoughts and symptoms, and try to replace your anxieties with more neutral thoughts.
• Learn new hobbies to put your energy into.
• Work with a therapist specializing in anxiety disorders or join a support group.

If you have IAD, you may want to limit the time you spend online researching health conditions and symptoms you may be experiencing. People who are more anxious about their health tend to search for health topics online more than others.

Stress can worsen your anxiety, so when it is higher, it may be helpful to avoid health research entirely. 

These are some more questions people frequently ask about hypochondria or IAD. They have been reviewed by Matthew Boland, Ph.D.

An example of someone with IAD ( some features that were previously known as hypochondria) is someone who is constantly checking their body for signs and symptoms of an illness. They may also continuously make medical appointments to discuss their symptoms or avoid them altogether out of fear of being diagnosed with a serious illness.

IAD (hypochondria) is a treatable mental health condition. Either with therapy alone or combined with medication, a mental health professional can help you to manage IAD. Mental health conditions are often not considered cured. However, they can improve significantly or go into remission, sometimes permanently.

The experience of having a serious illness in the past or having a loved one with a serious illness can increase your risk of developing IAD (hypochondria).

Doctors typically recommend antidepressants to treat IAD (hypochondria). This is generally used in combination with cognitive behavioral therapy (CBT).

IAD describes a fear of having a serious but undiagnosed health condition despite diagnostic tests showing no illness. This is a condition that used to be referred to as hypochondria.

People with IAD often experience extreme anxiety from the bodily responses associated with their fear of having or developing a potential illness.

There are various treatment options and therapies available to help manage IAD.