What is Health Anxiety?

Health anxiety, also known as Illness Anxiety Disorder, Somatic Symptom Disorder, or Hypochondriasis, is a mental health condition where an individual excessively worries about having a serious medical condition. These worries are often present even though the individual has typically been able to obtain a “clean bill of health” through qualified medical providers. The individual may experience no physical symptoms, mild physical symptoms, or even more severe physical symptoms, but the presence of any symptom or combination of symptoms (physical, neurological, physiological, etc.) would not support or explain a documented medical condition itself. If there is notable fear around such symptoms that relate to a documented medical diagnosis, most mental health providers would call this an adjustment reaction rather than health anxiety.

Since the label health anxiety is NOT actually a diagnosis, mental health and medical providers will break down health anxiety symptoms typically in one of two ways:

Illness Anxiety Disorder (IAD) (also called hypochondriasis)

The presence of excessive worries about a medical illness even though there is no evidence of this medical illness through any exams, tests, or evaluations done by a qualified medical provider. In Illness Anxiety Disorder, the individual experiences very mild or no physical symptoms but there can be persistent intrusive thoughts and fears about the possibility that they have or may develop a serious medical condition.

Somatic Symptom Disorder (SSD) (also called undifferentiated somatoform disorder)

The presence of excessive worries about a medical illness even though there is no evidence of this medical illness through any exams, tests, or evaluations done by a qualified medical provider. In Somatic Symptom Disorder, the individual experiences moderate to at times, severe physical symptoms which are then interpreted as the presence of a serious medical condition occurring even though all medical evidence does not align with this information. 

Causes and Risk Factors:

The exact cause of health anxiety is not fully understood, but it likely involves a combination of biological, psychological, and environmental factors. Some potential contributors to health anxiety include:

1. Genetics: There may be a genetic predisposition to anxiety disorders, including health anxiety, suggesting that certain individuals may be more susceptible to developing the condition when there is a family history of it.
2. Personality Traits: People with certain personality traits, such as perfectionism or a tendency to catastrophize, may be more prone to health anxiety.
3. Previous Medical Trauma: Negative experiences with illness, medical procedures, or healthcare providers can contribute to the development of health anxiety.
4. Stressful Life Events: Traumatic life events, chronic stress, or significant life changes can exacerbate anxiety symptoms, including health-related concerns.

Prevalence of Health Anxiety

Research suggests that health anxiety is relatively common, with estimates indicating that it affects about 4% to 5% of the general population. In primary care settings, where individuals often present with somatic symptoms or concerns about their health, the prevalence of health anxiety may be higher. Studies have reported rates of health anxiety ranging from 4-9% among patients seen in primary care settings and 5-10% (or higher) in medically involved populations (Weck al., 2014, Sunderland et al., 2013)

Certain demographic and psychological factors may also influence the prevalence of health anxiety. For example, women are more likely than men to experience health anxiety, with some studies suggesting that the condition is up to twice as common in women compared to men. Additionally, individuals with a history of anxiety disorders or other mental health conditions, such as depression or obsessive-compulsive disorder, may be at increased risk for developing health anxiety.

The prevalence of health anxiety may also vary across different age groups. While the condition can occur at any age, it often emerges in early adulthood and may persist over the lifespan if left untreated. Some research suggests that older adults may be more prone to health anxiety, possibly due to increased medical concerns or health-related worries associated with aging.

Not all health worries are ‘Health Anxiety’

Normal health worries are common and often transient. They may arise in response to specific symptoms, changes in health habits, or experiences that trigger concern. Normal health worries are typically related to specific circumstances or triggers. For example, feeling anxious before a medical test or experiencing mild concern after reading about a new health condition online. Normal health worries are proportionate to the perceived threat or risk. They may prompt individuals to take appropriate actions, such as scheduling a routine check-up or seeking advice from a healthcare provider. Finally, normal health worries tend to come and go, often resolving on their own or after receiving reassurance from a healthcare professional. They do not significantly interfere with daily functioning or quality of life.

In contrast, health anxiety level of worries involves persistent and excessive worry about one’s health, often despite medical reassurance and evidence to the contrary. Some key features of health anxiety include:

1. Excessive Preoccupation: Individuals with health anxiety may become preoccupied with the possibility of having a serious medical illness, constantly monitoring their bodies for signs of illness and seeking reassurance from healthcare providers, family members, or online sources.
2. Chronic Nature: Health anxiety is characterized by chronic and pervasive worry about health, which may persist for months or even years. The anxiety may fluctuate in intensity but remains a significant source of distress and impairment.
3. Interference with Functioning: Health anxiety can significantly interfere with daily functioning, leading to avoidance of medical appointments, excessive healthcare utilization, and impaired social or occupational functioning.