Health anxiety: what is hypochondria, and how can it be treated?

Health anxiety and hypochondria: everything you need to know

Health anxiety – or hypochondria, as it is sometimes termed – is a serious and sometimes debilitating type of anxiety which is often housed within the OCD spectrum of disorders. But what is it, and how should we deal with it? We put your questions to a handful of experts.

Most people will possess a certain amount of concern about their health. It’s in our human nature to prioritise and fight for our survival, so in a time when the world is fighting a global pandemic, it’s only natural to feel worried and take the necessary precautions to protect yourself from coronavirus.

But for people dealing with health anxiety – or hypochondria, as it is sometimes termed – that concern is disruptive at its best, and at its worst, completely debilitating. Someone with health anxiety may interpret seemingly unremarkable symptoms as the beginnings of a major illness and take action (e.g. washing their hands repeatedly or checking their body over and over again).

For many dealing with health anxiety, the recent coronavirus outbreak has triggered a lot of those worries and concerns. Think about it: when you’ve spent time in therapy tackling your irrational worries about germs, hearing the government tell everyone they need to wash their hands and stay home to avoid a potentially deadly virus is incredibly anxiety-inducing.

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Even people who may never have experienced a debilitating level of health anxiety before may be struggling with the current situation. When there’s so much talk of the symptoms and signs we should be looking out for, it can be hard to recognise when your worries are proportionate (“I have a tight chest – it’s probably because I’m feeling stressed today, but I’ll keep monitoring my symptoms”) or fuelled by high levels of anxiety (“I have a tight chest – I must be dying of coronavirus”).

If you believe you may be dealing with health anxiety, especially if your concern about your health is significantly disrupting your everyday life, it’s important to seek help from a qualified mental health professional (you can find out more about how to access NHS mental health support during the coronavirus outbreak here). Below, we asked a variety of experts to answer some of your most frequently asked questions about health anxiety, from the most common symptoms to what kind of treatments are out there. 

What is health anxiety?

Health anxiety: people dealing with hypochondria may interpret a twinge in their chest as the start of lung cancer.
Health anxiety: people dealing with hypochondria could interpret a twinge in their chest as the start of lung cancer, for example.

According to Dr Claudia Pastides, a GP for web-based health service Babylon, “health anxiety is the excessive fear of having or developing an illness,” meaning someone might become obsessively concerned with checking their body for signs that they’re unwell.

“Many of us will have times when we are anxious about our health or worried about a symptom and turn to Dr Google, but a diagnosis of health anxiety is made when the health concerns expressed are most likely unjustified and the worries start to take over a person’s life,” Pastides explains.

Often considered to be linked to Obsessive Compulsive Disorder (OCD), health anxiety can also be referred to as hypochondria – they are the same thing.

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“By nature, health anxiety consists of misconstruing physical signs of anxiety as indicators of a physical health issue,” Dr Daniel Atkinson, a GP for online health service, tells Stylist. “For instance, misinterpreting a sore throat for a chest infection.”    

What are the symptoms of health anxiety?

Despite seeming relatively straightforward in its description, health anxiety can manifest in a number of ways, from constant worry about health to frequent checking of the body for signs of illness.

“Besides persistent apprehension about your health, symptoms may include constantly scrutinising your body for signs such as lumps, pain and tingling, seeking reassurance from others that you are healthy, concern that your doctor hasn’t carried out a full examination, or perusing information about health on the internet or other media in an obsessive manner,” explains Dr Atkinson. 

Health anxiety: people dealing with health anxiety often concerned about developing longterm, serious illnesses such as cancer or HIV.
Health anxiety: people dealing with health anxiety often concerned about developing longterm, serious illnesses such as cancer or HIV.

“An aversion to anything associated with serious illness, such as medical documentaries, and behaving as if you are more seriously ill than you might be, are further symptoms of health anxiety,” he adds.

As Dr Atkinson highlights, cyberchondria – a kind of health anxiety which is worsened by looking up symptoms online – is an increasingly big problem in our digital world, and can be a dangerous tool for people worrying about their health.

“With little context, something that can be simple to treat and can be minor, tends to feel like a bigger issue causing even more anxiety as a result. Without the help of a medical professional to determine what the issue is, the idea that it’s something life-threatening starts to manifest and you’re unable to clarify the validity of the content you’re reading.”

Additionally, people dealing with health anxiety could experience the common symptoms associated with anxiety, such as a tight chest, heart palpitations or headaches. 

What’s the most common health worry among people who deal with health anxiety?

People living with health anxiety are likely to fear developing serious or long-term health problems, as opposed to a common cold or sore throat.

However, as Dr Atkinson points out, there are no set parameters for what people with health anxiety worry about.

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“The most widespread forms often concern serious conditions such as cancer, HIV or AIDS, but those affected may obsess about any illness – there are no limits with health anxiety.

“People may even become concerned about the fact that they’re always anxious (anxiety about anxiety). They may also worry that they’re bothering their doctor too much.”

When does a normal level of health concern become health anxiety?

Of course, we all have worries about our health from time to time, but our worries become health anxiety when they begin to affect our everyday life.

“It is common to have concerns about your health and certain symptoms you may be experiencing, and it would be a natural response to see your doctor. However, with health anxiety, extreme distress may be experienced to imagined symptoms, despite having any investigations and test results come back negative,” explains Dr Wendy Li, a psychological health lead clinician for AXA PPP healthcare. “The condition goes beyond an average concern when it starts interfering with your quality of life, including the ability to function on a daily basis or create and maintain meaningful relationships.”

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According to Li, there are certain signs to watch out for if you’re concerned you may be developing health anxiety, including:

  • Frequently checking your body for signs of illness
  • Asking for reassurance all of the time
  • Obsessively looking for information on illness or physical conditions
  • Avoidance of material related to serious illness
  • Acting as if you already have the illness/physical condition

What’s the difference between health anxiety and OCD?

Health anxiety is often viewed as falling under the umbrella of OCD, especially due to the fact that people with health anxiety are often plagued with obsessive worries about a specific aspect of their health.

“Health anxiety is often seen as a thought-based obsessional condition, which is similar and often housed within the obsessive compulsive disorder spectrum,” explains Dr Li. “Symptoms experienced can be similar in nature, such that there is an obsessional basis to thoughts or rituals that must be carried out in order to feel a sense of relief to the concern which is causing anxiety.”

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In some cases of health anxiety then, people develop OCD-like compulsions which help them to feel a small sense of relief in the face of their anxiety. These rituals or compulsions may include getting additional testing, seeking reassurance from both family and medical professionals, and regularly checking the body for signs of illness.

What kinds of treatments are available for people dealing with health anxiety?

Health anxiety: CBT could help people dealing with hypochondria to challenge their obsessive worries and negative thoughts.
Health anxiety: CBT could help people dealing with hypochondria to challenge their obsessive worries and negative thoughts.

Depending on the severity of the health anxiety – and to what extent it is impacting a person’s daily life – there are a range of different treatments and techniques available to reduce the levels of anxiety a person may be feeling.

“Cognitive behavioural therapy, other psychological treatments, antidepressants and mindfulness have all been shown to help,” explains Dr Pastides.

Cognitive behavioural therapy (CBT), is a therapy technique commonly used in the treatment/management of anxiety disorders. Unlike some other therapy techniques, CBT doesn’t focus on any past trauma a person may have dealt with; instead, the therapist will work with their patient to challenge the negative thoughts they’ve been experiencing and establish new patterns of thinking they can use to overcome their anxiety.

However, if CBT has been recommended by your GP, there may be a significant amount of waiting time before your first appointment. In this case, it’s important to try out a few self-help or mindfulness techniques to help you in the meantime. 

“There are a number of practical methods people can try, depending on the extent and severity of their symptoms,” explains Dr Atkinson. “Writing things down can help with several psychological conditions, healthy anxiety included.”

He continues: “Start by writing in a journal every time you think about your health, measure your symptoms, search online for potential conditions or seek reassurance. Initially, this might seem like a frightening prospect – but it needn’t be. The idea is to gradually reduce the amount of time you spend writing about your health anxiety. Try to limit, or gradually cut down on the amount of times per week you google your symptoms, measure your heart rate, or whatever the prevalent symptoms may be.

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“Try to challenge yourself and these intrusive, anxious thoughts. You can adopt a personal approach that suits you. An example might be that every time a negative thought enters your brain, combat it with a counterargument. For example: ‘I’ve felt this before, and it’s a feeling that passes’.”

Dr Li agrees that writing things down can help: “Depending on the severity of the condition, you can start by keeping a diary to challenge your thoughts or by distracting yourself to delay the need for reassurance.”

However, as is always the case, if you feel like your health anxiety is making it hard to cope, seek help from a medical professional immediately.

Can antidepressants help people dealing with health anxiety?

As with any form of anxiety, a type of antidepressant called an SSRI (selective serotonin reuptake inhibitor) can be helpful in some cases, but it’s important to talk to your GP about what your options are going forward.

“Antidepressants are helpful for some people,” explains Dr Pastides. “It is important that treatment is tailored to the individual however because antidepressants can cause side effects that add to the person’s health anxieties and worries.”

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Dr Atkinson concurs: “For some, the idea of introducing medicine into the body can simply serve to fuel their anxiety, panic and obsessive, compulsive thoughts. If someone has found from past experience that drugs or medicines have contributed to these intrusive thoughts surrounding their health, then antidepressants may not be of overall benefit.”

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