What is illness anxiety disorder?
Illness anxiety disorder is a preoccupation with having or acquiring a serious illness despite only mild or no symptoms. Their concerns are very real to them and they have a high level of anxiety about their health. Hence, the individual displays excessive health-related behaviors, e.g., repeatedly checks his or her body for signs of illness. And, even if a doctor reassures them that they have no illness, they continue to obsessively worry. Sometimes, they exhibit maladaptive avoidance, e.g., avoid doctor appointments and hospitals. Earlier, this disorder used to be called hypochondria.
Illness anxiety disorder may occur once or multiple times. Sometimes it can be present continuously. Typically, the onset is in early to middle adulthood (ages 25-35), but it can happen at any age. Its intensity can go up and down, and in some the illness becomes chronic. However, some people recover.
Nearly two-thirds of individuals with illness anxiety disorder are likely to have at least one other co-morbid major mental disorder. Specifically, it can co-occur with anxiety disorders and depressive disorders. They have an elevated risk for somatic symptom disorder and personality disorders.
What are the symptoms of illness anxiety disorder?
Symptoms of illness anxiety disorder are the following:
- They have excessive worry over having or contracting a serious illness.
- Physical symptoms are either mild or not present.
- If another illness is present or there is a high risk for it, the person’s concern is out of proportion.
- They become very anxious and unable to function normally. As a result, personal relationships and work performance take a hit.
- Some people examine themselves repeatedly. For instance, they may repeatedly check their pulse to ensure that their heartbeat is regular. New bodily sensations easily frighten them. For example, they may fear that the normal sounds of digestion, sweating or a mark on the skin are indicators of serious illness.
- Some of these people seek medical care frequently. Others feel too anxious to seek it.
- Their whole life revolves around their supposed illness. So much so that, this concern dominates their conversation with others. Similarly, they do extensive research on the illness they think they have. Even someone else’s illness alarms them.
- They repeatedly seek reassurance from family members, friends, and doctors. But when they are reassured by others, they feel their symptoms are not being taken seriously. This makes them more anxious. Often, their endless worrying is frustrating to others, leading to strained relationships.
- Affected people tend to avoid stressful situations, such as visiting sick family members. Sometimes, they may also avoid certain activities that they fear may endanger their health, such as exercise.
The cause of illness anxiety disorder is unknown. But certain factors can place an individual at high risk for illness anxiety disorder, such as:
- Major life stress: Illness anxiety disorder may sometimes be precipitated by major life stress.
- A serious but ultimately benign threat to the individual’s health, e.g., chest pain, memory issues
- History of childhood abuse
- History of serious childhood illness
- Having another mental disorder, e.g., major depression, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, or psychotic disorders
DSM-5 enumerates the following diagnostic criteria for illness anxiety disorder:
- Preoccupation with having or getting a serious illness.
- Bodily symptoms are only mild in intensity or not present. If another medical condition is present or there is a high risk for developing it, the preoccupation is out of proportion to it.
- High level of anxiety about health, and easily alarmed about personal health status.
- Performs excessive health-related behaviors – e.g., repeatedly checks his or her body for signs of illness; or exhibits maladaptive avoidance – e.g., avoids doctor appointments and hospitals.
- Symptoms present for at least 6 months, but the specific illness that is feared may change over that period of time.
- Another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type, does not better explain the illness-related preoccupation.
- Specify whether: (1) Care-seeking type: They frequently use medical care. (2) Care-avoidant type: They rarely use medical care.
Treatment of Illness Anxiety Disorder
Treatment is with either psychotherapy or medications. Sometimes, you can try complementary and alternative medicine therapy.
Cognitive-behavioral therapy (CBT) is the most commonly given psychotherapy. CBT helps you:
- Recognize what seems to make the symptoms worse: Identify your beliefs and fears about having a serious illness
- Develop methods of coping with the symptoms: Learn different ways to view your body sensations by changing unhelpful thoughts
- Keep yourself more active, even if you still have symptoms: Learn skills to cope with and tolerate anxiety and stress
- Address other mental health disorders, such as depression
Also, other helpful therapies are behavioral stress management and exposure therapy.
Antidepressants can help reduce the worry and physical symptoms of this disorder. So, they can be tried if talk therapy is not effective or only partially effective. Usually, doctors prescribe selective serotonin reuptake inhibitors as the antidepressants in this disorder.
Complementary and Alternative Medicine Therapies
- Use herbs like St. John’s wort, kava kava, and bacopa. They may reduce anxiety. But, inform your doctor before using herbs, because some herbal remedies may interact with medications or have other side effects.
- Avoid stimulants such as coffee, tobacco, and alcohol
- Practice mindfulness meditation
- Eat a healthy diet.