Most of us worry about our health at some point. You may notice a new symptom or change in your body and become convinced it’s a sign of a horrible illness; a loved one might become ill and you might worry it may also happen to you.
In fact, it can be helpful to be concerned about your health. This is the type of concern that might motivate you to visit your doctor to check a sore back, apply sunscreen to prevent skin cancer, eat well, exercise or drink enough water.
Usually, worries about your health are short-lived and disappear after symptoms go away or after you receive the all clear from your doctor.
But for some people, what starts as a normal health concern can tip over into a serious mental health problem you might know as hypochondria, health anxiety or to give it its official title, illness anxiety disorder.
So how can you tell if your health concerns are helpful or harmful? And where can you go for help?
What is illness anxiety disorder?
Illness anxiety disorder involves an overwhelming, disabling and crippling fear of illness and is a new psychiatric disorder listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5.
Illness anxiety disorder replaced the contentious diagnosis of hypochondriasis in previous versions of the DSM. The new label, which is also sometimes referred to as severe health anxiety or health anxiety for short, is less stigmatising, and better reflects the fact anxiety about illness is at the heart of this condition.
How do you know if you have it?
Like any mental health condition, answer the following questions to see if your anxiety has become a problem:
- Is it lasting too long, occurring too often and difficult to control?
- Is it out of proportion to the actual danger or seriousness of the physical symptoms?
- Is it distressing or affecting your quality of life, well-being and relationships?
Do you ever Google your symptoms or check your body a lot for illness signs and symptoms? Are you very careful about what and where you eat because you are afraid you might get sick? Do you seek a lot of reassurance from friends, loved ones or health professionals about your health, or go straight to the doctor as soon as you notice a change in your body? Or do you simply spend a lot of time thinking about your health, dreading the idea you may become sick?
These things aren’t necessarily a sign of anything unusual, but if they happen too often or start affecting your quality of life, they might be a signal you need to seek help and support.
Illness anxiety is common
We published data from an Australian population survey that found illness anxiety affects 5.7% of Australians at some point in their lives. That’s over one million people.
As well as placing a burden on the individual, it places a burden on society due to excessive health care use.
There is also little community awareness it exists. And it is often misdiagnosed as a “personality trait” rather than a treatable condition.
Illness anxiety comes in many shapes and sizes
The illnesses people fear are vast and varied. While the creative ways the mind interprets what is going on the body can be fascinating, it’s also troubling how debilitating this condition can be.
Some people are terrified of having cancer, heart defects, HIV or other STIs, despite repeated reassurance and negative test results. Others are anxious they have neurological conditions and dementia despite all evidence pointing to the contrary. Some are convinced they have parasites, mental illnesses and even Ebola.
Most people with illness anxiety frequently seek health care, with higher overall rates of health service use in people with illness anxiety compared to the general population. But people may also avoid health care because they are terrified of finding out they are sick.
Where you can find help?
Illness anxiety can be successfully treated using cognitive behavioural therapy or CBT, a kind of therapy that teaches new ways of thinking and behaving. In CBT, we teach people how to recognise the symptoms of illness anxiety, and practical strategies to overcome the thoughts, worries and unhelpful behaviours (like excessive counterproductive body checking) that make illness anxiety worse in the long term.
The aim of CBT is not to take away all anxiety but to help people live a normal, healthy life without the dread of illness hanging over them.
If you are considering CBT, the first step is to see a doctor you trust for a general health check, and to rule out serious illnesses.
You can receive CBT in face-to-face sessions at specialist anxiety clinics or with experienced psychologists. Recent research shows self-help and online treatment also have excellent results. Self-help resources and comprehensive online CBT programs are now available in Australia.
Jill Newby receives funding from the Australian National Health and Medical Research Council (NHMRC) in the form of an Early Career Fellowship (1037787).
Authors: Jill Newby, Lecturer and NHMRC Early Career Research Fellow, UNSW Australia