Find information on medical topics, symptoms, drugs, procedures, news and more, written in everyday language.

Illness Anxiety Disorder

by Joel E. Dimsdale, MD

Illness anxiety disorder is preoccupation with having or acquiring a serious disorder.

  • People are so worried that they are or might become ill that they become very distressed and have difficulty functioning.

  • Doctors diagnose the disorder if people continue to worry about having or getting a serious disorder after a thorough evaluation has ruled out serious disorders.

  • A relationship with a supportive, trusted doctor can help, as can cognitive-behavioral therapy.

Illness anxiety disorder most commonly begins during early adulthood and appears to affect men and women equally.

People may become overly anxious because they misinterpret insignificant physical symptoms or normal bodily functions (such as awareness of the heart's beating).

Symptoms

People are so preoccupied with the idea that they are or might become ill that they become very distressed and unable to function. As a result, personal relationships and work performance deteriorate.

People may or may not have physical symptoms. If people have physical symptoms, their concern is more about what the symptoms might mean (that is, a serious disorder) than with the symptoms themselves. If a physical disorder is present, their anxiety is out of proportion to the seriousness of the disorder.

Some people examine themselves repeatedly. For example, they may check their pulse repeatedly to see if their heart beat is regular. They are easily frightened by new bodily sensations. Some people seek medical care frequently. Others are too anxious to seek it.

Illness has a central place in their life and monopolizes their conversation with others. They extensively research the disorder they think they may have. They are easily alarmed about illness, even in someone else.

People repeatedly seek reassurance from family members, friends, and doctors. When their doctor tries to reassure them (for example, by telling them that examination and tests results are normal), they often think that the doctor is not taking their symptoms seriously. Then they become more anxious. Often, their endless worrying is frustrating to others, resulting in strained relationships. Affected people may then avoid situations that could result in more stress (such as visiting sick family members). They may also avoid activities that they fear may endanger their health (such as exercise).

Illness anxiety disorder tends to be chronic. It may abate, then recur. Some people recover.

Diagnosis

Doctors suspect the disorder when people are overly anxious about whether or not they have a serious disorder. Doctors do a thorough evaluation to determine whether a physical disorder is present. Doctors also evaluate people for depression and other mental health disorders. The diagnosis is confirmed when people continue to be anxious for 6 months or more despite reassurance that the medical evaluation has ruled out possible disorders or has identified a mild disorder that does not warrant their anxieties.

Treatment

A supportive, trustful relationship with a caring doctor is beneficial, especially if regular visits are scheduled. If symptoms are not adequately relieved, people may benefit from referral to a psychiatrist or another mental health practitioner for further evaluation and treatment, while continuing to be cared for by their primary doctor.

Treatment with serotonin reuptake inhibitors, a class of antidepressants, may be effective. Cognitive-behavioral therapy may help.