Illness Anxiety Disorder

ByJoel E. Dimsdale, MD, University of California, San Diego
Reviewed/Revised Aug 2022 | Modified Sep 2022

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.

(See also Overview of Somatic Symptom and Related Disorders.)

Illness anxiety disorder used to be called hypochondria, but that term was abandoned because of its negative connotations.

This 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 of Illness Anxiety Disorder

People can be 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 with illness anxiety disorder may or may not have physical symptoms. If they have physical symptoms, the symptoms are mild, and people are more concerned about what their symptoms might mean (that is, that they have a serious disorder) than with the symptoms themselves. Fear of illness is their main worry. (If people also have significant physical symptoms, they may have somatic symptom disorder.) If people with illness anxiety disorder have a physical disorder, 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 heartbeat is regular. They are easily frightened by new bodily sensations.

Some people with illness anxiety disorder 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 with illness anxiety disorder 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. Symptoms may lessen, then recur. Some people recover.

Diagnosis of Illness Anxiety Disorder

  • A doctor's evaluation

Doctors suspect illness anxiety 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 of illness anxiety disorder is confirmed when people continue to be anxious about illness for 6 months or more despite having no symptoms or mild symptoms and being reassured that the medical evaluation has ruled out possible disorders or has identified a mild disorder that does not warrant their anxieties.

Treatment of Illness Anxiety Disorder

  • Support from a doctor

  • Sometimes antidepressants or cognitive-behavioral therapy

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

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