Health Anxiety (Hypochondria) - The Fear of Having a Serious Illness

Introduction:

Health anxiety is a psychological condition that takes worry to the extreme. Imagine a mind consumed by relentless thoughts of having a severe illness, even at the slightest hint of a bodily sensation. This excessive fear and preoccupation with health can be paralyzing, hindering daily life and causing distress. People with health anxiety become trapped in a never-ending cycle of seeking reassurance, visiting doctors, and researching symptoms online, desperately searching for answers. Their fears persist besides medical comforts, leaving them in constant unease. People with health anxiety can reclaim their lives by overcoming their fears with proper support and treatment.

What Is Health Anxiety?

Health anxiety is the engrossment of acquiring or having a severe medical condition or illness without symptoms. People with health anxiety experience extreme fear or stress about their health, affecting their daily lives. These individuals remain unsatisfied even with constant reassurance from physicians, normal laboratory test report, and physical examinations. It is a persistent condition that necessitates monitoring of symptoms and bodily reactions, such as digestion or sweating.

What Are the Symptoms of Health Anxiety?

The symptoms of health anxiety include:

• Anxiety or fear about health.

• Severe engrossment about an underlying medical condition.

• No actual symptoms related to an illness.

• All reports are regular.

• Overthinking of a disability and death.

• Frequent complaints about hair loss, skin lesions, or any physical changes.

• Visit multiple physicians.

• Spending more time reviewing health-related information on the internet or other sources.

• History of serious illness.

• Describing normal body sensations as pathological changes.

• Depression.

What Are the Causes of Health Anxiety?

The exact causes of health anxiety are not fully understood, but several factors can contribute to its development:

• Having a personal or family history of anxiety disorders or other mental health conditions heightens the probability of developing health anxiety. Health anxiety can be triggered by previous traumatic encounters, such as witnessing the severe illness of a loved one or experiencing a traumatic medical event.

• Excessive exposure to sensationalized health news, medical dramas, or online health information may contribute to health anxiety by fueling fears and catastrophizing normal bodily sensations.

• Individuals with certain personality traits, including high anxiety levels, a tendency towards perfectionism, or excessive caution, are more prone to developing health anxiety.

• Having a history of significant or chronic medical conditions, or experiencing unexplained symptoms, can increase the likelihood of developing health anxiety.

• Certain thinking or cognitive patterns, such as catastrophizing (believing the worst possible outcome), overgeneralizing (applying one negative experience to all situations), or selectively attending to health-related information, can contribute to health anxiety.

• High-stress levels or significant life events, such as a loss, job change, or relationship difficulties, can exacerbate existing anxiety or trigger health anxiety.

How Is Health Anxiety Associated With Healthcare Use?

People with health anxiety often interpret minor bodily symptoms as signs of severe illness, leading to heightened distress and frequent healthcare seeking. While it is understandable that individuals with health anxiety may seek reassurance from medical professionals, excessive healthcare use can have positive and negative implications.

Patients with health anxiety are of two types:

1. A care-seeking type which utilizes the healthcare system keeps changing doctors and asks for multiple tests and treatments.

2. A care-avoidant type who avoids medical care and has severe anxiety with the thought that the physician or testing may reveal a life-threatening condition.

Association Between Health Anxiety and Healthcare Use:

• On the one hand, frequent healthcare visits may provide temporary relief and reassurance to individuals with health anxiety, as they receive medical evaluations and reassurances that they do not have a severe condition. Additionally, healthcare professionals can offer appropriate medical advice and help manage genuine health concerns. Seeking medical attention when experiencing troubling symptoms is essential to maintaining overall health and well-being.

• On the other hand, excessive healthcare utilization among individuals with health anxiety can have several negative consequences. It can lead to unnecessary medical tests, procedures, and interventions that may carry risks and side effects. Overutilizing healthcare resources may also strain the healthcare system and increase healthcare costs. Furthermore, frequent visits to healthcare providers can reinforce and perpetuate health anxiety by reinforcing the belief that every symptom warrants medical attention.

How to Diagnose Health Anxiety?

Diagnosis can be based on the DSM-5 (diagnostic and statistical manual of mental disorders) diagnostic criteria for health anxiety or illness anxiety disorder:

1. Worrying about having or acquiring a life-threatening health issue.

2. Corporeal symptoms are absent. If present, they are mild if there is a risk of developing a medical condition due to family history or extreme anxiety regarding a situation.

3. High level of health anxiety.

4. Extreme health-related behaviors (repeatedly checking for signs of illness) or avoidance (avoiding consultation or treatment).

5. Symptoms of the illness are present for at least six months.

6. Another mental disorder does not correctly explain the health anxiety worry.

How to Manage Health Anxiety?

Management of health anxiety includes:

• Providing support to the patient to cope with health anxieties.

• Make the patient feel comfortable by developing a rapport to discuss their health concerns.

• Patients' Fears and concerns should be acknowledged, and negative statements should be avoided.

• Once health anxiety is diagnosed, unnecessary investigations, overuse of medical systems, imaging tests, and specialist referrals should be avoided.

• These patients are then referred to a psychiatrist or a professional in a non-judgmental way without making them feel abandoned.

• Regular follow-ups should be planned to reduce emergency visits or other physicians.

• Psychotherapy is the choice of treatment for health anxiety. It includes cognitive behavioral therapy (CBT) to treat the patient's dysfunctional or abnormal cognitive beliefs through behavioral modifications.

• CBT includes mindfulness-based therapy, group therapy, and acceptance and commitment therapy.

• Pharmacological treatment includes anti-depressants such as SSRIs (selective serotonin reuptake inhibitors) for at least six to 12 months.

• A combination of psychotherapy and pharmacotherapy is most effective in some cases.

Conclusion:

Health anxiety is excessive worry or fear about a severe medical condition. Individuals with health anxiety may seek reassurance from medical professionals; excessive healthcare use can have positive and negative implications. Health anxiety should be approached with empathy and understanding. Balancing appropriate healthcare utilization with effective management of health anxiety can help individuals lead healthier, happier lives while reducing unnecessary healthcare burdens.