Health Anxiety, also referred to as Hypochondria or Illness Anxiety, is characterized by an excessive and irrational fear of having a serious illness, despite medical reassurance to the contrary. Individuals with Health Anxiety often misinterpret normal bodily sensations or minor symptoms as signs of severe medical conditions. This condition goes beyond typical health concerns and can significantly disrupt daily functioning, including work, school, and personal relationships. In my practice as a psychologist, I help people understand their health anxiety and work on educating my clients on how overt and covert safety behaviours/compulsions maintain the fear. This requires a portion of some of our sessions to be focusedon psychoeducation.
Symptoms of Health Anxiety
The symptoms of Health Anxiety can vary widely from person to person, but common patterns often emerge. Individuals may obsess over the following thoughts:
- Interpreting a headache as a brain tumor
- Believing a cough is a symptom of lung cancer
- Assuming mild chest pain is indicative of a heart attack
- Thinking a small sore is a sign of AIDS
Common compulsions or safety behaviours associated with Health Anxiety include:
- Visiting multiple doctors, sometimes even seeing several in one day
- Undergoing repeated medical tests for the same perceived illness
- Frequently checking the body for symptoms of an imagined health problem
- Avoiding situations or objects due to a fear of contracting a disease
- Excessively searching online for information about illnesses and symptoms ("Cyberchondria")
Research estimates that 4-6% of the population experiences clinically significant Health Anxiety, and up to 10% of primary care visits may be related to health-related fears. The symptoms often overlap with those of Obsessive-Compulsive Disorder (OCD), although a key difference is that people with OCD typically fear acquiring a disease, while those with Health Anxiety fear already having one. Both conditions share a cycle of increasing symptoms, perpetuated by obsessive thinking and compulsive behavior.
Treatment of Health Anxiety
Due to the similarities between Health Anxiety and OCD, Cognitive-Behavioral Therapy (CBT) is commonly used to treat both conditions and this is what I use in my practice with my patients as well. Studies from institutions like Harvard University and the Mayo Clinic have shown that CBT is particularly effective for Health Anxiety. A key component of CBT for both OCD and Health Anxiety is Exposure and Response Prevention (ERP), where individuals gradually confront their health-related fears in a controlled way, without performing the compulsive behaviors they usually engage in to alleviate anxiety. Response prevention is the most important part of the work because the compulsions maintain the fear.
Another CBT technique, Cognitive Restructuring, helps individuals identify and challenge the distorted thoughts that fuel their health anxiety, encouraging healthier, more realistic thinking patterns. We also work on introducing cognitive distortions that may influence the negative thinking.
A variation of ERP called imaginal exposure has also been shown to be effective for Health Anxiety. In this method, clients listen to audiotaped short stories that depict their health-related fears (e.g., contracting cancer or AIDS). This technique allows individuals to confront their anxieties in a safe environment and helps reduce their sensitivity to intrusive health-related thoughts and images. Combining this method with traditional ERP and Cognitive Restructuring can significantly decrease the frequency and intensity of health obsessions and compulsions.
Another valuable approach is Mindfulness-Based Cognitive-Behavioral Therapy (MB-CBT). MB-CBT focuses on helping individuals accept their uncomfortable thoughts, feelings, and sensations without trying to control or eliminate them. For people with Health Anxiety, the goal is to learn to tolerate these uncomfortable experiences rather than resorting to compulsions, avoidance, or seeking reassurance. Research has shown that accepting discomfort without reacting to it can reduce psychological distress and help individuals manage their health anxiety more effectively.
Through these therapeutic techniques, individuals with Health Anxiety can challenge their fears, reduce compulsive behaviors, and learn healthier ways to cope with their anxieties. With the right support, people can regain control over their lives and improve their overall well-being.
