Health anxiety, previously referred to as hypochondria, is now known as illness anxiety disorder or somatic symptom disorder depending on the diagnosis. These are chronic mental illnesses where the person impacted fears they have a serious medical condition or high risk of getting ill.
In a survey conducted by CertaPet consisting of over 800 Americans, 75.6% reported they have more general health anxiety now than they had five years ago, pre-pandemic. For health anxiety disorders, there are an estimated 4-5% of people diagnosed worldwide.
Health experts believe the number of people around the world living with a health anxiety disorder may be higher, as it is commonly undiagnosed. Professionals believe it may affect more than 10% of the population.
If you’re preparing to work in healthcare as a nurse, or studying online BSN to MSN programs, understanding mental health, including disorders like health anxiety, can benefit your career and make you a better nurse.
Understanding health anxiety disorders
When discussing health anxiety, it’s important to understand the term ‘hypochondria’ or ‘hypochondriasis’ is outdated. Health anxiety is now split into two disorders, illness anxiety disorder and somatic symptom disorder.
It’s normal to be concerned about your health, but if it gets to the point where the thoughts get irrational and all-consuming, it can result in health anxiety. In this case, it can lead to severe anxiety and feelings of distress, even when doctors or test results show everything is okay.
A health anxiety disorder goes beyond normal worry and concern about one’s health and can interfere with quality of life, especially in severe cases. This can include their ability to work, function, and create meaningful relationships, which can also lead to poor well-being.
What causes health anxiety?
Health experts don’t know the exact cause of health anxiety disorders, however, research shows several factors may play a role. These include:
- Family history of anxiety disorders or serious illness
- Previous major stress, illness, or death within a family
- Previous experiences with trauma or abuse
- A history of previous serious illnesses
- Other mental health issues like depression or anxiety can increase the risk of health anxiety
Certain activities can also trigger episodes of anxiety if someone has an illness anxiety disorder or somatic symptom disorder. These events can include:
- Reading about diseases online
- Knowing someone or a family member with a serious condition
- Feeling unwell
- Consuming media, like a movie, that features a serious illness
What are the risk factors?
Studies have shown that it’s most common for health anxiety disorders to begin in either early or middle adulthood. It’s also common for the disorders to worsen with age, especially if left untreated.
Common risk factors include:
- History of stressful events
- Having a serious childhood illness or a caregiver who had a serious illness
- Personality traits, like having a ‘worrying’ personality
- Excessively checking your health and symptoms on the internet (e.g.: WebMD)
- Experiencing abuse as a child
- Having previously had a possibility of a serious illness that didn’t turn out to be severe
How is it diagnosed?
Hypochondria (or hypochondriasis) is now no longer included in the American Psychological Association Diagnostic and Statistical Manual of Mental Disorders. Now, people who have or would have a diagnosis of hypochondria might be classified with either illness anxiety disorder or somatic symptom disorder.
- Illness anxiety disorder is where a person excessively worries about their health, believing they might have or might become seriously ill despite having zero or near-to-zero symptoms. It is a long-term condition that can result in debilitating anxiety due to fear of health risks.
- Somatic symptom disorder is when a person has a significant obsession with their physical well-being, unhealthily focusing on physical symptoms like pain, weakness, or shortness of breath, to a level that causes major distress.
Although both of these disorders are different, they both fall under the term ‘health anxiety’ and are connected to hypochondria.
For a doctor to diagnose a patient with either illness anxiety disorder or somatic symptom disorder, there are a few steps. These include:
- The doctor performs a physical exam to rule out any of the illnesses or symptoms the patient is concerned about.
- A referral to a mental healthcare professional where they can perform a psychological evaluation, which may include questions about symptoms, past experiences, family history, and any stressful factors in the patient’s life.
- In most cases, patients will also need to fill out psychological self-assessments or questionnaires and answer questions regarding alcohol and substance use.
Guidelines set by the American Psychiatric Association list that health anxiety disorders, like illness anxiety disorder, are marked by:
- Obsessive thoughts about having or potentially getting sick with a serious illness
- Not having any physical symptoms, or only having mild symptoms
- Being excessively preoccupied regarding an existing medical condition or family history of a serious illness
- Performing unreasonable health-related behaviors, which may include:
- Checking symptoms online
- Screening for illnesses excessively
- Avoiding doctor’s appointments to rule out diagnosis
- Preoccupation with having a serious illness lasting for at least 6 months
Treatment options
There are a range of effective treatment options for health anxiety disorders. This includes psychoeducation, cognitive behavioral therapy, and medication, to reduce and manage symptoms.
Psychoeducation
Psychoeducation is a proven treatment option for health anxiety. This involves a therapeutic intervention, where the medical professional provides the patient with educational resources and information regarding the disorder, treatment options, and strategies to manage it in their day-to-day life.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) through a licensed professional, like a psychologist, can help patients living with a health anxiety disorder. It is a psychotherapy (talking therapy) based on the idea that how you think and act affects how you feel.
A therapist can help with recognizing any cognition (patterns of thinking) and behaviors that feed into health anxiety. Then, through CBT, they can teach you practical strategies to break the habit of any negative thinking and actions.
Medication
Medicines, like antidepressants, can also be used to reduce symptoms like stress and anxiety. Medication for health anxiety can be prescribed either by a doctor or a psychologist, depending on the diagnosis.
Health anxiety as a nurse
As a nurse, understanding health anxiety, including the causes and symptoms, will equip you with the knowledge to help any patients living with a related disorder. You’ll be able to recognize any signs early and potentially help them before they progress too far.
If you’re looking to further your career as a nurse, learning more about mental health conditions, including health anxiety, will be useful—especially if you’re looking to work as a mental health or psychiatric nurse.
Studies also show that medical professionals, including nurses, are at risk of health anxiety. So, by understanding healthy anxiety conditions, you’ll have self-awareness and recognition, and know the best coping strategies.
