Hypochondria, or hypochondriasis, is an anxiety condition often referred to as health anxiety. People with hypochondria have a fear of injury or illness that others may consider irrational. They may make frequent trips to the doctor, for example, or become convinced they have serious undiagnosed illnesses.
Those whose health anxiety is serious enough to impact typical function may find it beneficial to seek support from a therapist or counselor.
It’s natural to want to avoid contracting illnesses or experiencing injury. Most people tend to habitually avoid those things by washing their hands, taking vitamins, or not being in the company of people who are ill. But those with health anxiety or hypochondriasis are preoccupied with their present or future health to a point where their everyday life is affected.
While hypochondriasis is no longer a diagnosable condition in the fifth edition of The Diagnostic and Statistical Manual (DSM-5), the majority of cases that were once diagnosed as hypochondria are now diagnosed as somatic symptom disorder (SSD) or illness anxiety disorder (IAD). Both of these conditions are listed in the DSM-5 under Somatic Symptom and Related Disorders, but only people with somatic symptom disorder will show symptoms psychosomatically through their worry.
If someone with somatic symptom disorder or illness anxiety already has a chronic health condition, they might worry it’s worsening or developing complications. Others who are physically healthy may believe they have some ailment or condition that needs medical attention.
The DSM-5 lists different criteria for somatic symptom disorder and illness anxiety disorder, which were both previously recognized as hypochondria. One key difference between the two is that people with somatic symptom disorder feel somatic, or physical symptoms while those with illness anxiety disorder do not.
The following are symptoms of somatic symptom disorder:
- At least one somatic symptom that interrupts a person’s ability to function
- Anxious or obsessive thoughts about physical symptoms
- Individual spends a significant amount of time thinking about or addressing their symptom
- Symptoms have persisted for at least 6 months
People with somatic symptom disorder can manifest symptoms such as pain, dizziness, or stomach aches. While symptoms associated with somatic symptom disorder can be painful, this is not always the case. It’s also possible for somatic symptom disorder to occur during or after a medical issue.
Some symptoms unique to illness anxiety disorder include:
- Fear of contracting a serious disease or the belief one has a disease
- Feeling the need to check on health symptoms often
- Fear of checking on health symptoms or seeing a doctor
- Lack of or only mild somatic symptoms
- Worry about illness has persisted for at least 6 months
- Anxious thoughts are not caused by delusion, body dysmorphia, generalized anxiety, or obsessive-compulsive disorder
For those who experience illness anxiety disorder, more emphasis may be placed on the fear and worry about contracting or having an illness when physical symptoms aren’t present. While some people may visit multiple doctors in order to find someone who can help address their symptoms, others may avoid health care, fearing they will be diagnosed with a dangerous disease.
There is no single cause of hypochondria, although environmental factors are thought to play a larger role in causing health anxiety than genetic factors. Intense stress or a history of childhood abuse may also contribute to illness anxiety. Some other potential causes of hypochondria include:
- Past trauma or neglect
- History of illness
- A severe physical symptom without a known cause
- Generalized anxiety disorder
- Mental health issues that involve psychosis
- Major depression
- Obsessive-compulsive disorder (OCD)
As environmental factors can significantly influence whether an individual develops hypochondria, early intervention and prevention are often particularly important. A study published in World Psychiatry suggests psychosocial treatment approaches may be effective when treating hypochondria.
The prevalence of internet medical advice has given people a platform to research symptoms and receive free information about health concerns. But looking into real or imagined symptoms can only fuel worry and distress over perceived illness in people with health anxiety.
Some people report that researching symptoms online results in feelings of overwhelming anxiety or fears that a headache is caused by a brain tumor or a cough indicates cancer. This particular behavior is sometimes informally referred to as cyberchondria. Doctors increasingly caution against spending too much time researching symptoms or illnesses online.
Like other mental health issues, hypochondria is a condition often tossed around lightly in conversation; it is not uncommon to hear someone called a “hypochondriac.” This pejorative term can undermine the potential severity of illness anxiety, however, like other instances of casual self-diagnosis or labeling of others.
As hypochondria may severely impact an individual’s ability to function in day-to-day life, treatment can be key. Learn more about therapy and treatment for hypochondria and somatic symptom disorders here.
- Brakoulias, V. (2014, October 8). Two disorders introduced for better diagnoses. Anxiety.org. Retrieved from https://www.anxiety.org/hypochondriasis-replaced-by-two-new-disorders-in-dsm-5
- Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychological Association.
- Goodman, K. (2016). Understand the facts: Health anxiety. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/health-anxiety
- Health anxiety (hypochondria). (2015). NHS.uk. Retrieved from http://www.nhs.uk/conditions/hypochondria/Pages/Introduction.aspx
- Illness anxiety disorder: Beyond hypochondriasis. (2015). Retrieved from https://my.clevelandclinic.org/health/diseases/9886-illness-anxiety-disorder-beyond-hypochondriasis
- Kahn, D. (2018, March 6). Illness anxiety disorder (formerly hypochondriasis) clinical presentation. Retrieved from https://emedicine.medscape.com/article/290955-clinical
- Phillips, K. A., & Stein, D. J. (Eds.). (2015). Handbook on obsessive-compulsive and related disorders. Arlington, VA: American Psychiatric Pub.
- Starcevic, V., & Berle, D. (2013). Cyberchondria: Towards a better understanding of excessive health-related internet use. Expert Review of Neurotherapeutics, 13(2), 205-213. Retrieved from http://www.tandfonline.com/doi/abs/10.1586/ern.12.162
- Taylor, S., Thordarson, D. S., Jang, K. L., & Asmundson, G. J. G. (2006). Genetic and environmental origins of health anxiety: A twin study. World Psychiatry, 5(1), 47-50. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472263
- White, R. W., & Horvitz, E. (2009). Cyberchondria: Studies of the escalation of medical concerns in web search. ACM Transactions on Information Systems (TOIS), 27(4), 23. doi: 10.1145/1629096.1629101