Health anxiety (hypochondria) 

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Introduction 

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Next review due: 01/04/2016

Have I got health anxiety?

If you can answer YES to most of these questions, it's likely you are affected by health anxiety.

During the past six months:

  • Have you been preoccupied with having a serious illness because of body symptoms, which has lasted at least six months?
  • Have you felt distressed because of this preoccupation?
  • Have you found this preoccupation impacts negatively on all areas of life including family life, social life and work?
  • Have you felt you have needed to carry out constant self-examination and self-diagnosis?
  • Have you experienced disbelief over a diagnosis from a doctor, or felt you are unconvinced by your doctor's reassurances that you are fine?
  • Do you constantly need reassurance from doctors, family and friends that you are fine, even if you don't really believe what you are being told?

Source: Anxiety UK

Most of us worry about our health from time to time. But for some people, this worry never goes away and becomes a problem in itself.

Health anxiety (hypochondria) is obsessive worrying about your health, usually to the point where it causes great distress and affects your ability to function properly.

Some people with health anxiety have unexplained physical symptoms, such as chest pain or headaches, which they assume are a sign of serious disease despite the doctor's reassurance. Read about medically unexplained symptoms, and why these are often nothing to worry about. 

Others may just be permanently anxious about their future health, worrying about things like 'What if I get cancer or heart disease?'

This page aims to explain how health anxiety comes about, what keeps the worries going, and the help that is available.

What causes health anxiety?

There are many reasons why someone worries too much about their health.

You may be going through a particularly stressful period of your life. There may have been illness or death in your family, or another family member may have worried a lot about your health when you were young.

Personality can play a role; you may be vulnerable to health anxiety because you are a worrier generally. You may find it difficult to handle emotions and conflict, and tend to 'catastrophise' when faced with problems in your life.

Sometimes, health anxiety can be a symptom of a mental illness, such as depression or anxiety disorder, which needs recognising and treating in its own right (see below). 

Why health anxiety is a vicious circle

Conditions such as low back painirritable bowel syndrome and eczema are known to be triggered or made worse by psychological problems such as stress or anxiety.

When physical symptoms are triggered or made worse by worrying, it causes even more anxiety, which just worsens the symptoms. Excessive worrying can also lead to panic attacks or even depression.

Health anxiety is a vicious circle in other ways, too. 

If you constantly check your body for signs of illness, such as a rash or bump, you will eventually find something. It often won't be anything serious – it could be a natural body change, or you could be misinterpreting signs of anxiety (such as increased heart rate and sweating) as signs of serious disease. However, the discovery tends to cause great anxiety and make you self-check even more.

You may find yourself needing more and more reassurance from doctors, friends and family. The comfort you get from this reassurance may be short-lived, or you may stop believing it, which only means you need more and more of it to feel better. Seeking reassurance just keeps the symptoms in your head, and usually makes you feel worse.

People with health anxiety can fall into one of two extremes:

  • constantly seeking information and reassurance – for example, obsessively researching illnesses from the internet and booking frequent GP appointments, or
  • avoidant behaviour – avoiding medical TV programmes, GP appointments and anything else that might trigger the anxiety, and avoiding activities such as exercise that are perceived to make the condition worse (when it fact many people find that exercise helps – for example, read about exercise for depression)

Neither of these behaviours are healthy, and need addressing if you are to break the cycle of health anxiety. 

How your GP can help

If you think you suffer from health anxiety, there is much to be gained from a good consultation with your GP.

Once your GP has established that you do suffer from health anxiety, and there is no underlying physical cause for any symptoms you might have, they should investigate whether you might have a problem such as depression or anxiety disorder that may be causing or worsening your symptoms. 

If this is the case, you may be referred for psychological therapy and you may benefit from antidepressants (see below).

If this is not the case, the aim should still be to help you become less worried about your health. You may find that your GP's advice and self-help resources (see below) are all you need to start feeling better, or you may still benefit from a referral for psychological therapy.

Psychological therapy

Cognitive behavioural therapy (CBT) is an effective treatment for many people with health anxiety. It involves working with a trained CBT therapist to identify the thoughts and emotions you experience and the things you do to cope.

On example of an unhealthy thought is jumping to conclusions like "If the doctor sent me for tests, she must be really worried".

The aim is to change unhealthy thoughts and behaviours that maintain health anxiety to those that break this cycle.

CBT looks at ways to challenge the way you interpret symptoms, to encourage a more balanced and realistic view. It should help you to:

  • learn what seems to make the symptoms worse
  • develop methods of coping with the symptoms
  • keep yourself more active, even if you still have symptoms

Find out more about cognitive behavioural therapy.

However, CBT is not the best treatment to try for everyone with health anxiety. Some people may benefit more from a different psychological therapy, such as trauma-focused therapy or a psychotherapy that will help a particular psychological condition. Accurate assessment is needed to select the right treatment for you and for your problem, so, if necessary, you may be referred to a mental health specialist for this next step. 

Medication

Antidepressant medication may be helpful if you have a psychological problem such as depression. For some people, these may work better than CBT. Your GP can directly prescribe antidepressants or refer you to a mental health specialist for treatment.  

However, treating symptoms with drugs is not always the answer. Long-term use of painkillers or sedatives, for example, may lead to dependence. The possible benefits of medication always need to be weighed against the potential side effects.

Helping yourself

There's lots you can do to help yourself. A good first step would be to read the NHS Health Anxiety leaflet, which can be downloaded from the Northumberland, Tyne and Wear NHS website. It provides advice and exercises you can try yourself, such as keeping a diary of your preoccupations and symptoms and counteracting them with realistic and rational thinking.

Page last reviewed: 22/01/2013

Next review due: 22/01/2015

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Comments

The 8 comments posted are personal views. Any information they give has not been checked and may not be accurate.

wales850 said on 09 June 2014

NatB93: sorry to hear how you feell but dont dispare you have exactlty the same sysmptoms as me. i have been on this journey for 6 months everyday i get stabbing pains in my chest, feelings like im going to die and leave my wife and child fatherless, but it is getting better.
Sysmptoms since starting CBT have eased, i have great days and bad days but if you add it all up its getting better, it will for you too,

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User492629 said on 18 February 2014

No wonder people today worry about their health We cannot open a newspaper without reading that something is bad for us and there are so many conflicting articles being printed about health so who are we supposed to believe. Reading your article it looks to me that doctors are trying to turn our health anxiety into a new illness for drug companies to make even more money. I think they try and push antidepressants onto us for any reason instead of understanding that feeling happy, sad, anxious, worried etc is all quite natural and part of being human. Many of these feelings are natural reactions to life itself. I think drugs like antidepressants are given out far too frequently and cause problems of their own. Given the right help and support people learn to deal with their emotions and become mentally and physically stronger. Harsh drugs are not the answer to everything !! We are only human

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dibbs09 said on 31 January 2014

Hi natb93. Im 22 and I have been suffering with my anxiety for a 1 1/2 now. It started when I graduated, moved house and started a new job. Woke up one morning and started having palpatations and felt like I was not in my own body . They prescribed me propanalol and for a while it was ok, but last two months have been quite bad . I am forever phoning doctor to book an appointment I must go there at least 2 times a week . I am always on my phone looking up different medical problems . Symptoms , for the last 5 days I have had headaches, dizeness, heart palpitation feeling im not in my body , loss of appetite . Do you have the same symptoms as me ?

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NatB93 said on 21 January 2014

I have been suffering from this condition for around 6/12 months but was only told last night by my doctor what i was suffering from. I make alot of doctors appointments for different illness's i have: Headaches, Dizziness, Stomach Pain, Palpitations - But although i have ever test done and they come back fine i still dont believe it. I believe i have a heart condition even though my ECG was fine. I have make alot of appointments to see different doctors for there opinions, but each said the same I AM OK, so why do i find this so hard to believe?? I am 20 years old and this is effecting my life, my work. Because of my fear of illness's i have never been to a different country as i have a fear of being ill and having to go to hospital. Also i will not get on a plane, incase i have a heart attack and the plane cant land quick enough, please tell me someone else has suffered or is suffering with this and what i can do?

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bevangirl said on 15 December 2013

My GP keeps treating me for a UTI with antibiotics but I'm beginning to think it may be brought on by stress. Whatever it is, I feel absolutely awful, shakey, hot, cold but no fever. Every time it happens I think it must be something worse.

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Herby said on 19 July 2013

This is an excellent article and one I can relate to fully and worth reading through in full. I really want to help myself and enjoy everyday of this life, this information is going to help get me 'back on track' Thank you.

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sowhat said on 04 June 2013

One of the GP partners in my practice accused me of being a hypochondriac simply because he couldn't work out what was wrong with me.

The more up to date Nurse Practitioner found I was Vitamin D deficient and have a genetic issue with my White Blood cells.

Both he could have worked out if he kept his knowledge up to date and was willing to spend the extra to do blood tests.

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karla bubbles said on 02 May 2013

They forgot a cause, I have a core belief that I am dying, I know its silly but you can't reason with a core belief, on top of that a huge mistrust of doctors after one diagnosed my father with anxiety instead of checking him for bowel cancer (which he actually had) and therefore delaying his treatment. It doesn't get any better when you get one doctor diagnosing you with a UTI and the other saying that all UTIs are in my imagination so I end up avoiding doctors because all I am told is that I am making it up to then get a rather nasty infection because it actually wasn't in my head after all. I would love to know how I am supposed to think rationally when I can't even trust doctors any more. I don't spend my entire life worrying, I don't sit around doing nothing, despite the assumption that many Gps make, I am not stressed but I am busy but as soon as I get a worrying symptom that is it, I can no longer function.

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Medically unexplained symptoms

Advice for anyone suffering from persistent complaints that don't appear to have an obvious cause