Introduction 

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.

Reading Well Books on Prescription

Reading Well Books on Prescription is an early intervention service to help people understand and manage their mental health. The agency provides a core book list of accredited titles recommended by healthcare professionals that covers a range of common mental health conditions such as anxiety, depression, phobias and eating disorders.

Media last reviewed: 01/04/2014

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

Page last reviewed: 22/01/2013

Next review due: 22/01/2015