Health-Related Anxiety: Symptoms, Disorders, & Treatment
Worried about feeling sick as a dog? You might be experiencing health anxiety, an umbrella term which is associated with several different underlying conditions.
Think about the most significant health scare you have ever experienced. Then multiply this experience by a factor of about 10. Unfortunately, this is a daily reality for many individuals suffering from health-related anxiety, a debilitating condition that can have devastating effects on one’s mood, relationships, and ability to function in academic and professional settings.
What is health anxiety?
Health-related anxiety is a general term that refers to intense fear or worry about one’s physical health. Fear about illness (or potential illness) might develop in situations in which an individual has a diagnosed medical illness. These health conditions might include:
- a diagnosed, progressive medical condition (e.g., worry about advancing symptoms of Alzheimer’s disease).
- a diagnosed medical condition that requires management and/or health behavior changes (e.g., anxiety following a diagnosis of diabetes or after experiencing a heart attack).
- a diagnosed chronic medical condition (e.g., worry about learning how to manage chronic pain).
- a diagnosed, single episode medical condition (e.g., fear about the reoccurrence of an injury).
If you have never experienced serious physical illness, the impact of an unexpected health scare may be difficult to appreciate fully. Serious illness can highlight your own mortality and profoundly alter your worldview. A life that previously felt long and full of potential comes to feel fragile and tenuous. Confusion, hopelessness, and depression often follow.
However, health-related anxiety is not only associated with diagnosed medical conditions. Often, people worry about potentially getting sick or think they may have a disease that has not yet been diagnosed. They might have existing hereditary, lifestyle, or environmental risk factors for cancer or another serious illness; or despite not having major risk factors, they feel especially vulnerable to developing a serious illness. These might include situations in which the individual has:
- a constellation of unexplained physical symptoms (e.g., aches, pains, nausea, tingling sensations) that might represent a currently undiagnosed medical condition (e.g., worry that one might have cancer, AIDS/HIV, ALS, Parkinson’s Disease, etc. despite not having significant medical signs of the illness).
- fear of getting sick or experiencing “intolerable” physical symptoms of illness (e.g., intense fear that one would not be able to “handle” symptoms like nausea, vomiting, diarrhea, etc.) in the absence of current symptoms.
- residual fear about the possible reoccurrence of a disease or illness.
- fear about catastrophic outcomes that might occur if one were to contract an illness.
- fear of heightened vulnerability or susceptibility to disease or illness.
- health-related or somatic obsessions.
In such cases, it is not uncommon for the individual to take drastic steps to preserve their health and/or to obtain an accurate diagnosis. In these cases, individuals may consult with many different doctors (including multiple specialists), undergo many different diagnostic procedures, take many vitamins or supplements, spend significant time researching possible explanations for symptoms, avoid contact with sick people, engage in frequent use of hand sanitizers, engage in frequent hand-washing behaviors, and practice other pro-health behaviors. Although these behaviors are adopted to reduce disease susceptibility and health-related anxiety, they can have the unfortunate effect of paradoxically reinforcing and strengthening the underlying fear.
How is health anxiety diagnosed?
Health anxiety, per se, is not a formal diagnosis. In fact, symptoms of health anxiety may be due to one of many different etiologies. In some cases, worry about getting sick reflects part of the natural process of recovering from a serious illness. It is scary at first, but this fear diminishes with time and experience.
In other cases, health-related anxiety might reflect an underlying anxiety disorder or somatoform disorder. Common diagnoses associated with health anxiety include OCD, panic disorder, agoraphobia, anxiety disorder NOS, adjustment disorder, somatization disorder, and hypochondriasis (among others).
How is health anxiety treated?
Treatment of health-related anxiety depends on the specific underlying condition (if any). As such, the first step is obtaining an accurate (mental-health related) diagnosis from your doctor, psychologist, or psychiatrist. This diagnosis then guides treatment selection, which should involve using the best available research evidence to select an appropriate evidence-based treatment protocol. In many cases, cognitive-behavioral therapy (CBT) will be indicated, but CBT approaches are often modified on the basis of the specific diagnosis being treated.
Thoughts? Questions? Experiences with health-related anxiety? Please share below…
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Dr. Steven Seay is a licensed psychologist in Florida & Missouri. He is the Director of the Center for Psychological & Behavioral Science and provides treatment & therapy throughout South Florida, including Palm Beach Gardens, Jupiter, West Palm Beach, Boca Raton, Boynton Beach, Fort Lauderdale, & Miami.
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What an excellent article. I think you have hit the nail on the head in recognizing the fears, symptoms and avoidances. Clearly, treatment follows suit.
Thanks for reading, GG. Treatment is a process that requires much hard work, but persistence pays off.
I am suffering from health related anxiety along with OCD. It started off three months ago because of some bad diagnosis which is causing me to fear of suffering benign things like flu etc. What are the treatment approaches for this ?. Thanks
Cognitive behavioral therapy (CBT) is the most evidence-based treatment for health anxiety. If your health anxiety is more OCD-like, you should also investigate exposure and response prevention (ERP), which is a particular type of CBT that was developed to address symptoms of OCD.
Thanks for the reply doc….I think my health anxiety has increased my mild OCD symptoms to more pronounced.
Hang in there. Label the false alarms as false alarms and keep working on it.
Hi there Steven! Stumbled upon your blog tonight, and wow these are some of the best articles on OCD I’ve read. Thank you for writing such great stuff.
One of my main OCD obsessions is that I may be schizophrenic…I often obsess that I’ll start hearing voices or seeing things and worry about it a lot…would this fall under the health anxiety category?
Thank you 🙂
Hi Monika,
The fear of developing schizophrenia is incredibly common for people with OCD–I encounter that worry often. I wouldn’t necessarily consider it health anxiety, but rather OCD involving a specific feared outcome. Of course, it would be important to differentiate the fear of hearing/seeing things vs. actually experiencing sensory disturbances.
Hi, my name is Cheri and I have experiences health anxiety from a very young age. I am very hyper sensitive to body sensations and strong feelings in my body such as pains, bumps, bruises etc. but, I also will avoid a doctor until absolutely necessary. I am looking for some one to help. Can you recommend anyone. I live in Michigan but, will do online or phone consultations.
I am just like you—I really need help
Please help me! I am desperate. My mind is always thinking negative thoughts with every pain, noise, sensation that I feel. I want to live a normal happy life and I struggle everyday. I tied hypnotism and that didn’t work. I cannot take ms bc of kidney issue—please help
Hypnosis is not an effective treatment for symptoms like these. Find a therapist who uses exposure and response prevention (ERP), a specific type of cognitive behavioral therapy (CBT).
Health related anxiety can be a very costly form of anxiety. I have seen people run to the doctor at even the slightest twinges thinking they have something very serious. They are then sent home from the doctor time and time again. I think addressing the underlying anxiety issues are the answer. Also, giving someone you know with the condition emotional support. Maybe just someone telling them they will be alright is all they need.
I agree with everything you’ve said except the last statement. Sometimes, external reassurance contributes to one’s ongoing symptoms. For some people, reassurance-seeking can make symptoms significantly worse.
I am not on SSI or anything but I have no income or money. I really wish people would donate their time to help people in such situations in South Florida. It is really frustrating…to want to be better but inability to have income. Its a vicious cycle and I hope someone or something changes
Have bad stomach issues to the point where i hardly eat anything and i’m down to 86 lbs. I have had tests that come back neg. except for hiiatal hernia. Everything i eat makes me feel sick. i do believe it is stress and my neg. way of thinking. I have gone to ther. but can’t seem to find person. Is there a diy therapy that would work?
Thank you for this article. I have had a series of life threatening injuries and medical conditions since 1997. It seems that once I survive a “non survivable” event and get back on my feet, another one comes along. I noticed that I seem terrified that any new symptoms might be the fore bearer of another life threatening disease. This article helps me understand.
Infection from bilateral TMJ cadaver implant; HA MRSA; Csncer; ILD (Fibtosis)
It sounds like “what if” thoughts have been reinforced a lot in your life. Given that, it’s understandable that new worries would emerge with greater credibility.
I believe I have health related anxiety. In 2013 at the age of 26 I was an RN in a busy hospital and I contracted a hospital acquired infection called Cdiff. It is a bacteria that can naturally live in the gut and makes a person ill when the bad bacteria overtakes the good bacteria in the gut( most commonly after taking broad spectrum antibiotics.) You can also contract this infection if you are in close contact with the feces of an infected person and do not properly wash your hands. It causes diarrhea and vomiting and it is contagious. The infection can only be killed with bleach and soap and water.
I got physically better but mentally I changed overnight. It was like a switch was flipped. I was terrified of a reoccurrence of cdiff and terrified of germs. Excessive hand washing, using gloves for a BM, cleaning the toilet with bleach after I use it, wiping down surfaces in my homes with bleach wipes. Cdiff spores can live up to 2 years on a hard surface. Now that I’ve had Cdiff there is no cure. You can treated for active symptoms and test negative but some doctors believe the cdiff still resides in your gut and will make you sick again if you are exposed to it or take an antibiotic. Knowing these facts made my anxiety almost unbearable, I quit my job, it affected my marital life as well as my social life. I tried to forget and just live my life but living with these scary thoughts was very hard on me and also my husband.
Fast forward to 2017 and I’m doing well enough, but I need to take an antibiotic for a complicated UTI and I was pregnant with my 3rd child. Antibiotics pose a risk for cdiff reoccurrence and I was terrified again. My GI doctor assured me the cdiff was a fluke the first time and that I would not get it again. I was young, healthy and active and it was a very slim almost minimal chance.
However 2 weeks after the antibiotic I had the symtoms of cdiff began and I tested positive again. This was earth shattering for me bc it had been my biggest fear for 5 years and it was happening again. Now I was a mother of two kids, pregnant with a 3rd ,physically ill from cdiff and my anxiety at all time high. I recovered with medication. But 7 months later in 2018 I needed another antibiotic while in the hospital delivering my 3rd baby and I contracted cdiff for the 3rd time. I received medication and gave miw bern recovered for 4 months.
But I feel like my mental health is in shambles. I’m scared each time I take a BM, I need to be in my own house so I can shower immediately after. Any kind of irregularities can send me into full blown panic.
I think the most distressing is I started a ritual where I showered after each BM. It only takes 10 minutes but it has greatly reduced my quality of life. I only eat breakfast and dinner. I skip lunch so I won’t have a BM while I am out and about. I wake up very early each morning so I can have a BM and shower. It’s the only way I feel clean and I feel like I’m protecting my kids bc I’m washing away any germs that could potentially hurt them. That’s one of the scary things about cdiff is that if a person does not wash hands well enough after a BM then the infection can be contagious. Another scary aspect is that doctors are not sure how long the cdiff can be present in your stool after you have recovered from a active infection.
I don’t want to live this way anymore but I’m scared to let go of these cleaning rituals (which many are hospital protocol for for a person with cdiff, they are not just random rituals I made up ).
What kind of therapy is even available for a disease carrier who now has what I believe is contamination OCD?? It is ironic bc most patients with this type of OCD have irrational fears about germs but my fears are based on something which actually happen to me and could still pose a threat to my health and the physical health of others.
I’m so lost and I don’t even know what kind of help to seek. I tried therapy but neither counselor was familiar with cdiff and did not seem to realize that all my anxiety stemmed from this. I was not previously an anxious person.
Please help! I seem so normal to other people but I know I’m not. I’used to be young, attractive wife and mom with a normal social life but I feel like this anxiety touches every aspect of my life.
I feel so bad for my kids and husbands bc of how their lives are altered. I’m very anxious in public bathrooms and doctors offices , I now think pets are dirty, I no longer allow shoes inside, , I’m overly anxious about getting sick and sanitize often, I make everyone wash hands when we get home , and I avoid friends if I know they’ve been sick.
I know I can’t keep living like this but I’m too scared to try CBT. What if I have to touch a toilet or use the bathroom without washing my hands?! The thought is really distressing for me as my GI doctor would actually tell me not to do these things bc of my cdiff history.